1
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Escrig JI, Miyamoto Y, Aznar AD, Eckmann L, Debnath A. Antigiardial and antiamebic activities of fexinidazole and its metabolites: new drug leads for giardiasis and amebiasis. Antimicrob Agents Chemother 2024; 68:e0073123. [PMID: 38063401 PMCID: PMC10777846 DOI: 10.1128/aac.00731-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/04/2023] [Indexed: 01/11/2024] Open
Abstract
The intestinal parasites Giardia lamblia and Entamoeba histolytica are major causes of morbidity and mortality associated with diarrheal diseases. Metronidazole is the most common drug used to treat giardiasis and amebiasis. Despite its efficacy, treatment failures in giardiasis occur in up to 5%-40% of cases. Potential resistance of E. histolytica to metronidazole is an increasing concern. Therefore, it is critical to search for more effective drugs to treat giardiasis and amebiasis. We identified antigiardial and antiamebic activities of the rediscovered nitroimidazole compound, fexinidazole, and its sulfone and sulfoxide metabolites. Fexinidazole is equally active against E. histolytica and G. lamblia trophozoites, and both metabolites were 3- to 18-fold more active than the parent drug. Fexinidazole and its metabolites were also active against a metronidazole-resistant strain of G. lamblia. G. lamblia and E. histolytica cell extracts exhibited decreased residual nitroreductase activity when metabolites were used as substrates, indicating nitroreductase may be central to the mechanism of action of fexinidazole. In a cell invasion model, fexinidazole and its metabolites significantly reduced the invasiveness of E. histolytica trophozoites through basement membrane matrix. A q.d. oral dose of fexinidazole and its metabolites at 10 mg/kg for 3 days reduced G. lamblia infection significantly in mice compared to control. The newly discovered antigiardial and antiamebic activities of fexinidazole, combined with its FDA-approval and inclusion in the WHO Model List of Essential Medicines for the treatment of human African trypanosomiasis, offer decreased risk and a shortened development timeline toward clinical use of fexinidazole for treatment of giardiasis or amebiasis.
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Affiliation(s)
- Jose Ignacio Escrig
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California, USA
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Alejandro Delgado Aznar
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California, USA
| | - Lars Eckmann
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Anjan Debnath
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California, USA
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2
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So M, Miyamoto Y, Iwagami M, Ishimaru M, Takahashi M, Egorova N, Kuno T. Response to: Hemoglobin drop associated with the risk of hospital mortality and acute kidney injury among COVID-19 inpatients. QJM 2023; 116:964-965. [PMID: 37335856 DOI: 10.1093/qjmed/hcad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Indexed: 06/21/2023] Open
Affiliation(s)
- M So
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, 10003, USA
| | - Y Miyamoto
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, 113-8655, Japan
| | - M Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, 305-8575, Japan
| | - M Ishimaru
- Department of Health Services Research, University of Tsukuba, Tsukuba, 305-8575, Japan
| | - M Takahashi
- Laboratory of Systems Cancer Biology, The Rockefeller University, New York, NY, 10065, USA
| | - N Egorova
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, 10029-6504, USA
| | - T Kuno
- Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, 10467-2401, USA
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3
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Yagi K, Okazaki S, Ohbatake A, Nakaya M, Liu J, Arite E, Miyamoto Y, Ito N, Nakano K, Yamaaki N, Honoki H, Fujisaka S, Chujo D, Tsunoda SI, Yanagimoto K, Nozue T, Yamada M, Ooe K, Araki T, Nakashima A, Azami Y, Sodemoto Y, Tadokoro K, Nagano M, Noguchi T, Nohara A, Origasa H, Niida Y, Tada H. Negative correlation between organ heteroplasmy, particularly hepatic heteroplasmy, and age at death revealed by post-mortem studies of m.3243A > G cases. Mol Genet Metab 2023; 140:107691. [PMID: 37660570 DOI: 10.1016/j.ymgme.2023.107691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/27/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
Mitochondrial DNA m.3243A > G mutation causes mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and its associated multi-organ disorders, including diabetes. To clarify associations between m.3243A > G organ heteroplasmy and clinical phenotypes, including the age at death, we combined genetic and pathological examinations from seven unreported and 36 literature cases of autopsied subjects. Clinical characteristics of subjects were as follows: male, 13; female, 28; unknown, 2; the age at death, 36.9 ± 20.2 [4-82] years; BMI, 16.0 ± 2.9 [13.0-22.3]; diabetes, N = 21 (49%), diabetes onset age 38.6 ± 14.2 years; deafness, N = 27 (63%); stroke-like episodes (StLEp), N = 25 (58%); congestive heart failure (CHF), N = 15 (35%); CHF onset age, 51.3 ± 14.5 years. Causes of death (N = 32) were as follows: cardiac, N = 13 (41%); infection, N = 8 (25%); StLEp, N = 4 (13%); gastrointestinal, N = 4 (13%); renal, N = 2 (6%); hepatic, N = 1 (2%). High and low heteroplasmies were confirmed in non-regenerative and regenerative organs, respectively. Heteroplasmy of the liver, spleen, leukocytes, and kidney for all subjects was significantly associated with the age at death. Furthermore, the age at death was related to juvenile-onset (any m.3243A > G-related symptoms appeared before 20) and stroke-like episodes. Multiple linear regression analysis with the age at death as an objective variable showed the significant contribution of liver heteroplasty and juvenile-onset to the age at death. m.3243A > G organ heteroplasmy levels, particularly hepatic heteroplasmy, are significantly associated with the age at death in deceased cases.
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Affiliation(s)
- Kunimasa Yagi
- Center for Clinical Genomics, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan; Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan; First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan.
| | - Satoko Okazaki
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Azusa Ohbatake
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Masako Nakaya
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Jianhui Liu
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan; First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Eiko Arite
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Yukiko Miyamoto
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Naoko Ito
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Kaoru Nakano
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Naoto Yamaaki
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Hisae Honoki
- First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Shiho Fujisaka
- First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Daisuke Chujo
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan; First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Shin-Ichiro Tsunoda
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Kunio Yanagimoto
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Tsuyoshi Nozue
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Masayo Yamada
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Kotaro Ooe
- Department of Internal Medicine, Saiseikai Kanazawa Hospital, Kanazawa 920-0353, Japan
| | - Tsutomu Araki
- Department of Internal Medicine, Saiseikai Kanazawa Hospital, Kanazawa 920-0353, Japan
| | - Akikatsu Nakashima
- Department of Internal Medicine, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Japan
| | | | | | - Kenichi Tadokoro
- Bio Medical Laboratory (BML), Inc., 1361-1 Matoba, Kawagoe, Saitama 350-1101, Japan
| | - Makoto Nagano
- Bio Medical Laboratory (BML), Inc., 1361-1 Matoba, Kawagoe, Saitama 350-1101, Japan
| | - Tohru Noguchi
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Atushi Nohara
- Department of Internal Medicine, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Japan
| | - Hideki Origasa
- The Institute of Statistical Mathematics, Toyama University, Toyama 934-0194, Japan
| | - Yo Niida
- Center for Clinical Genomics, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan
| | - Hayato Tada
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
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Silhan J, Fajtova P, Bartosova J, Hurysz BM, Almaliti J, Miyamoto Y, Eckmann L, Gerwick WH, O’Donoghue AJ, Boura E. Structural elucidation of recombinant Trichomonas vaginalis 20S proteasome bound to covalent inhibitors. bioRxiv 2023:2023.08.17.553660. [PMID: 37645851 PMCID: PMC10462138 DOI: 10.1101/2023.08.17.553660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Proteasomes are essential for protein homeostasis in mammalian cells1-4 and in protozoan parasites such as Trichomonas vaginalis (Tv).5 Tv and other protozoan 20S proteasomes have been validated as druggable targets.6-8 However, in the case of Tv 20S proteasome (Tv20S), biochemical and structural studies were impeded by low yields and purity of the native proteasome. We successfully made recombinant Tv20S by expressing all seven α and seven β subunits together with the Ump-1 chaperone in insect cells. We isolated recombinant proteasome and showed that it was biochemically indistinguishable from the native enzyme. We confirmed that the recombinant Tv20S is inhibited by the natural product marizomib (MZB)9 and the recently developed peptide inhibitor carmaphycin-17 (CP-17)8,10. Specifically, MZB binds to the β1, β2 and β5 subunits, while CP-17 binds the β2 and β5 subunits. Next, we obtained cryo-EM structures of Tv20S in complex with these covalent inhibitors at 2.8Å resolution. The structures revealed the overall fold of the Tv20S and the binding mode of MZB and CP-17. Our work explains the low specificity of MZB and higher specificity of CP-17 towards Tv20S as compared to human proteasome and provides the platform for the development of Tv20S inhibitors for treatment of trichomoniasis.
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Affiliation(s)
- Jan Silhan
- Institute of Organic Chemistry and Biochemistry AS CR, v.v.i., Flemingovo nam. 2., 166 10 Prague 6, Czech Republic
| | - Pavla Fajtova
- Institute of Organic Chemistry and Biochemistry AS CR, v.v.i., Flemingovo nam. 2., 166 10 Prague 6, Czech Republic
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, 92037, USA
| | - Jitka Bartosova
- Institute of Organic Chemistry and Biochemistry AS CR, v.v.i., Flemingovo nam. 2., 166 10 Prague 6, Czech Republic
| | - Brianna M. Hurysz
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, 92037, USA
| | - Jehad Almaliti
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, 92037, USA
| | - Yukiko Miyamoto
- Division of Gastroenterology, School of Medicine, University of California San Diego, La Jolla, CA, 92037, USA
| | - Lars Eckmann
- Division of Gastroenterology, School of Medicine, University of California San Diego, La Jolla, CA, 92037, USA
| | - William H. Gerwick
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, 92037, USA
| | - Anthony J. O’Donoghue
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, 92037, USA
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Evzen Boura
- Institute of Organic Chemistry and Biochemistry AS CR, v.v.i., Flemingovo nam. 2., 166 10 Prague 6, Czech Republic
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5
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Fajtova P, Hurysz BM, Miyamoto Y, Serafim M, Jiang Z, Trujillo DF, Liu L, Somani U, Almaliti J, Myers SA, Caffrey CR, Gerwick WH, Kirk CJ, Boura E, Eckmann L, O'Donoghue AJ. Development of subunit selective substrates for Trichomonas vaginalis proteasome. bioRxiv 2023:2023.04.05.535794. [PMID: 37066163 PMCID: PMC10104049 DOI: 10.1101/2023.04.05.535794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
The protozoan parasite, Trichomonas vaginalis (Tv) causes trichomoniasis, the most common, non-viral, sexually transmitted infection in the world. Only two closely related drugs are approved for its treatment. The accelerating emergence of resistance to these drugs and lack of alternative treatment options poses an increasing threat to public health. There is an urgent need for novel effective anti-parasitic compounds. The proteasome is a critical enzyme for T. vaginalis survival and was validated as a drug target to treat trichomoniasis. However, to develop potent inhibitors of the T. vaginalis proteasome, it is essential that we understand which subunits should be targeted. Previously, we identified two fluorogenic substrates that were cleaved by T. vaginalis proteasome, however after isolating the enzyme complex and performing an in-depth substrate specificity study, we have now designed three fluorogenic reporter substrates that are each specific for one catalytic subunit. We screened a library of peptide epoxyketone inhibitors against the live parasite and evaluated which subunits are targeted by the top hits. Together we show that targeting of the β5 subunit of T. vaginalis is sufficient to kill the parasite, however, targeting of β5 plus either β1 or β2 results in improved potency.
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6
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Tezuka Y, Akao M, Suzuki S, Yamashita T, Kodani E, Tsuda T, Hayashi K, Furusho H, Sawano M, Fukuda K, Nakai M, Sasahara Y, Miyamoto Y, Tomita H, Okumura K. Usefulness of echocardiographic parameters in predicting the incidence of ischemic stroke in Japanese patients with non-valvular atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a risk factor for ischemic stroke (IS). We developed a novel risk score of IS (HELT-E2S2 score) in non-valvular atrial fibrillation (NVAF) patients from the combined database of 5 major AF registries in Japan. However, this score does not include echocardiographic (Echo) parameters that have been reported to be risk factors of IS, such as left atrial diameter (LAD) enlargement or increased relative wall thickness (RWT) of left ventricle (LV).
Purpose
To investigate the predictive value of Echo parameters in Japanese patients with NVAF.
Methods
After excluding patients without the Echo data, 6,032 NVAF patients were analyzed in the present study. LAD was measured in the parasternal long axis view at the end-ventricular systole. RWT was calculated as (2x posterior wall thickness)/ LV end-diastolic dimension. We compared clinical characteristics and the incidence of IS between NVAF patients divided by LAD level (High/Low LAD group) and RWT level (High/Low RWT group). To balance the follow-up period among the registries, event data from individuals whose follow-up period exceeded 730 days were excluded from the analysis.
Results
The optimal cut-off value of LAD and RWT to predict the incidence of IS with the receiver operating characteristic analysis was 43.3 mm and 0.4167, respectively. Between the High/Low LAD groups (High LAD: n=2,640 vs. Low LAD: n=3,392), age (70.3±12.1 vs. 68.3±12.5 years; p<0.001), CHA2DS2-VASc score (3.02±1.84 vs. 2.57±1.78; p<0.001), HELT-E2S2 score (2.20±1.31 vs. 1.55±1.33; p<0.001), the prescription of oral anticoagulants (OACs) (69.5 vs. 51.5%; p<0.001), LV ejection fraction (60.4±13.4 vs. 64.4±10.7%; p<0.001) and RWT (0.401±0.091 vs. 0.396±0.082; p=0.02) were significantly different. Between the High/Low RWT groups (High RWT: n=2,293 vs. Low RWT: n=3,739), percentage of female (35.6 vs. 27.8%; p<0.001), age (71.2±12.1 vs. 68.0±12.4 years; p<0.001), CHA2DS2-VASc score (3.08±1.82 vs. 2.58±1.79; p<0.001), HELT-E2S2 score (2.10±1.39 vs. 1.67±1.31; p<0.001), the prescription of OACs (62.6 vs. 57.4%; p<0.001), LV ejection fraction (65.5±9.9 vs. 60.9±13.0%; p<0.001) and LAD (43.0±8.1 vs. 42.4±8.3; p=0.004) were significantly different. In Kaplan-Meier analysis, the incidence of IS was different between the groups during the median follow-up period of 730 days (High LAD vs. Low LAD; 1.82 vs. 1.00 per 100 person-years; p<0.001, by log-rank test, High RWT vs. Low RWT; 1.86 vs. 1.06; p<0.001) (Figure). Both High LAD (hazard ratio: 1.65, 95% CI: 1.12–2.46; p=0.01) and High RWT (hazard ratio: 1.43, 95% CI: 1.01–2.04; p=0.045) were independent predictors of the incidence of IS after adjustment by the components of the HELT-E2S2 score and other clinically relevant variables including co-existing diseases, gender, and the prescription of OACs (Table).
Conclusion
Echo parameters, LAD and RWT, were independently associated with the incidence of IS among Japanese patients with NVAF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development
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Affiliation(s)
- Y Tezuka
- Mitsubishi Kyoto Hospital , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, Department of Cardiology , Kyoto , Japan
| | - S Suzuki
- Cardiovascular Institute, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Yamashita
- Cardiovascular Institute, Department of Cardiovascular Medicine , Tokyo , Japan
| | - E Kodani
- Nippon Medical School Hospital, Department of Internal Medicine and Cardiology , Tokyo , Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - K Hayashi
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - H Furusho
- Kanazawa University, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - M Sawano
- Keio University School of Medicine, Department of Cardiovascular Medicine , Tokyo , Japan
| | - K Fukuda
- Keio University School of Medicine, Department of Cardiovascular Medicine , Tokyo , Japan
| | - M Nakai
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - Y Sasahara
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - H Tomita
- Hirosaki University Graduate School of Medicine, Department of Cardiology , Hirosaki , Japan
| | - K Okumura
- Hirosaki University Graduate School of Medicine, Department of Cardiology , Hirosaki , Japan
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Otsuka Y, Ishii M, Nakamura T, Tsujita K, Fujita H, Matoba T, Kohro T, Kabutoya T, Kario K, Kiyosue A, Mizuno Y, Nakayama M, Miyamoto Y, Sato H, Nagai R. Impact of BNP level in patients with heart failure on major bleeding events after percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
The Academic Research Consortium for High Bleeding Risk (ARC-HBR) presents a bleeding risk assessment in antithrombotic therapy for patients post percutaneous coronary intervention (PCI). In Japanese patients, heart failure (HF), peripheral vascular disease, and frailty are established as bleeding risk factors in addition to ARC-HBR. However, it is unknown whether left ventricular function or severity of HF is associated with HBR. The aim of this study was to investigate the association between the severity of HF measured by BNP and future bleeding events after PCI.
Methods
Clinical Deep Data Accumulation System (CLIDAS), a multicenter database with 7 tertiary medical hospitals in JAPAN, was developed to collect data directly for patient characteristics, medications, laboratory test, physiological test, cardiac catheterization and PCI treatment in electronic medical records using Standardized Structured Medical Information eXchange Extended Storage (SS-MIX). This retrospective analysis using CLIDAS database included 7160 patients who underwent PCI during April 2014 and March 2020 in the participating hospitals and also who have completed 3-year follow-up were divided into two groups: No HF (n=6645) and HF (n=515). HF patients were furthermore divided based on high BNP (≥100 pg/ml) group (n=384) and low BNP (<100 pg/ml) group (n=131). Primary outcome was defined as bleeding events according to the moderate and severe bleeding in the GUSTO classification. In addition, secondary endpoint was major adverse cardiovascular events (MACE) defined as a composite of cardiac death, myocardial infraction and stroke.
Results
Multivariable Cox regression adjusted for age, sex, BMI, acute coronary syndrome, hypertension, diabetes, dyslipidemia, chronic kidney disease, hemodialysis, previous PCI, previous coronary artery bypass grafting, prior myocardial infraction, prior stroke, prior atrial fibrillation, prior PVD, left main trunk disease, multivessel disease, and anticoagulants use showed that HF with high BNP was significantly associated with bleeding events (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.10–2.50), MACE (HR, 2.16; 95% CI, 1.60–2.90), and all-cause death (HR, 1.74; 95% CI, 1.30–2.33), but not HF with low BNP.
Conclusions
The CLIDAS real-world database revealed that HF with high BNP was associated with future bleeding events, suggesting that bleeding risk might be altered depending on severity of HF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Otsuka
- Kumamoto University Hospital , Kumamoto , Japan
| | - M Ishii
- Kumamoto University Hospital , Kumamoto , Japan
| | - T Nakamura
- Kumamoto University Hospital , Kumamoto , Japan
| | - K Tsujita
- Kumamoto University Hospital , Kumamoto , Japan
| | - H Fujita
- Jichi Medical University , Tochigi , Japan
| | - T Matoba
- Kyushu University , Fukuoka , Japan
| | - T Kohro
- Jichi Medical University , Tochigi , Japan
| | - T Kabutoya
- Jichi Medical University , Tochigi , Japan
| | - K Kario
- Jichi Medical University , Tochigi , Japan
| | | | - Y Mizuno
- University of Tokyo , Tokyo , Japan
| | | | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital , Osaka , Japan
| | - H Sato
- Precision K.K. , Tokyo , Japan
| | - R Nagai
- Jichi Medical University , Tochigi , Japan
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8
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Kawagoe Y, Otuka F, Onozuka D, Ueda H, Ikeda Y, Ogo K, Matsumoto M, Amemiya K, Asaumim Y, Kataoka Y, Nishimura K, Miyamoto Y, Noguchi T, Hatakeyama K, Yasuda S. Early vascular responses to abluminal biodegradable polymer-coated versus circumferential durable polymer-coated newer-generation drug-eluting stents in humans: a pathologic study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent clinical trials are testing strategies for short (1–3 months) dual antiplatelet therapy (DAPT) following newer-generation drug-eluting stent (DES) placement. However, the safety of short DAPT regimens is not supported by biological evidence in humans.
Purpose
We sought to evaluate early pathologic responses to newer-generation DES by comparing abluminal biodegradable polymer-coated DES (BP-DES) with circumferential durable polymer-coated DES (DP-DES) in human autopsy cases.
Methods
The study included a total of 37 coronary lesions with thin strut newer-generation DES (DP-DES=23 [XIENCE=18, Resolute Integrity=5] and BP-DES=14 [SYNERGY=9, Ultimaster=5]) with duration of implantation <90 days in 25 autopsy cases. The process of stent healing was precisely evaluated for every single strut in association with underlying tissue characteristics. The degree of strut coverage was defined as follows: grade 0 (bare struts), grade 1 (struts covered with thrombus, fibrin, or other tissues or cells without endothelium), grade 2 (struts covered with single-layered endothelium without underlying smooth muscle cell layers), and grade 3 (struts covered with endothelium and underlying smooth muscle cell layers) (Figure 1).
Results
Duration of implantation was similar in lesions with DP-DES and those with BP-DES (median=20 vs. 17 days). A total of 1986 struts (DP-DES=1261, BP-DES=725) were pathologically analyzed. Focal grade 2 coverage was observed as early as 5 days after the implantation in both stents. Multilevel mixed-effects ordered logistic regression model demonstrated that BP-DES exhibited greater strut coverage compared with DP-DES (odds ratio; 3.50, 95% CI; 1.31–9.41, P=0.013), which remained significant after adjustment for duration of implantation and underlying tissue characteristics (odds ratio; 2.64, 95% CI; 1.04–6.68, P=0.040). The time course of vessel healing assessed as predictive probability of strut coverage (grade 0–3) stratified by duration of implantation is shown in Figure 2. Predictive probability of grade 2 and 3 coverage was comparably limited at 30 days (DP-DES=17.7% vs. BP-DES=29.0%) and increased at 90 days (DP-DES=76.1% vs. BP-DES=85.9%). Both stents showed few inflammation and similar degree of fibrin deposition.
Conclusions
The current first pathologic study on early biological responses to newer-generation DES in humans demonstrated that single-layered endothelial coverage begins in days following the stent placement, and abluminal BP-DES potentially exhibit faster strut coverage with smooth muscle cell infiltration than circumferential DP-DES. Nevertheless, vessel healing remains suboptimal at 30 days in both DP- and BP-DES, which progresses with time to become substantial at 90 days. Our results suggest that very short duration of DAPT for 1 month should be applied with caution, taking into account the trade-off between bleeding and thrombotic risks.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science
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Affiliation(s)
- Y Kawagoe
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine , Suita , Japan
| | - F Otuka
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine , Suita , Japan
| | - D Onozuka
- Kyoto Prefectural University of Medicine, Department of Medical Informatics and Clinical Epidemiology , Kyoto , Japan
| | - H Ueda
- National Cerebral & Cardiovascular Center, Department of Pathology , Suita , Japan
| | - Y Ikeda
- National Cerebral & Cardiovascular Center, Department of Pathology , Suita , Japan
| | - K Ogo
- National Cerebral & Cardiovascular Center, Department of Pathology , Suita , Japan
| | - M Matsumoto
- National Cerebral & Cardiovascular Center, Department of Pathology , Suita , Japan
| | - K Amemiya
- National Cerebral & Cardiovascular Center, Department of Pathology , Suita , Japan
| | - Y Asaumim
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine , Suita , Japan
| | - Y Kataoka
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine , Suita , Japan
| | - K Nishimura
- National Cerebral & Cardiovascular Center, Department of Preventive Medicine and Epidemiology , Suita , Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Open Innovation Center , Suita , Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine , Suita , Japan
| | - K Hatakeyama
- National Cerebral & Cardiovascular Center, Department of Pathology , Suita , Japan
| | - S Yasuda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine , Sendai , Japan
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9
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Akashi N, Fujita H, Matoba T, Kohro T, Kabutoya T, Imai Y, Kario K, Kiyosue A, Nakayama M, Miyamoto Y, Nakamura T, Tsujita K, Matoba Y, Sato H, Nagai R. Hyperuricemia predicts worse prognosis in patients with chronic coronary syndrome after percutaneous coronary intervention: insights from Japanese real-world database using a storage system. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The relationship between hyperuricemia (HUA) and cardiovascular disease was observed in some epidemiological studies. However, the association between HUA and chronic coronary syndrome (CCS) after percutaneous coronary intervention (PCI) is not fully elucidated.
Purpose
The purpose of this study was to investigate the prognostic impact of HUA in patients with CCS after PCI.
Methods
This study is a retrospective, multicenter, observational study. We developed the Clinical Deep Data Accumulation System (CLIDAS), which consists of 6 university hospitals and the national cardiovascular center in Japan, directly obtains clinical data including patients background, laboratory data, echocardiogram, electrocardiogram, cardiac catheterization report, prescription, and long-term outcome from electronic medical records. A total of 9936 consecutive patients after PCI were analyzed. Of them, 5138 patients with CCS after PCI during April 2013 and March 2019 were analyzed, and divided into HUA group (patients with HUA at baseline, n=1724) and non-HUA group (patients without HUA at baseline, n=3414). HUA was defined as a serum uric acid levels ≥7.0 mg/dL for men or ≥6.0 mg/dL for women and/or taking urate-lowering drugs. The primary outcome was the major cardiovascular events (MACE) defined as being the composite of cardiovascular death, myocardial infarction, and hospitalization for heart failure.
Results
The median follow-up duration was 910 days (interquartile range: 307–1479 days). The proportion of male (78% vs. 78%) and age (71±11 vs. 71±10) were similar between the HUA and the non-HUA groups. The prevalence of hypertension (87% vs. 82%), atrial fibrillation (9% vs. 5%), and history of previous hospitalization for heart failure (15% vs. 6%) and baseline creatinine value (1.8±2.3 vs. 1.5±2.0 mg/dL) were significantly higher in the HUA group. In contrast, the prevalence of diabetes (43% vs. 48%) was significantly lower in the HUA group. The incidence of MACE was significantly higher in the HUA group than in the non-HUA group (13.1% vs. 6.4%, log rank P<0.001). Multivariate Cox regression analyses revealed that hyperuricemia was significantly associated with MACE (hazard ratio 1.50, 95% confidence interval 1.22–1.84, P<0.001) after controlling for other cardiovascular risk factors.
Conclusion
The real-world database CLIDAS revealed that hyperuricemia was significantly associated with the increase of MACE in patients with CCS after PCI. This result sheds light on the significant role of urate in prediction of prognosis, suggesting the possibility of new therapeutic approaches using urate-lowering drugs or SGLT2 inhibitors for the CCS patients.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Jichi Medical University, Tochigi, Japan, and Kowa Co., Ltd
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Affiliation(s)
- N Akashi
- Jichi Medical University Saitama Medical Center , Saitama , Japan
| | - H Fujita
- Jichi Medical University Saitama Medical Center , Saitama , Japan
| | - T Matoba
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine , Fukuoka , Japan
| | - T Kohro
- Jichi Medical University, Clinical Informatics , Tochigi , Japan
| | - T Kabutoya
- Jichi Medical University, Cardiovascular Medicine , Tochigi , Japan
| | - Y Imai
- Jichi Medical University, Clinical Pharmacology , Tochigi , Japan
| | - K Kario
- Jichi Medical University, Cardiovascular Medicine , Tochigi , Japan
| | - A Kiyosue
- University of Tokyo Hospital, Cardiovascular Medicine , Tokyo , Japan
| | - M Nakayama
- Tohoku University Graduate School of Medicine, Medical Informatics , Sendai , Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Open Innovation Center , Osaka , Japan
| | - T Nakamura
- Kumamoto University Hospital, Medical Informatics , Kumamoto , Japan
| | - K Tsujita
- Kumamoto University Hospital, Cardiovascular Medicine , Kumamoto , Japan
| | | | - H Sato
- Precision , Tokyo , Japan
| | - R Nagai
- Jichi Medical University , Tochigi , Japan
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10
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Zhou J, Miyamoto Y, Ihara S, Kroll AV, Nieskens N, Tran VN, Hanson EM, Fang RH, Zhang L, Eckmann L. Codelivery of Antigens and Adjuvant in Polymeric Nanoparticles Coated With Native Parasite Membranes Induces Protective Mucosal Immunity Against Giardia lamblia. J Infect Dis 2022; 226:319-323. [PMID: 35262728 PMCID: PMC9400425 DOI: 10.1093/infdis/jiac074] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/07/2022] [Indexed: 11/12/2022] Open
Abstract
The protozoan pathogen Giardia lamblia is an important worldwide cause of diarrheal disease and malabsorption. Infection is managed with antimicrobials, although drug resistance and treatment failures are a clinical challenge. Prior infection provides significant protection, yet a human vaccine has not been realized. Individual antigens can elicit partial protection in experimental models, but protection is weaker than after prior infection. Here, we developed a multivalent nanovaccine by coating membranes derived from the parasite onto uniform and stable polymeric nanoparticles loaded with a mucosal adjuvant. Intranasal immunization with the nanovaccine induced adaptive immunity and effectively protected mice from G. lamblia infection.
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Affiliation(s)
- Jiarong Zhou
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Sozaburo Ihara
- Department of Medicine, University of California San Diego, La Jolla, California, USA.,Division of Gastroenterology, Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan
| | - Ashley V Kroll
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Noelle Nieskens
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Vivien N Tran
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Elaine M Hanson
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Ronnie H Fang
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Liangfang Zhang
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Lars Eckmann
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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11
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Russell BJ, Brown SD, Siguenza N, Mai I, Saran AR, Lingaraju A, Maissy ES, Dantas Machado AC, Pinto AFM, Sanchez C, Rossitto LA, Miyamoto Y, Richter RA, Ho SB, Eckmann L, Hasty J, Gonzalez DJ, Saghatelian A, Knight R, Zarrinpar A. Intestinal transgene delivery with native E. coli chassis allows persistent physiological changes. Cell 2022; 185:3263-3277.e15. [PMID: 35931082 PMCID: PMC9464905 DOI: 10.1016/j.cell.2022.06.050] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/15/2022] [Accepted: 06/25/2022] [Indexed: 12/26/2022]
Abstract
Live bacterial therapeutics (LBTs) could reverse diseases by engrafting in the gut and providing persistent beneficial functions in the host. However, attempts to functionally manipulate the gut microbiome of conventionally raised (CR) hosts have been unsuccessful because engineered microbial organisms (i.e., chassis) have difficulty in colonizing the hostile luminal environment. In this proof-of-concept study, we use native bacteria as chassis for transgene delivery to impact CR host physiology. Native Escherichia coli bacteria isolated from the stool cultures of CR mice were modified to express functional genes. The reintroduction of these strains induces perpetual engraftment in the intestine. In addition, engineered native E. coli can induce functional changes that affect physiology of and reverse pathology in CR hosts months after administration. Thus, using native bacteria as chassis to “knock in” specific functions allows mechanistic studies of specific microbial activities in the microbiome of CR hosts and enables LBT with curative intent. Native E. coli strains isolated from mouse stool are genetically engineered for long-term engraftment in the conventional mouse gut and enable long-term systemic effects on the host, such as improvements in insulin sensitivity in mouse models of type 2 diabetes.
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Affiliation(s)
- Baylee J Russell
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Steven D Brown
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Nicole Siguenza
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Irene Mai
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Anand R Saran
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Amulya Lingaraju
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Erica S Maissy
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Ana C Dantas Machado
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Antonio F M Pinto
- Clayton Foundation Laboratories for Peptide Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Concepcion Sanchez
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Leigh-Ana Rossitto
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Yukiko Miyamoto
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - R Alexander Richter
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Samuel B Ho
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA; VA Health Sciences San Diego, La Jolla, CA 92161, USA
| | - Lars Eckmann
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Jeff Hasty
- BioCircuits Institute, University of California, San Diego, La Jolla, CA 92093, USA; Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA
| | - David J Gonzalez
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA
| | - Alan Saghatelian
- Clayton Foundation Laboratories for Peptide Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Rob Knight
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA; Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Amir Zarrinpar
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA; VA Health Sciences San Diego, La Jolla, CA 92161, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA.
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12
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Kankanam Gamage S, Hashimoto S, Miyamoto Y, Nakano T, Yamanaka M, Koike A, Satoh M, Morimoto Y. P-218 Mitochondria transfer from adipose stem cell ameliorates the development potential of cryopreserved oocytes. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.211] [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: 11/13/2022] Open
Abstract
Abstract
Study question
Could autologous adipose stem cell (ASC) mitochondria supplementation restore the post-fertilization development potentialin vitrified-thawed oocytes?
Summary answer
Autologous ASC mitochondria supplementation could rejuvenate the quality of vitrified-thawed oocytes and enhance the embryo’s developmental capacity.
What is known already
Pre- and post-implantation developmental potential of embryos derived from vitrified oocytes are remarkedly lower than those of fresh oocytes. Despite its’ low efficacy, oocyte cryopreservation is becoming prevalent in assisted reproductive technologies to cater the growing demands due to patients' sociological and pathological conditions. Unfavorable effects to mitochondrial membrane potential, mitochondrial structure, ATP production, reactive oxygen species (ROS), meiotic spindle and microfilaments, and Ca2+ ion regulation are reported as detrimental damages in oocytes following the cryopreservation, that adversely affect the development potential. Furthermore, autologous stem cell mitochondria supplementation can rescue the aging-related oocyte mitochondrial damages.
Study design, size, duration
The mature oocytes, autologous ASC, and mitochondria were collected from young mice and analyzed at Osaka City University, Japan. In total, 600 young mouse mature oocytes were occupied in this prospective study.
Participants/materials, setting, methods
Young C57BL/6JJmsmouse (8weeks) mature oocytes that have been pre-vitrified were thawed before the start of the ICSI procedure.ASC specificity and ASC mitochondria function and ultrastructure were pre-analyzed. ASC mitochondria were isolated on the same day and supplemented with intracellular sperm injection (ICSI) and as the control, the mitochondrial buffer was injected. The survival rate, fertilization rate, blastulation, mitochondria function, ROS level in 2 cell embryos, and live birth rates were compared between the 2 groups.
Main results and the role of chance
The ASC mitochondriashowed higher membrane potential compared to the somatic cells and were spherical in shape with low cristae numbers. The survival rate and the fertilization ratewere comparable in both mitochondria supplemented and control groups. However, theASC mitochondria supplementation seemed to havesignificantly improvedthe blastocyst development capacity from 2cell embryos compared to the control group (P < 0.05;56.8% & 38.2%, respectively).And interestingly, a significantly higher ATP level was found in the mitochondria supplemented group’s 2 cell embryos thanin the control group (P < 0.05;905.6pmol & 561.1pmol respectively). And though it was not statistically significant, a higher potential ofgetting live birth was found in the mitochondria supplemented group thanthe control group after 2 cell embryo transfer.
Limitations, reasons for caution
We acknowledge that the absence of compared data with fresh oocytes’ ICSI, the detailed cellular mechanism behind theimprovement of embryo development, and transgenerational safety in offspring developed fromthe mitochondria supplementation werethe limitations of this study.
Wider implications of the findings
With these results, we propose that ASC mitochondria supplementation could rejuvenate the quality of cryopreserved oocytes and enhance the embryo developmental capacity, signifying another possible approach of mitochondrial transplantation therapy.
Trial registration number
not applicable
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Affiliation(s)
| | - S Hashimoto
- Osaka City University, Reproductive Science Institute , Osaka, Japan
| | - Y Miyamoto
- HORAC Grand Front Osaka Clinic , Embryology, Osaka, Japan
| | - T Nakano
- IVF Namba Clinic, Embryology , Osaka, Japan
| | - M Yamanaka
- IVF Namba Clinic, Research & Development , Osaka, Japan
| | - A Koike
- HORAC Grand Front Osaka Clinic , Embryology, Osaka, Japan
| | - M Satoh
- IVF Namba Clinic, Embryology , Osaka, Japan
| | - Y Morimoto
- HORAC Grand Front Osaka Clinic, Medical & Executive , Osaka, Japan
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13
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Sunakawa Y, Satake H, Usher J, Jaimes Y, Miyamoto Y, Nakamura M, Kataoka M, Shiozawa M, Takagane A, Terazawa T, Watanabe T, Ishiguro K, Tanaka C, Takeuchi M, Fujii M, Danenberg K, Danenberg P, Lenz HJ, Sekikawa T, Ichikawa W. Dynamic changes in RAS gene status in circulating tumour DNA: a phase II trial of first-line FOLFOXIRI plus bevacizumab for RAS-mutant metastatic colorectal cancer (JACCRO CC-11). ESMO Open 2022; 7:100512. [PMID: 35688061 PMCID: PMC9271512 DOI: 10.1016/j.esmoop.2022.100512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/22/2022] Open
Abstract
Background Few prospective studies have used liquid biopsy testing in RAS-mutant metastatic colorectal cancer (mCRC), and its clinical significance remains unknown. Therefore, this study aimed to carry out a biomarker analysis by liquid biopsy using updated data of the phase II trial of FOLFOXIRI plus bevacizumab as first-line chemotherapy for RAS-mutant mCRC. Materials and methods A total of 64 patients who received modified FOLFOXIRI regimen (irinotecan 150 mg/m2, oxaliplatin 85 mg/m2, levofolinate 200 mg/m2, and fluorouracil 2400 mg/m2) plus bevacizumab biweekly were enrolled. The primary endpoint was the objective response rate (ORR). Plasma samples were collected at pre-treatment, 8 weeks after treatment, and progression in participants included in the biomarker study. The levels of circulating tumour DNA (ctDNA) and specific KRAS and NRAS variants were evaluated using real-time PCR assays. Results There were 62 patients (median age: 62.5 years, 92% performance status 0, 27% right side) who were assessable for efficacy and 51 for biomarker analysis. ORR was 75.8% (95% confidence interval 65.1% to 86.5%). The median progression-free survival was 12.1 months, and the median overall survival (OS) was 30.2 months. In 78% of patients, RAS mutations disappeared in the ctDNA at 8 weeks after treatment; these patients tended to have better outcomes than those with RAS mutations. Interestingly, RAS mutations remained undetectable during progression in 62% of patients. Survival analysis indicated that the median OS from progression was significantly longer in patients with RAS mutation clearance than in those with RAS mutation in the ctDNA at disease progression (15.1 versus 7.3 months, hazard ratio: 0.21, P = 0.0046). Conclusions Our biomarker study demonstrated no RAS mutations in ctDNA at disease progression in 62% of patients with RAS-mutant mCRC. Both OS and post-progression survival were better in patients with clearance of RAS mutations in ctDNA after triplet-based chemotherapy. First-line FOLFOXIRI plus bevacizumab is effective for RAS-mutant mCRC with comparable efficacy in elderly patients. RAS mutations disappeared in ctDNA after intensive chemotherapy in 62% of patients with mCRC with RAS-mutant tumours. Survival time was longer in patients with RAS mutation clearance than in those with RAS mutations in ctDNA.
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14
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Ihara S, Miyamoto Y, Le CHY, Tran VN, Hanson EM, Fischer M, Hanevik K, Eckmann L. Conserved metabolic enzymes as vaccine antigens for giardiasis. PLoS Negl Trop Dis 2022; 16:e0010323. [PMID: 35468132 PMCID: PMC9037923 DOI: 10.1371/journal.pntd.0010323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 03/12/2022] [Indexed: 11/20/2022] Open
Abstract
Giardia lamblia is a leading protozoal cause of diarrheal disease worldwide. Infection is associated with abdominal pain, malabsorption and weight loss, and protracted post-infectious syndromes. A human vaccine is not available against G. lamblia. Prior studies with human and murine immune sera have identified several parasite antigens, including surface proteins and metabolic enzymes with intracellular functions. While surface proteins have demonstrated vaccine potential, they can exhibit significant variation between G. lamblia strains. By comparison, metabolic enzymes show greater conservation but their vaccine potential has not been established. To determine whether such proteins can serve as vaccine candidates, we focused on two enzymes, α-enolase (ENO) and ornithine carbamoyl transferase (OCT), which are involved in glycolysis and arginine metabolism, respectively. We show in a cohort of patients with confirmed giardiasis that both enzymes are immunogenic. Intranasal immunization with either enzyme antigen in mice induced strong systemic IgG1 and IgG2b responses and modest mucosal IgA responses, and a marked 100- to 1,000-fold reduction in peak trophozoite load upon oral G. lamblia challenge. ENO immunization also reduced the extent and duration of cyst excretion. Examination of 44 cytokines showed only minimal intestinal changes in immunized mice, although a modest increase of CCL22 was observed in ENO-immunized mice. Spectral flow cytometry revealed increased numbers and activation state of CD4 T cells in the small intestine and an increase in α4β7-expressing CD4 T cells in mesenteric lymph nodes of ENO-immunized mice. Consistent with a key role of CD4 T cells, immunization of CD4-deficient and Rag-2 deficient mice failed to induce protection, whereas mice lacking IgA were fully protected by immunization, indicating that immunity was CD4 T cell-dependent but IgA-independent. These results demonstrate that conserved metabolic enzymes can be effective vaccine antigens for protection against G. lamblia infection, thereby expanding the repertoire of candidate antigens beyond primary surface proteins. Giardia lamblia is a leading parasitic cause of diarrheal disease worldwide. Symptomatic infection is associated with abdominal pain, malabsorption and weight loss, and can lead to protracted post-infectious syndromes. Despite its medical importance, a human vaccine has not been developed against the pathogen. Here we show that two highly conserved enzymes with metabolic functions in the cytoplasm of the parasite can be used as antigens for effective vaccines against G. lamblia, thereby significantly expanding the repertoire of candidate antigens against this clinically important infection beyond primary surface proteins.
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Affiliation(s)
- Sozaburo Ihara
- Department of Medicine, University of California San Diego, La Jolla, California
- Division of Gastroenterology, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Christine H. Y. Le
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Vivien N. Tran
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Elaine M. Hanson
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Marvin Fischer
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Kurt Hanevik
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Lars Eckmann
- Department of Medicine, University of California San Diego, La Jolla, California
- * E-mail:
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15
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Demir M, Lang S, Hartmann P, Duan Y, Martin A, Miyamoto Y, Bondareva M, Zhang X, Wang Y, Kasper P, Bang C, Roderburg C, Tacke F, Steffen HM, Goeser T, Kruglov A, Eckmann L, Stärkel P, Fouts DE, Schnabl B. The fecal mycobiome in non-alcoholic fatty liver disease. J Hepatol 2022; 76:788-799. [PMID: 34896404 PMCID: PMC8981795 DOI: 10.1016/j.jhep.2021.11.029] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [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: 08/16/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Studies investigating the gut-liver axis have largely focused on bacteria, whereas little is known about commensal fungi. We characterized fecal fungi in patients with non-alcoholic fatty liver disease (NAFLD) and investigated their role in a fecal microbiome-humanized mouse model of Western diet-induced steatohepatitis. METHODS We performed fungal internal transcribed spacer 2 sequencing using fecal samples from 78 patients with NAFLD, 16 controls and 73 patients with alcohol use disorder. Anti-Candida albicans (C. albicans) IgG was measured in blood samples from 17 controls and 79 patients with NAFLD. Songbird, a novel multinominal regression tool, was used to investigate mycobiome changes. Germ-free mice were colonized with feces from patients with non-alcoholic steatohepatitis (NASH), fed a Western diet for 20 weeks and treated with the antifungal amphotericin B. RESULTS The presence of non-obese NASH or F2-F4 fibrosis was associated with a distinct fecal mycobiome signature. Changes were characterized by an increased log-ratio for Mucor sp./Saccharomyces cerevisiae (S. cerevisiae) in patients with NASH and F2-F4 fibrosis. The C. albicans/S. cerevisiae log-ratio was significantly higher in non-obese patients with NASH when compared with non-obese patients with NAFL or controls. We observed a different fecal mycobiome composition in patients with NAFLD and advanced fibrosis compared to those with alcohol use disorder and advanced fibrosis. Plasma anti-C. albicans IgG was increased in patients with NAFLD and advanced fibrosis. Gnotobiotic mice, colonized with human NASH feces and treated with amphotericin B were protected from Western diet-induced steatohepatitis. CONCLUSIONS Non-obese patients with NAFLD and more advanced disease have a different fecal mycobiome composition to those with mild disease. Antifungal treatment ameliorates diet-induced steatohepatitis in mice. Intestinal fungi could be an attractive target to attenuate NASH. LAY SUMMARY Non-alcoholic fatty liver disease is one of the most common chronic liver diseases and is associated with changes in the fecal bacterial microbiome. We show that patients with non-alcoholic fatty liver disease and more severe disease stages have a specific composition of fecal fungi and an increased systemic immune response to Candida albicans. In a fecal microbiome-humanized mouse model of Western diet-induced steatohepatitis, we show that treatment with antifungals reduces liver damage.
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Affiliation(s)
- Münevver Demir
- Department of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany
| | - Sonja Lang
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany,Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, CA, USA,Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Yi Duan
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Anna Martin
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Marina Bondareva
- Belozerskiy Research Institute for Physical and Chemical Biology and Faculty of Bioengineering and Bioinformatics, M.V. Lomonosov Moscow State University, Moscow, 119991, Russia,Chronic Inflammation Lab, German Rheumatism Research Center, a Leibniz Institute, Berlin, Germany
| | - Xinlian Zhang
- Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Yanhan Wang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Philipp Kasper
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany
| | - Corinna Bang
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany
| | - Christoph Roderburg
- Department of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany,Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Frank Tacke
- Department of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany
| | - Hans-Michael Steffen
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany
| | - Tobias Goeser
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany
| | - Andrey Kruglov
- Belozerskiy Research Institute for Physical and Chemical Biology and Faculty of Bioengineering and Bioinformatics, M.V. Lomonosov Moscow State University, Moscow, 119991, Russia,Chronic Inflammation Lab, German Rheumatism Research Center, a Leibniz Institute, Berlin, Germany
| | - Lars Eckmann
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Peter Stärkel
- St. Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Derrick E. Fouts
- Department of Genomic Medicine, J. Craig Venter Institute, Rockville, MD, USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA.
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16
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Krakovka S, Ribacke U, Miyamoto Y, Eckmann L, Svärd S. Characterization of Metronidazole-Resistant Giardia intestinalis Lines by Comparative Transcriptomics and Proteomics. Front Microbiol 2022; 13:834008. [PMID: 35222342 PMCID: PMC8866875 DOI: 10.3389/fmicb.2022.834008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/13/2022] [Indexed: 12/13/2022] Open
Abstract
Metronidazole (MTZ) is a clinically important antimicrobial agent that is active against both bacterial and protozoan organisms. MTZ has been used extensively for more than 60 years and until now resistance has been rare. However, a recent and dramatic increase in the number of MTZ resistant bacteria and protozoa is of great concern since there are few alternative drugs with a similarly broad activity spectrum. To identify key factors and mechanisms underlying MTZ resistance, we utilized the protozoan parasite Giardia intestinalis, which is commonly treated with MTZ. We characterized two in vitro selected, metronidazole resistant parasite lines, as well as one revertant, by analyzing fitness aspects associated with increased drug resistance and transcriptomes and proteomes. We also conducted a meta-analysis using already existing data from additional resistant G. intestinalis isolates. The combined data suggest that in vitro generated MTZ resistance has a substantial fitness cost to the parasite, which may partly explain why resistance is not widespread despite decades of heavy use. Mechanistically, MTZ resistance in Giardia is multifactorial and associated with complex changes, yet a core set of pathways involving oxidoreductases, oxidative stress responses and DNA repair proteins, is central to MTZ resistance in both bacteria and protozoa.
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Affiliation(s)
- Sascha Krakovka
- Department of Cell and Molecular Biology, Biomedical Center (BMC), Uppsala University, Uppsala, Sweden
| | - Ulf Ribacke
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Yukiko Miyamoto
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Lars Eckmann
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Staffan Svärd
- Department of Cell and Molecular Biology, Biomedical Center (BMC), Uppsala University, Uppsala, Sweden.,SciLifeLab, Uppsala University, Uppsala, Sweden
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17
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Yagi K, Imamura T, Tada H, Liu J, Miyamoto Y, Ohbatake A, Ito N, Shikata M, Enkaku A, Takikawa A, Honoki H, Fujisaka S, Chujo D, Origasa H, Kinugawa K, Tobe K. Fragmented QRS on electrocardiography as a predictor for diastolic cardiac dysfunction in type 2 diabetes. J Diabetes Investig 2022; 13:1052-1061. [PMID: 35092353 PMCID: PMC9153843 DOI: 10.1111/jdi.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022] Open
Abstract
Aims/Introduction Diastolic cardiac dysfunction in type 2 diabetes (DD2D) is a critical risk of heart failure with preserved ejection fraction. However, there is no established biomarker to detect DD2D. We aimed to investigate the predictive impact of fragmented QRS (fQRS) on electrocardiography on the existence of DD2D. Materials and Methods We included in‐hospital patients with type 2 diabetes without heart failure symptoms who were admitted to our institution for glycemic management between November 2017 and April 2021. An fQRS was defined as an additional R′ wave or notching/splitting of the S wave in two contiguous electrocardiography leads. DD2D was diagnosed according to the latest guidelines of the American Society of Echocardiography. Results Of 320 participants, 122 patients (38.1%) had fQRS. DD2D was diagnosed in 82 (25.6%). An fQRS was significantly associated with the existence of DD2D (odds ratio 4.37, 95% confidence interval 2.33–8.20; p < 0.0001) adjusted for seven potential confounders. The correlation between DD2D and diabetic microvascular disease was significant only among those with fQRS. Classification and regression tree analysis showed that fQRS was the most relevant optimum split for DD2D. Conclusions An fQRS might be a simple and promising predictor of the existence of DD2D. The findings should be validated in a larger‐scale cohort.
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Affiliation(s)
- Kunimasa Yagi
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Teruhiko Imamura
- 2nd Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Hayato Tada
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Jianhui Liu
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Yukiko Miyamoto
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Azusa Ohbatake
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Naoko Ito
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Masataka Shikata
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Asako Enkaku
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Akiko Takikawa
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Hisae Honoki
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Shiho Fujisaka
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Daisuke Chujo
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology University of Toyama Graduate School of Medicine and Pharmaceutical Sciences 2630 Sugitani Toyama 934‐0194 Japan
| | - Koichiro Kinugawa
- 2nd Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Kazuyuki Tobe
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
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18
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Hartmann P, Duan Y, Miyamoto Y, Demir M, Lang S, Hasa E, Stern P, Yamashita D, Conrad M, Eckmann L, Schnabl B. Colesevelam ameliorates non-alcoholic steatohepatitis and obesity in mice. Hepatol Int 2022; 16:359-370. [PMID: 35075592 PMCID: PMC9013343 DOI: 10.1007/s12072-022-10296-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022]
Abstract
Background Obesity, non-alcoholic fatty liver disease (NAFLD) and its more advanced form non-alcoholic steatohepatitis (NASH) are important causes of morbidity and mortality worldwide. Bile acid dysregulation is a pivotal part in their pathogenesis. The aim of this study was to evaluate the bile acid sequestrant colesevelam in a microbiome-humanized mouse model of diet-induced obesity and steatohepatitis. Methods Germ-free C57BL/6 mice were associated with stool from patients with NASH and subjected to 20 weeks of Western diet feeding with and without colesevelam. Results Colesevelam reduced Western diet-induced body and liver weight gain in microbiome-humanized mice compared with controls. It ameliorated Western diet-induced hepatic inflammation, steatosis, fibrosis and insulin resistance. Colesevelam increased de novo bile acid synthesis and decreased hepatic cholesterol content in microbiome-humanized mice fed a Western diet. It further induced the gene expression of the antimicrobials Reg3g and Reg3b in the distal small intestine and decreased plasma levels of LPS. Conclusions Colesevelam ameliorates Western diet-induced steatohepatitis and obesity in microbiome-humanized mice.
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Affiliation(s)
- Phillipp Hartmann
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, University of California San Diego, MC0063, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Yi Duan
- Department of Medicine, University of California San Diego, MC0063, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, MC0063, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Münevver Demir
- Department of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany
| | - Sonja Lang
- Department of Medicine, University of California San Diego, MC0063, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, University of Cologne, Cologne, Germany
| | - Elda Hasa
- Department of Medicine, University of California San Diego, MC0063, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | | | | | | | - Lars Eckmann
- Department of Medicine, University of California San Diego, MC0063, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, MC0063, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA.
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19
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Orecchioni M, Kobiyama K, Winkels H, Ghosheh Y, McArdle S, Mikulski Z, Kiosses WB, Fan Z, Wen L, Jung Y, Roy P, Ali AJ, Miyamoto Y, Mangan M, Makings J, Wang Z, Denn A, Vallejo J, Owens M, Durant CP, Braumann S, Mader N, Li L, Matsunami H, Eckmann L, Latz E, Wang Z, Hazen SL, Ley K. Olfactory receptor 2 in vascular macrophages drives atherosclerosis by NLRP3-dependent IL-1 production. Science 2022; 375:214-221. [PMID: 35025664 PMCID: PMC9744443 DOI: 10.1126/science.abg3067] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Atherosclerosis is an inflammatory disease of the artery walls and involves immune cells such as macrophages. Olfactory receptors (OLFRs) are G protein–coupled chemoreceptors that have a central role in detecting odorants and the sense of smell. We found that mouse vascular macrophages express the olfactory receptor Olfr2 and all associated trafficking and signaling molecules. Olfr2 detects the compound octanal, which activates the NLR family pyrin domain containing 3 (NLRP3) inflammasome and induces interleukin-1β secretion in human and mouse macrophages. We found that human and mouse blood plasma contains octanal, a product of lipid peroxidation, at concentrations sufficient to activate Olfr2 and the human ortholog olfactory receptor 6A2 (OR6A2). Boosting octanal levels exacerbated atherosclerosis, whereas genetic targeting of Olfr2 in mice significantly reduced atherosclerotic plaques. Our findings suggest that inhibiting OR6A2 may provide a promising strategy to prevent and treat atherosclerosis.
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Affiliation(s)
| | - Kouji Kobiyama
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Division of Vaccine Science, Department of Microbiology and Immunology, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo 108-8639, Japan
| | - Holger Winkels
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Internal Medicine III, Division of Cardiology, Heart Center, University Hospital of Cologne, 50937 Cologne, Germany
| | - Yanal Ghosheh
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Sara McArdle
- Histology and Microscopy Core Facility, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Zbigniew Mikulski
- Histology and Microscopy Core Facility, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - William B. Kiosses
- Histology and Microscopy Core Facility, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Zhichao Fan
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Immunology, School of Medicine, UConn Health, University of Connecticut, Farmington, CT 06030, USA
| | - Lai Wen
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Yunmin Jung
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Payel Roy
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Amal J. Ali
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Yukiko Miyamoto
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Matthew Mangan
- Institute of Innate Immunity, University Hospital Bonn, 53127 Bonn, Germany
| | | | - Zhihao Wang
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Angela Denn
- Histology and Microscopy Core Facility, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | | | - Michaela Owens
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | | | - Simon Braumann
- Department of Internal Medicine III, Division of Cardiology, Heart Center, University Hospital of Cologne, 50937 Cologne, Germany
| | - Navid Mader
- Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, Germany
| | - Lin Li
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Hiroaki Matsunami
- Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC 27708, USA
| | - Lars Eckmann
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Eicke Latz
- Institute of Innate Immunity, University Hospital Bonn, 53127 Bonn, Germany
| | - Zeneng Wang
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Stanley L. Hazen
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Klaus Ley
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA.,Corresponding author.
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20
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Natto MJ, Miyamoto Y, Munday JC, AlSiari TA, Al-Salabi MI, Quashie NB, Eze AA, Eckmann L, De Koning HP. Comprehensive characterization of purine and pyrimidine transport activities in Trichomonas vaginalis and functional cloning of a trichomonad nucleoside transporter. Mol Microbiol 2021; 116:1489-1511. [PMID: 34738285 PMCID: PMC8688338 DOI: 10.1111/mmi.14840] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/30/2021] [Accepted: 10/30/2021] [Indexed: 11/30/2022]
Abstract
Trichomoniasis is a common and widespread sexually-transmitted infection, caused by the protozoan parasite Trichomonas vaginalis. T. vaginalis lacks the biosynthetic pathways for purines and pyrimidines, making nucleoside metabolism a drug target. Here we report the first comprehensive investigation into purine and pyrimidine uptake by T. vaginalis. Multiple carriers were identified and characterized with regard to substrate selectivity and affinity. For nucleobases, a high-affinity adenine transporter, a possible guanine transporter and a low affinity uracil transporter were found. Nucleoside transporters included two high affinity adenosine/guanosine/uridine/cytidine transporters distinguished by different affinities to inosine, a lower affinity adenosine transporter, and a thymidine transporter. Nine Equilibrative Nucleoside Transporter (ENT) genes were identified in the T. vaginalis genome. All were expressed equally in metronidazole-resistant and -sensitive strains. Only TvagENT2 was significantly upregulated in the presence of extracellular purines; expression was not affected by co-culture with human cervical epithelial cells. All TvagENTs were cloned and separately expressed in Trypanosoma brucei. We identified the main broad specificity nucleoside carrier, with high affinity for uridine and cytidine as well as purine nucleosides including inosine, as TvagENT3. The in-depth characterization of purine and pyrimidine transporters provides a critical foundation for the development of new anti-trichomonal nucleoside analogues.
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Affiliation(s)
- Manal J. Natto
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Yukiko Miyamoto
- Department of Medicine, University of California, San Diego, La Jolla, California 92093, United States
| | - Jane C. Munday
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Tahani A. AlSiari
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Mohammed I. Al-Salabi
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Neils B. Quashie
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, University of Ghana
| | - Anthonius A. Eze
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Current affiliation: Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Lars Eckmann
- Department of Medicine, University of California, San Diego, La Jolla, California 92093, United States
| | - Harry P. De Koning
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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21
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Oba Y, Kohro T, Sato H, Nochioka K, Nakayama M, Fujita H, Mizuno Y, Kiyosue A, Iwanaga Y, Miyamoto Y, Matoba T, Tsutsui H, Nakamura T, Usuku K, Nagai R. The relationships among the pulse rate, use of beta-blockers, and prognosis in patients with ischemic heart disease in a real-world database using a storage system. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The use of β-blockers has the effect of improving the prognosis of patients with ischemic heart disease (IHD). One of the underlying mechanisms is a decrease in the cardiac load due to a reduction in the heart rate.
Purpose
To clarify the relationships among the pulse rate, the use of β-blockers, and the prognosis in patients with IHD in a multicenter study using a storage system.
Methods
The Clinical Deep Data Accumulation System (CLIDAS) collects (1) basic patient information, prescriptions, and laboratory data from electronic medical records from the Standardized Structured Medical Information eXchange (SS-MIX2) standard storage, and (2) the results of physiological tests, cardiac catheterization, and cardiac catheter intervention reports from the SS-MIX2 extended storage. 8540 cases who underwent cardiac catheterization from 6 university hospitals and the national cardiovascular center in Japan were registered (male: 77%, average age: 70.2 years). We evaluated these patients' pulse rate at admission and at the discharge of cardiac catheterization in 6,598 patients. We divided the pulse rates at discharge into quartiles (Q1: <60, Q2: 60–66, Q3: 67–75, Q4: ≥76 bpm), and we analyzed the relationship between the pulse rate and the prognosis by dividing the patients into the stable angina group (n=2,631) and the acute coronary syndrome (ACS) group (n=2,394). Regarding the use of β-blockers, we compared the pulse rates of the patients taking carvedilol (n=1,728) and those taking bisoprolol (n=2,761) at admission and discharge. Major adverse cardiovascular events (MACE) were defined as cardiovascular death, non-fatal myocardial infarction, unstable angina, heart failure, stroke, and other hospitalized cardiovascular events.
Results
A total of 600 MACEs occurred during an average observation period of 890 days. The incidence of cardiovascular events was significantly higher in the Q4 patients in the stable angina group (hazard ratio 1.79, 95% confidence interval 1.32–2.41, but there was no significant difference among the four pulse rate subgroups in the ACS group. The bisoprolol-treated patients had lower pulse rates at discharge (67.4±12.2 vs. 68.8±11.8 bpm, p<0.001) and a lower percentage of patients in the Q4 group (21.2 vs. 24.9%, p=0.005) compared to the carvedilol-treated patients. The pulse rate at admission was similar in the bisoprolol- and carvedilol-treated patients (74.3±19.3 vs. 73.2±29.5 bpm, p=0.328).
Conclusion
In a real-world database using a storage system, a pulse rate of ≤75 bpm was associated with a good prognosis in patients with ACS. Compared to carvedilol, bisoprolol was associated with a decreased pulse rate at discharge.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Kowa Company, Ltd.
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Affiliation(s)
- Y Oba
- Jichi Medical University, Department of Internal Medicine, Tochigi, Japan
| | - T Kohro
- Jichi Medical University, Department of Internal Medicine, Tochigi, Japan
| | - H Sato
- Precision Inc., Tokyo, Japan
| | | | | | - H Fujita
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Y Mizuno
- University of Tokyo, Tokyo, Japan
| | | | - Y Iwanaga
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Matoba
- Kyushu University, Fukuoka, Japan
| | | | | | - K Usuku
- Kumamoto University, Kumamoto, Japan
| | - R Nagai
- Jichi Medical University, Department of Internal Medicine, Tochigi, Japan
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22
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Matoba T, Fujita H, Kohro T, Kabutoya T, Kiyosue A, Mizuno Y, Nakayama M, Nochioka K, Miyamoto Y, Iwanaga Y, Tsujita K, Nakamura T, Sato H, Tsutsui H, Nagai R. Clinical Deep Data Accumulation System (CLIDAS) reveals lipid paradox in guideline-defined high risk Japanese patients after PCI. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Japanese clinical guidelines recommend a stratification of the risks and LDL-cholesterol (LDL-C) treatment goals for patients with coronary artery disease after percutaneous coronary intervention (PCI), i.e. <100 mg/dL for normal risk patients and <70 mg/dL for high risk patients; however, less is known about the association between baseline LDL-C values and long-term prognosis.
Purpose
To investigate the association between LDL-C goals and baseline LDL-C levels in relation to major adverse cardiovascular events (MACE) among high-risk patients after PCI, using a real-world database.
Methods
We developed the Clinical Deep Data Accumulation System (CLIDAS) that acquires clinical data directly from hospital information system, and implemented the system in 6 university hospitals and the national cardiovascular center in Japan. The CLIDAS database accumulates data regarding patient background, laboratory data, prescriptions, electrocardiogram, echocardiogram, PCI report, and long-term prognosis. We retrospectively analyzed 8540 consecutive patients who underwent PCI during April 2014 and March 2020 in participating hospitals, and classified them into the normal risk group (n=3712, 43%) and the high risk group [n=4828, 57%, with any of acute coronary syndrome (ACS), familial hypercholesterolemia (FH), or diabetes with additional risk factor(s)], for which LDL-C goals are <100 mg/dL and <70 mg/dL, respectively, according to the Japanese Atherosclerosis Society guidelines or the diagnosis and prevention of atherosclerotic cardiovascular diseases. The primary outcome was the time to first occurrence of MACE, a composite of cardiovascular death, stroke, myocardial infarction, and coronary revascularization in associations with baseline LDL-C levels and patient background.
Results
Proportion of male (77% vs. 77%) and age (71±11 vs. 70±11) were similar between 2 groups. The prevalence of ACS at the index PCI (0% vs. 62%), FH (0% vs. 2%), hypertension (61% vs. 86%), diabetes (11% vs. 67%), dyslipidemia (73% vs. 84%), hemodialysis (4% vs. 9%), peripheral artery disease (5% vs. 9%), smoking (16% vs. 30%), and prescription of statins (79% vs. 86%) were significantly higher in the high risk group. Among patients in the high risk group, but not in the normal risk group, baseline LDL-C <70 mg/dL was paradoxically associated with higher risk of MACE (P<0.0001 by Log-rank test) (Figure). The Cox proportional hazard model confirmed that the high risk group (risk ratio 1.54, 95% CI [1.31–1.81]), baseline LDL-C <70mg/dL (risk ratio 1.44, 95% CI [1.18–1.75]), baseline age (risk ratio 1.36, 95% CI [1.28–1.45] per 10 year), and prescription of statins (risk ratio 0.80, 95% CI [0.66–0.96]) were significantly associated with the risk of MACE in this population.
Conclusion
The CLIDAS real-world database revealed that baseline low LDL-C paradoxically associated with an increased risk of MACE among guideline-defined high risk patients after PCI.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Jichi Medical University, Tochigi, Japan, and Kowa
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Affiliation(s)
- T Matoba
- Kyushu University, Cardiovascular Medicine, Fukuoka, Japan
| | - H Fujita
- Jichi Medical University Saitama Medical Center, Cardiology, Saitama, Japan
| | - T Kohro
- Jichi Medical University, Medical Informatics, Tochigi, Japan
| | - T Kabutoya
- Jichi Medical University, Cardiology, Tochigi, Japan
| | - A Kiyosue
- University of Tokyo Hospital, Cardiology, Tokyo, Japan
| | - Y Mizuno
- University of Tokyo Hospital, Cardiology, Tokyo, Japan
| | - M Nakayama
- Tohoku University Graduate School of Medicine, Medical Informatics, Sendai, Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Medical Informatics, Sendai, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - Y Iwanaga
- National Cerebral and Cardiovascular Center Hospital, Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - K Tsujita
- Kumamoto University Hospital, Cardiovascular Center, Kumamoto, Japan
| | - T Nakamura
- Kumamoto University Hospital, Medical Informatics, Kumamoto, Japan
| | | | - H Tsutsui
- Kyushu University, Cardiovascular Medicine, Fukuoka, Japan
| | - R Nagai
- Jichi Medical University, Tochigi, Japan
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23
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Iwai T, Katoka Y, Murai K, Hosoda H, Honda S, Fujino M, Yoneda S, Otsuka F, Nishihira K, Kanaya T, Asaumi Y, Murata S, Miyamoto Y, Yasuda S, Noguchi T. Comparison of coronary atherosclerotic features in response to achieving LDL-C <55 mg/dl between non-diabetic and diabetic patients: insights from the REASSURE-NIRS registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Current ESC guideline recommends achieving LDL-C <1.4 mmol/l in very high-risk subjects. Despite fabvourable anti-atherosclerotic effects of lowering LDL-C, its efficacy is diminished in type 2 diabetic patients. Whether response of coronary atheroma to on-treatment LDL-C <1.4 mmol/l differs in diabetic and non-diabetic subjects has not been elucidated yet.
Methods
The REASSURE-NIRS registry is an on-going multi-center registry to enroll CAD subjects receiving PCI under the guidance of near-infrared spectroscopy/intravascular ultrasound (NIRS/IVUS: DualProTM, Nipro, Tokyo, Japan) imaging. Culprit lesions in 557 CAD patients who already received a statin were evaluated by NIRS/IVUS. Maximum 4-mm-lipid-core burden-index (maxLCBI4mm) and plaque calcification grade at culprit sites were measured. Calcification grade at each 1-mm cross-sectional image was defined as follows: calcium arc 0° = 0, 0–90° = 1, 90–180° = 2, 180–270° = 3, 270–360° = 4. MaxLCBI4mm and the averaged calcification grade were compared in diabetic and non-diabetic subjects stratified according to on-treatment LDL-C level, respectively.
Result
The proportion of diabetic (n=293, HbA1c; 6.9±0.9%) and non-diabetic patients (n=264) with on-treatment LDL-C <1.4 mmol/l was 8.54 and 16.67%, respectivey (p=0.01). In non-diabetic patients, achieving LDL-C <1.4mmol/L was associated with a lower maxLCBI4mm, whereas, in diabetic patients, maxLCBI4mm was numerically smaller under achieving LDL-C <1.4 mmol/l, but this comparison did not meet statistical significance (Figure 1). Furthermore, a greater degree of calcification grade in non-diabetic patients was observed in association with on-treatment LDL-C level (Figure 2). However, plaque calcification at diabetic coronary atheroma was not necessarily induced under achieving stricter LDL-C goal. Subgroup analysis demonstrated that diabetic patients with body mass index ≥25 (odds ratio = 0.15; 95% CI: 0.18–1.19, p=0.04), estimated glomerular filtration rate <60 (mL/min/1.73m2) (odds ratio = 0.31; 95% CI: 0.10–0.90, p=0.03) and non-insulin use (odds ratio = 0.36; 95% CI: 0.14–0.87, p=0.02) benefit from achieving LDL-C <1.4 mmol/l.
Conclusion
Achieving LDL-C <1.4 mmol/l was associated with more stabilized atheroma in non-diabetic patients with CAD, whereas these favourable effects were not observed in diabetic subjects. Our findings suggest the potential need to modify additional atherogenic risks for stabilizing diabetic coronary atheroma under achieving LDL-C <1.4 mmol/l.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- T Iwai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Katoka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Murai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Hosoda
- Chikamori Hospital, Department of Cardiology, Kochi, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Murata
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yasuda
- Tohoku University, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Suita, Japan
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24
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Yamaguchi T, Nakai M, Yano T, Matsuyama M, Miyamoto Y, Kodama T, Ogino H. Population-based incidence and outcomes of acute aortic dissection in Japan. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The population-based incidence and outcomes of acute aortic dissection (AAD) are still unknown because some patients are already dead on arrival at the hospital, and the accurate diagnosis of AAD is difficult due to the low autopsy rate for patients with cardiopulmonary arrest outside of the hospital. We performed a population-based review of all patients with AAD in a well-defined geographical area in the southern part of Japan between 2016 and 2018.
Methods
Data of all patients with AAD at our Hospital, which performs medical care for 120,000 residents, were collected retrospectively. The emergency medical service is dedicated to the transfer of all patients in this area to the MPNH. For all patients who were dead on arrival, the diagnosis of AAD was made by autopsy imaging (AI) using computed tomography. The age-adjusted incidence and mortality per 100,000 population were calculated using the Japanese population distribution model in 2015.
Results
The total incidence of AAD was 79 (type A: 64.5%, n=51). Of those, 60.8% (31/51) of patients with type A and 21.4% (6/28) with type B were dead on arrival and diagnosed by AI. The 30-day mortality rates after the onset of AAD were 74.5% (38/51) in type A and 25.0% (7/28) in type B. Excluding the dead-on-arrival patients, the 30-day mortality rates were 35.0% (7/20) in type A and 4.5% (1/22) in type B. The age-adjusted incidence and mortality of AAD per 100,000 inhabitants were 17.3 (type A: 11.3, type B: 6.0) and 9.6 (type A: 8.4, type B: 1.2), respectively. Both values were significantly higher in men than in women.
Conclusions
The population-based survey of emergency medical care for AAD showed that the age-adjusted incidence of AAD was two-fold higher than in previous reports, and the actual mortality rates after AAD onset were markedly higher due to the high incidence of dead-on-arrival.
Funding Acknowledgement
Type of funding sources: None. Representative CT images of type A AAD
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Affiliation(s)
| | - M Nakai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Yano
- Miyazaki Prefectural Nobeoka hospital, Miyazaki, Japan
| | - M Matsuyama
- Miyazaki Prefectural Nobeoka hospital, Miyazaki, Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Kodama
- Toranomon Hospital, Tokyo, Japan
| | - H Ogino
- Tokyo Medical University Hospital, Tokyo, Japan
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25
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Jain S, Sakamoto T, Jung Y, Davidson IA, Barua P, Hayes JR, Shibahara K, Mizuno T, Miyamoto Y, Nakajima K, Richardson DJ. High spatial-density, cladding-pumped 6-mode 7-core fiber amplifier for C-band operation. Opt Express 2021; 29:30675-30681. [PMID: 34614788 DOI: 10.1364/oe.428142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
We present a C-band 6-mode 7-core fiber amplifier in an all-fiberized cladding-pumped configuration for space division multiplexed transmission supporting a record 42 spatial channels. With optimized fiber components (e.g. passively cooled pump laser diode, pump coupler, pump stripper), high power multimode pump light is coupled to the active fiber without any noticeable thermal degradation and an average gain of 18 dB and noise figure of 5.4 dB are obtained with an average differential modal gain of 3.4 dB.
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26
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Zhou D, Xue J, Miyamoto Y, Poulsen O, Eckmann L, Haddad GG. Microbiota Modulates Cardiac Transcriptional Responses to Intermittent Hypoxia and Hypercapnia. Front Physiol 2021; 12:680275. [PMID: 34248668 PMCID: PMC8267877 DOI: 10.3389/fphys.2021.680275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/20/2021] [Indexed: 12/22/2022] Open
Abstract
The microbiota plays a critical role in regulating organismal health and response to environmental stresses. Intermittent hypoxia and hypercapnia, a condition that represents the main hallmark of obstructive sleep apnea in humans, is known to induce significant alterations in the gut microbiome and metabolism, and promotes the progression of atherosclerosis in mouse models. To further understand the role of the microbiome in the cardiovascular response to intermittent hypoxia and hypercapnia, we developed a new rodent cage system that allows exposure of mice to controlled levels of O2 and CO2 under gnotobiotic conditions. Using this experimental setup, we determined the impact of the microbiome on the transcriptional response to intermittent hypoxia and hypercapnia in the left ventricle of the mouse heart. We identified significant changes in gene expression in both conventionally reared and germ-free mice. Following intermittent hypoxia and hypercapnia exposure, we detected 192 significant changes in conventionally reared mice (96 upregulated and 96 downregulated) and 161 significant changes (70 upregulated and 91 downregulated) in germ-free mice. Only 19 of these differentially expressed transcripts (∼10%) were common to conventionally reared and germ-free mice. Such distinct transcriptional responses imply that the host microbiota plays an important role in regulating the host transcriptional response to intermittent hypoxia and hypercapnia in the mouse heart.
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Affiliation(s)
- Dan Zhou
- Division of Respiratory Medicine, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
| | - Jin Xue
- Division of Respiratory Medicine, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
| | - Yukiko Miyamoto
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Orit Poulsen
- Division of Respiratory Medicine, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
| | - Lars Eckmann
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Gabriel G Haddad
- Division of Respiratory Medicine, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States.,Rady Children's Hospital-San Diego, San Diego, CA, United States
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27
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Natto MJ, Hulpia F, Kalkman ER, Baillie S, Alhejeli A, Miyamoto Y, Eckmann L, Van Calenbergh S, de Koning HP. Deazapurine Nucleoside Analogues for the Treatment of Trichomonas vaginalis. ACS Infect Dis 2021; 7:1752-1764. [PMID: 33974405 DOI: 10.1021/acsinfecdis.1c00075] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Trichomoniasis is the most common nonviral sexually transmitted disease in humans, but treatment options are limited. Here, we report a resorufin-based drug sensitivity assay for high-throughput microplate-based screening under hypoxic conditions. A 5203-compound enamine kinase library and several specialized compound series were tested for the inhibition of Trichomonas growth at 10 μM with Z' values of >0.5. Hits were rescreened in serial dilution to establish an IC50 concentration. A series of 7-substituted 7-deazaadenosine analogues emerged as highly potent anti-T. vaginalis agents, with EC50 values in the low double digit nanomolar range. These analogues exhibited excellent selectivity indices. Follow-up medicinal chemistry efforts identified an optimal ribofuranose and C7 substituent. Several nucleosides rapidly cleared cultures of T. vaginalis at a concentrations of just 2 × EC50. Preliminary in vivo evaluation in a murine trichomoniasis model (Tritrichomonas foetus) revealed promising activity upon topical administration, validating purine nucleoside analogues as a new class of antitrichomonal agents.
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Affiliation(s)
- Manal J. Natto
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, U.K
| | - Fabian Hulpia
- Laboratory for Medicinal Chemistry, Campus Heymans (FFW), Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium
| | - Eric R. Kalkman
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, U.K
| | - Susan Baillie
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, U.K
| | - Amani Alhejeli
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, U.K
| | | | | | - Serge Van Calenbergh
- Laboratory for Medicinal Chemistry, Campus Heymans (FFW), Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium
| | - Harry P. de Koning
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, U.K
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28
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Takahashi A, Kamada K, Kudoh T, Kudoh K, Takamaru N, Kurio N, Sugawara C, Miyamoto Y. Evaluation of anatomical references for locating the course of the posterior superior alveolar artery for dental implant surgery. Int J Oral Maxillofac Surg 2021; 51:257-262. [PMID: 34083086 DOI: 10.1016/j.ijom.2021.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/25/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
This retrospective cohort study aimed to identify the best anatomical reference for predicting the posterior superior alveolar artery (PSAA) location. Computed tomographic images of 90 maxillary sinuses were evaluated. We studied five references, including the alveolar crest, maxillary sinus floor, zygomatoalveolar crest, hard palate and soft palate, and measured the distances between them and the PSAA. Variations in the distance were evaluated by the standard deviation and coefficient of variation (CV). The zygomatoalveolar crest was an unstable reference, owing to its high standard deviation and CV. The smallest CV was for the distance between the alveolar crest and PSAA, although the distance was smaller in edentulous jaws than dentulous jaws. The distance between the sinus floor and PSAA was larger in male and edentulous patients. The PSAA was detected in 40.0%, 44.4%, 54.4% and 56.7% of the sinus walls at the first and second premolar and the first and second molar positions, respectively. At these tooth positions, the respective heights above the hard palate were 11.2 ± 4.9, 8.2 ± 4.9, 6.2 ± 2.8 and 8.1 ± 2.9 mm. The hard palate was the most stable reference for predicting the location of the PSAA, irrespective of sex, age and dentition.
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Affiliation(s)
- A Takahashi
- Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
| | - K Kamada
- Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - T Kudoh
- Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - K Kudoh
- Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - N Takamaru
- Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - N Kurio
- Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - C Sugawara
- Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Y Miyamoto
- Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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29
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Miyamoto Y, Aggarwal S, Celaje JJA, Ihara S, Ang J, Eremin DB, Land KM, Wrischnik LA, Zhang L, Fokin VV, Eckmann L. Gold(I) Phosphine Derivatives with Improved Selectivity as Topically Active Drug Leads to Overcome 5-Nitroheterocyclic Drug Resistance in Trichomonas vaginalis. J Med Chem 2021; 64:6608-6620. [PMID: 33974434 DOI: 10.1021/acs.jmedchem.0c01926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Trichomonas vaginalis causes the most common, nonviral sexually transmitted infection. Only metronidazole (Mz) and tinidazole are approved for treating trichomoniasis, yet resistance is a clinical problem. The gold(I) complex, auranofin, is active against T. vaginalis and other protozoa but has significant human toxicity. In a systematic structure-activity exploration, we show here that diversification of gold(I) complexes, particularly as halides with simple C1-C3 trialkyl phosphines or as bistrialkyl phosphine complexes, can markedly improve potency against T. vaginalis and selectivity over human cells compared to that of the existing antirheumatic gold(I) drugs. All gold(I) complexes inhibited the two most abundant isoforms of the presumed target enzyme, thioredoxin reductase, but a subset of compounds were markedly more active against live T. vaginalis than the enzyme, suggesting that alternative targets exist. Furthermore, all tested gold(I) complexes acted independently of Mz and were able to overcome Mz resistance, making them candidates for the treatment of Mz-refractory trichomoniasis.
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Affiliation(s)
- Yukiko Miyamoto
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Shubhangi Aggarwal
- Department of Chemistry, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California 90089, United States
| | - Jeff Joseph A Celaje
- Department of Chemistry, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California 90089, United States
| | - Sozaburo Ihara
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Jonathan Ang
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Dmitry B Eremin
- Department of Chemistry, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California 90089, United States
| | - Kirkwood M Land
- Department of Biological Sciences, University of the Pacific, Stockton, California 95211, United States
| | - Lisa A Wrischnik
- Department of Biological Sciences, University of the Pacific, Stockton, California 95211, United States
| | - Liangfang Zhang
- Department of NanoEngineering, University of California, San Diego, La Jolla, California 92093, United States
| | - Valery V Fokin
- Department of Chemistry, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California 90089, United States
| | - Lars Eckmann
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
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30
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Yagi K, Imamura T, Tada H, Chujo D, Liu J, Shima Y, Ohbatake A, Miyamoto Y, Okazaki S, Ito N, Nakano K, Shikata M, Enkaku A, Takikawa A, Honoki H, Fujisaka S, Origasa H, Tobe K. Diastolic Cardiac Function Improvement by Liraglutide Is Mainly Body Weight Reduction Dependent but Independently Contributes to B-Type Natriuretic Peptide Reduction in Patients with Type 2 Diabetes with Preserved Ejection Fraction. J Diabetes Res 2021; 2021:8838026. [PMID: 33855087 PMCID: PMC8019623 DOI: 10.1155/2021/8838026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 02/15/2021] [Accepted: 03/06/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES A single-arm prospective study was conducted among Japanese patients with type 2 diabetes having preserved ejection fraction. The aim was to investigate (1) whether liraglutide therapy could improve B-type natriuretic peptide (BNP) levels and diastolic cardiac function assessed by the E-wave to E' ratio (E/E') using transthoracic echocardiography (TTE), and (2) whether E/E' contributed to BNP improvement independent of bodyweight reduction (UMIN000005565). METHODS Patients with type 2 diabetes and left ventricular ejection fraction (LVEF) ≥ 40% without heart failure symptoms were enrolled, and daily injection with liraglutide (0.9 mg) was introduced. Cardiac functions were assessed by TTE before and after 26 weeks of liraglutide treatment. Diastolic cardiac function was defined as septal E/E' ≥ 13.0. RESULTS Thirty-one patients were analyzed. BNP and E/E' improved, with BNP levels declining from 36.8 ± 30.5 pg/mL to 26.3 ± 25.9 pg/mL (p = 0.0014) and E/E' dropping from 12.7 ± 4.7 to 11.0 ± 3.3 (p = 0.0376). The LVEF showed no significant changes. E/E' improved only in patients with E/E' ≥ 13.0. Favorable changes in E/E' were canceled when adjusted for body mass index (BMI). Multivariate linear regression analysis revealed that the left ventricular diastolic diameter and ∆E/E'/∆BMI contributed to ∆BNP/baseline BNP (p = 0.0075, R 2 = 0.49264). CONCLUSIONS Liraglutide had favorable effects on BNP and E/E' but not on LVEF. E/E' improvement was only seen in patients with diastolic cardiac function. Body weight reduction affected the change of E/E'. The BMI-adjusted E/E' significantly contributed to the relative change of BNP. GLP-1 analog treatment could be considered a therapeutic option against diabetic diastolic cardiac dysfunction regardless of body weight. This trial is registered with the University Hospital Medical Information Network in Japan, with clinical trial registration number: UMIN000005565.
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Affiliation(s)
- Kunimasa Yagi
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Teruhiko Imamura
- 2nd Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Hayato Tada
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Daisuke Chujo
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Jianhui Liu
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Yuuki Shima
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Azusa Ohbatake
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Yukiko Miyamoto
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Satoko Okazaki
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Naoko Ito
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Kaoru Nakano
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Masataka Shikata
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Asako Enkaku
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Akiko Takikawa
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Hisae Honoki
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Shiho Fujisaka
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 934-0194, Japan
| | - Kazuyuki Tobe
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
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Fujimoto N, Kozuki T, Aoe K, Miyamoto Y, Wada S, Harada D, Yoshida M, Sakurai J, Hotta K. 1898P A phase II trial of first-line combination chemotherapy with cisplatin, pemetrexed, and nivolumab for unresectable malignant pleural mesothelioma: JME-001. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1441] [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: 10/23/2022] Open
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32
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d’Errico F, Abegāo L, Souza S, Chierici A, Lazzeri L, Puccini M, Vitolo S, Miyamoto Y, Nanto H, Yamamoto T. Entrance surface dosimetry with radiophotoluminescent films. RADIAT MEAS 2020. [DOI: 10.1016/j.radmeas.2020.106423] [Citation(s) in RCA: 1] [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: 10/23/2022]
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33
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Lauwaet T, Miyamoto Y, Ihara S, Le C, Kalisiak J, Korthals KA, Ghassemian M, Smith DK, Sharpless KB, Fokin VV, Eckmann L. Click chemistry-facilitated comprehensive identification of proteins adducted by antimicrobial 5-nitroimidazoles for discovery of alternative drug targets against giardiasis. PLoS Negl Trop Dis 2020; 14:e0008224. [PMID: 32302296 PMCID: PMC7190177 DOI: 10.1371/journal.pntd.0008224] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/29/2020] [Accepted: 03/16/2020] [Indexed: 12/21/2022] Open
Abstract
Giardiasis and other protozoan infections are major worldwide causes of morbidity and mortality, yet development of new antimicrobial agents with improved efficacy and ability to override increasingly common drug resistance remains a major challenge. Antimicrobial drug development typically proceeds by broad functional screens of large chemical libraries or hypothesis-driven exploration of single microbial targets, but both strategies have challenges that have limited the introduction of new antimicrobials. Here, we describe an alternative drug development strategy that identifies a sufficient but manageable number of promising targets, while reducing the risk of pursuing targets of unproven value. The strategy is based on defining and exploiting the incompletely understood adduction targets of 5-nitroimidazoles, which are proven antimicrobials against a wide range of anaerobic protozoan and bacterial pathogens. Comprehensive adductome analysis by modified click chemistry and multi-dimensional proteomics were applied to the model pathogen Giardia lamblia to identify dozens of adducted protein targets common to both 5'-nitroimidazole-sensitive and -resistant cells. The list was highly enriched for known targets in G. lamblia, including arginine deiminase, α-tubulin, carbamate kinase, and heat shock protein 90, demonstrating the utility of the approach. Importantly, over twenty potential novel drug targets were identified. Inhibitors of two representative new targets, NADP-specific glutamate dehydrogenase and peroxiredoxin, were found to have significant antigiardial activity. Furthermore, all the identified targets remained available in resistant cells, since giardicidal activity of the respective inhibitors was not impacted by resistance to 5'-nitroimidazoles. These results demonstrate that the combined use of click chemistry and proteomics has the potential to reveal alternative drug targets for overcoming antimicrobial drug resistance in protozoan parasites.
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Affiliation(s)
- Tineke Lauwaet
- Department of Pathology, University of California, San Diego, La Jolla, California, United States of America
| | - Yukiko Miyamoto
- Department of Medicine, University of California, San Diego, La Jolla, California, United States of America
| | - Sozaburo Ihara
- Department of Medicine, University of California, San Diego, La Jolla, California, United States of America.,Division of Gastroenterology, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan
| | - Christine Le
- Department of Medicine, University of California, San Diego, La Jolla, California, United States of America
| | - Jarosław Kalisiak
- Department of Chemistry and The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California, United States of America
| | - Keith A Korthals
- Department of Chemistry and The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California, United States of America
| | - Majid Ghassemian
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, California, United States of America
| | - Diane K Smith
- Department of Chemistry and Biochemistry, San Diego State University, San Diego, California, United States of America
| | - K Barry Sharpless
- Department of Chemistry and The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California, United States of America
| | - Valery V Fokin
- Department of Chemistry, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Lars Eckmann
- Department of Medicine, University of California, San Diego, La Jolla, California, United States of America
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34
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Shinriki S, Maeshiro M, Shimamura K, Kawashima J, Araki E, Ibusuki M, Yamamoto Y, Iwase H, Miyamoto Y, Baba H, Yamaguchi M, Matsui H. Evaluation of an amplicon-based custom gene panel for the diagnosis of hereditary tumors. Neoplasma 2020; 67:898-908. [PMID: 32241160 DOI: 10.4149/neo_2020_190918n925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/06/2019] [Indexed: 11/08/2022]
Abstract
Genetic testing based on next-generation sequencing (NGS) analysis has recently been used to diagnose hereditary diseases. In this study, we explored the usefulness of our custom amplicon panel that targeted 23 genes related to hereditary tumors given in the American College of Medical Genetics and Genomics recommendations. We applied our custom NGS panel to samples from 12 patients previously diagnosed by Sanger sequencing as having the diseases or diagnosed clinically by meeting the diagnostic criteria in this study. Our gene panel not only successfully identified all variants detected by Sanger sequencing but also identified previously unrecognized variants that resulted in confirmation of the disease, or even in the revision of the diagnosis. For instance, a patient identified with an SDHD gene mutation actually had von Hippel-Lindau (VHL) syndrome, as determined by the presence of a pathogenic VHL gene variant. We also identified false-positive results that were generated by amplification of genome regions that are not intended to be investigated. In conclusion, NGS-based amplicon sequencing is a highly effective method to detect germline variants, as long as they are also carefully reviewed by manual inspection.
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Affiliation(s)
- S Shinriki
- Department of Molecular Laboratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - M Maeshiro
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan.,Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - K Shimamura
- Department of Molecular Laboratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - J Kawashima
- Department of Metabolic Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - E Araki
- Department of Metabolic Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - M Ibusuki
- Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Yamamoto
- Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - H Iwase
- Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | | | - H Matsui
- Department of Molecular Laboratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
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35
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Baba Y, Yagi T, Kosumi K, Okadome K, Nomoto D, Eto K, Hiyoshi Y, Nagai Y, Ishimoto T, Iwatsuki M, Iwagami S, Miyamoto Y, Yoshida N, Komohara Y, Watanabe M, Baba H. Morphological lymphocytic reaction, patient prognosis and PD-1 expression after surgical resection for oesophageal cancer. Br J Surg 2020; 106:1352-1361. [PMID: 31414718 DOI: 10.1002/bjs.11301] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 04/15/2019] [Accepted: 06/06/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors, such as antibody against programmed cell death protein (PD-1), have demonstrated antitumour effects in patients with malignancies, including oesophageal cancer. A lymphocytic reaction observed by pathological examination is a manifestation of the host immune response to tumour cells. It was hypothesized that a stronger lymphocytic reaction to tumours might be associated with favourable prognosis in oesophageal cancer. METHODS Using a database of resected oesophageal cancers, four morphological components of lymphocytic reactions (peritumoral, intranest, lymphoid and stromal) to tumours were evaluated in relation to clinical outcome, PD-1 expression by immunohistochemistry and total lymphocyte count in blood. RESULTS Resected oesophageal cancer specimens from 436 patients were included in the study. Among the four morphological components, only peritumoral reaction was associated with patient prognosis (multivariable P for trend <0·001); patients with a higher peritumoral reaction had significantly longer overall survival than those with a lower reaction (multivariable hazard ratio 0·48, 95 per cent c.i. 0·34 to 0·67). The prognostic effect of peritumoral reaction was not significantly modified by other clinical variables (all P for interaction >0·050). Peritumoral reaction was associated with total lymphocyte count in the blood (P < 0·001), supporting the relationship between local immune response and systemic immune competence. In addition, higher morphological peritumoral reaction was associated with high PD-1 expression on lymphocytes in tumours (P = 0·034). CONCLUSION These findings should help to improve risk-adapted therapeutic strategies and help stratify patients in the future clinical setting of immunotherapy for oesophageal cancer.
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Affiliation(s)
- Y Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan.,Department of Next-Generation Surgical Therapy Development, Graduate School of Medical Sciences, Kumamoto University, Kumumato, Japan
| | - T Yagi
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - K Kosumi
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - K Okadome
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - D Nomoto
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - K Eto
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - Y Hiyoshi
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - Y Nagai
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - T Ishimoto
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - M Iwatsuki
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - S Iwagami
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - Y Miyamoto
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - N Yoshida
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan
| | - Y Komohara
- Department of Cell Pathology, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumumato, Japan
| | - M Watanabe
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumumato, Japan.,Centre for Metabolic Regulation of Healthy Ageing, Kumamoto University, Kumumato, Japan
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36
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Izumida E, Suzawa T, Miyamoto Y, Yamada A, Otsu M, Saito T, Yamaguchi T, Nishimura K, Ohtaka M, Nakanishi M, Yoshimura K, Sasa K, Takimoto R, Uyama R, Shirota T, Maki K, Kamijo R. Functional Analysis of PTH1R Variants Found in Primary Failure of Eruption. J Dent Res 2020; 99:429-436. [PMID: 31986066 DOI: 10.1177/0022034520901731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although many variants of the parathyroid hormone 1 receptor (PTH1R) gene are known to be associated with primary failure of eruption (PFE), the mechanisms underlying the link remains poorly understood. We here performed functional analyses of PTH1R variants reported in PFE patients-namely, 356C>T (P119L), 395C>T (P132L), 439C>T (R147C), and 1148G>A (R383Q)-using HeLa cells with a lentiviral vector-mediated genetic modification. Two particular variants, P119L and P132L, had severe reduction in a level of N-linked glycosylation when compared with wild-type PTH1R, whereas the other 2 showed modest alteration. PTH1R having P119L or P132L showed marked decrease in the affinity to PTH1-34, which likely led to severely impaired cAMP accumulation upon stimulation in cells expressing these mutants, highlighting the importance of these 2 amino acid residues for ligand-mediated proper functioning of PTH1R. To further gain insights into PTH1R functions, we established the induced pluripotent stem cell (iPSC) lines from a patient with PFE and the heterozygous P132L mutation. When differentiated into osteoblastic-lineage cells, PFE-iPSCs showed no abnormality in mineralization. The mRNA expression of RUNX2, SP7, and BGLAP, the osteoblastic differentiation-related genes, and that of PTH1R were augmented in both PFE-iPSC-derived cells and control iPSC-derived cells in the presence of bone morphogenetic protein 2. Also, active vitamin D3 induced the expression of RANKL, a major key factor for osteoclastogenesis, equally in osteoblastic cells derived from control and PFE-iPSCs. In sharp contrast, exposure to PTH1-34 resulted in no induction of RANKL mRNA expression in the cells expressing P132L variant PTH1R, consistent with the idea that a type of heterozygous PTH1R gene mutation would spoil PTH-dependent response in osteoblasts. Collectively, this study demonstrates a link between PFE-associated genetic alteration and causative functional impairment of PTH1R, as well as a utility of iPSC-based disease modeling for future elucidation of pathogenesis in genetic disorders, including PFE.
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Affiliation(s)
- E Izumida
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - T Suzawa
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Y Miyamoto
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - A Yamada
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - M Otsu
- Stem Cell Bank & Division of Stem Cell Processing, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Present address: Department of Transfusion and Cell Transplantation, School of Medicine, Kitasato University, Sagamihara, Japan
| | - T Saito
- Division of Tissue Engineering, Department of Bone and Cartilage Regenerative Medicine, University of Tokyo Hospital, The University of Tokyo, Tokyo, Japan
| | - T Yamaguchi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - K Nishimura
- Laboratory for Gene Regulation, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - M Ohtaka
- TOKIWA-Bio, Inc., Tsukuba, Japan
| | - M Nakanishi
- Biotechnology Research Institute for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - K Yoshimura
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - K Sasa
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - R Takimoto
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan
| | - R Uyama
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - T Shirota
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan
| | - K Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - R Kamijo
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
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37
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Tokunaga R, Nakagawa S, Miyamoto Y, Ohuchi M, Izumi D, Kosumi K, Taki K, Higashi T, Miyata T, Yoshida N, Baba H. The clinical impact of preoperative body composition differs between male and female colorectal cancer patients. Colorectal Dis 2020; 22:62-70. [PMID: 31344314 DOI: 10.1111/codi.14793] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022]
Abstract
AIM Patient body composition is an important indicator of metabolic status and is associated with cancer progression. Because body composition varies between men and women, we aimed to examine the difference in clinical impact of preoperative body composition according to sex. METHOD We used an integrated dataset of 559 colorectal cancer (CRC) patients. The association between preoperative body composition indices [body mass index (BMI), visceral to subcutaneous fat area ratio (VSR) and skeletal muscle index (SMI)] and patient outcome, clinicopathological factors and preoperative inflammation and nutritional status was analysed, comparing men and women. RESULTS Preoperative low BMI and low SMI in men was significantly associated with unfavourable overall survival (OS) [BMI: hazard ratio (HR) 2.22, 95% CI 1.28-4.14, P = 0.004; SMI: HR 2.54, 95% CI 1.61-4.07, P < 0.001] and high VSR in women was significantly associated with unfavourable OS (HR 1.79, 95% CI 1.03-3.02, P = 0.040). Additionally, low SMI in men was significantly associated with deeper tumour invasion and greater distant metastasis and high VSR in women was significantly associated with advanced age, right-sided tumour, lower total lymphocyte count and lower albumin levels. Interestingly, low BMI in men was significantly associated with deeper tumour invasion, but also with favourable inflammation and nutritional status (lower C-reactive protein and higher albumin). CONCLUSION The clinical impact of preoperative body composition differed between men and women: SMI in men and VSR in women were good prognosticators. Our findings may provide a novel insight for CRC treatment strategies.
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Affiliation(s)
- R Tokunaga
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - S Nakagawa
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - M Ohuchi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - D Izumi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - K Kosumi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - K Taki
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - T Higashi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - T Miyata
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - N Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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38
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Makino H, Tanaka A, Asakura K, Koezuka R, Tochiya M, Ohata Y, Tamanaha T, Son C, Shimabara Y, Fujita T, Miyamoto Y, Kobayashi J, Hosoda K. Addition of low-dose liraglutide to insulin therapy is useful for glycaemic control during the peri-operative period: effect of glucagon-like peptide-1 receptor agonist therapy on glycaemic control in patients undergoing cardiac surgery (GLOLIA study). Diabet Med 2019; 36:1621-1628. [PMID: 31335979 DOI: 10.1111/dme.14084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 01/20/2023]
Abstract
AIM To test the hypothesis that the addition of a glucagon-like peptide-1 receptor agonist that can decrease glucose levels without increasing the hypoglycaemia risk will achieve appropriate glycaemic control during the peri-operative period. METHODS We studied 70 people with Type 2 diabetes who underwent elective cardiac surgery. Participants were randomized to either an insulin-alone or an insulin plus liraglutide 0.6 mg/day group. We evaluated average M values, which indicated the proximity index of the target glucose level from day 1 to day 10. RESULTS The average M value in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (liraglutide plus insulin 5.8 vs insulin-alone 12.3; P < 0.001). The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (odds ratio 0.19, 95% CI 0.08-0.49; P < 0.001). The frequency of hypoglycaemia in the liraglutide plus insulin group tended to be lower than that in the insulin-alone group (odds ratio 0.57, 95% CI 0.15-2.23; P = 0.21). CONCLUSIONS The results of this study showed that the addition of low-dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low-dose liraglutide may achieve better glycaemic control during the peri-operative period. (Clinical trials registry no.: UMIN 000008003).
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Affiliation(s)
- H Makino
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - A Tanaka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Asakura
- Department of, Data Science, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - R Koezuka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - M Tochiya
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Ohata
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Tamanaha
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - C Son
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Shimabara
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Fujita
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Miyamoto
- Department of, Preventive Cardiology, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - J Kobayashi
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Hosoda
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
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39
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Zhang Y, Miyamoto Y, Ihara S, Yang JZ, Zuill DE, Angsantikul P, Zhang Q, Gao W, Zhang L, Eckmann L. Composite thermoresponsive hydrogel with auranofin-loaded nanoparticles for topical treatment of vaginal trichomonad infection. Adv Ther (Weinh) 2019; 2:1900157. [PMID: 32377561 PMCID: PMC7202563 DOI: 10.1002/adtp.201900157] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Indexed: 12/17/2022]
Abstract
Trichomonas vaginalis is responsible for the most common non-viral sexually-transmitted disease worldwide. Standard treatment is with oral nitro-heterocyclic compounds, metronidazole or tinidazole, but resistance to these drugs is emerging and adverse effects can be problematic. Topical treatment offers potential benefits for increasing local drug concentrations and efficacy, while reducing systemic drug exposure, but no topical strategies are currently approved for trichomoniasis. The anti-rheumatic drug, auranofin (AF), was recently discovered to have significant trichomonacidal activity, but has a long plasma half-life and significant adverse effects. Here, we used this drug as a model to develop a novel topical formulation composed of AF-loaded nanoparticles (NP) embedded in a thermoresponsive hydrogel for intravaginal administration. The AF-NP composite gel showed sustained drug release for at least 12 h, and underwent sol-gel transition with increased viscoelasticity within a minute. Intravaginal administration in mice showed excellent NP retention for >6 h and markedly increased local AF levels, but reduced plasma and liver levels compared to oral treatment with a much higher dose. Furthermore, intravaginal AF-NP gel greatly outperformed oral AF in eliminating vaginal trichomonad infection in mice, while causing no systemic or local toxicity. These results show the potential of the AF-NP hydrogel formulation for effective topical therapy of vaginal infections.
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Affiliation(s)
- Yue Zhang
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California 92093, USA
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, La Jolla, California 92093, USA
| | - Sozaburo Ihara
- Department of Medicine, University of California San Diego, La Jolla, California 92093, USA
| | - Justin Z Yang
- Department of Medicine, University of California San Diego, La Jolla, California 92093, USA
| | - Douglas E Zuill
- Department of Medicine, University of California San Diego, La Jolla, California 92093, USA
| | - Pavimol Angsantikul
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California 92093, USA
| | - Qiangzhe Zhang
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California 92093, USA
| | - Weiwei Gao
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California 92093, USA
| | - Liangfang Zhang
- Department of NanoEngineering and Moores Cancer Center, University of California San Diego, La Jolla, California 92093, USA
| | - Lars Eckmann
- Department of Medicine, University of California San Diego, La Jolla, California 92093, USA
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40
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Duan Y, Llorente C, Lang S, Brandl K, Chu H, Jiang L, White RC, Clarke TH, Nguyen K, Torralba M, Shao Y, Liu J, Hernandez-Morales A, Lessor L, Rahman IR, Miyamoto Y, Ly M, Gao B, Sun W, Kiesel R, Hutmacher F, Lee S, Ventura-Cots M, Bosques-Padilla F, Verna EC, Abraldes JG, Brown RS, Vargas V, Altamirano J, Caballería J, Shawcross DL, Ho SB, Louvet A, Lucey MR, Mathurin P, Garcia-Tsao G, Bataller R, Tu XM, Eckmann L, van der Donk WA, Young R, Lawley TD, Stärkel P, Pride D, Fouts DE, Schnabl B. Bacteriophage targeting of gut bacterium attenuates alcoholic liver disease. Nature 2019; 575:505-511. [PMID: 31723265 PMCID: PMC6872939 DOI: 10.1038/s41586-019-1742-x] [Citation(s) in RCA: 429] [Impact Index Per Article: 85.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022]
Abstract
Chronic liver disease due to alcohol use disorder contributes markedly to the global burden of disease and mortality1–3. Alcoholic hepatitis is a severe and life-threatening form of alcohol-associated liver disease. The gut microbiota promotes ethanol-induced liver disease in mice4, but little is known about microbial factors responsible for this process. We identified cytolysin, a two-subunit exotoxin secreted by Enterococcus faecalis (E. faecalis)5,6, to cause hepatocyte death and liver injury. Compared with controls, patients with alcoholic hepatitis have increased fecal numbers of E. faecalis. The presence of cytolysin-positive (cytolytic) E. faecalis correlated with liver disease severity and mortality in patients with alcoholic hepatitis. Using humanized mice colonized with bacteria from feces of patients with alcoholic hepatitis, we investigated the therapeutic effects of bacteriophages that target cytolytic E. faecalis. We found these phages to decrease cytolysin in the liver and abolish ethanol-induced liver disease in humanized mice. Our findings link cytolysin-positive E. faecalis with worse clinical outcomes and mortality in patients with alcoholic hepatitis. We show that bacteriophages can specifically target cytolytic E. faecalis, providing a method to precisely edit the intestinal microbiota. A prospective clinical trial with a larger cohort is required to validate human relevance of our findings and to test whether this new therapeutic approach is effective for patients with alcoholic hepatitis.
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Affiliation(s)
- Yi Duan
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Sonja Lang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Katharina Brandl
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA
| | - Huikuan Chu
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Lu Jiang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | | | | | | | | | - Yan Shao
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
| | - Jinyuan Liu
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | | | - Lauren Lessor
- Center for Phage Technology, Texas A & M AgriLife Research and Texas A & M University, College Station, TX, USA
| | - Imran R Rahman
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Melissa Ly
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Bei Gao
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Weizhong Sun
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Roman Kiesel
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Felix Hutmacher
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Suhan Lee
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Meritxell Ventura-Cots
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh Liver Research Center, Pittsburgh, PA, USA
| | - Francisco Bosques-Padilla
- Hospital Universitario, Departamento de Gastroenterología, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Elizabeth C Verna
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Juan G Abraldes
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert S Brown
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, USA
| | - Victor Vargas
- Liver Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Jose Altamirano
- Liver Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan Caballería
- Centro de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.,Liver Unit, Hospital Clinic, Barcelona, Spain
| | - Debbie L Shawcross
- Liver Sciences, Department of Inflammation Biology, School of Infectious Diseases and Microbial Sciences, King's College London, London, UK
| | - Samuel B Ho
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Alexandre Louvet
- Service des Maladies de L'appareil Digestif et Unité INSERM, Hôpital Huriez, Lille, France
| | - Michael R Lucey
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Philippe Mathurin
- Service des Maladies de L'appareil Digestif et Unité INSERM, Hôpital Huriez, Lille, France
| | - Guadalupe Garcia-Tsao
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.,Section of Digestive Diseases, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ramon Bataller
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh Liver Research Center, Pittsburgh, PA, USA
| | - Xin M Tu
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Lars Eckmann
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Wilfred A van der Donk
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Howard Hughes Medical Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ry Young
- Department of Biochemistry and Biophysics, Texas A & M University, College Station, TX, USA.,Center for Phage Technology, Texas A & M AgriLife Research and Texas A & M University, College Station, TX, USA
| | - Trevor D Lawley
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
| | - Peter Stärkel
- St Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - David Pride
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Pathology, University of California San Diego, La Jolla, CA, USA.,Center for Innovative Phage Applications and Therapeutics, University of California San Diego, La Jolla, CA, USA
| | | | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, USA. .,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA. .,Center for Innovative Phage Applications and Therapeutics, University of California San Diego, La Jolla, CA, USA.
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Nishikawa T, Miyamatsu N, Higashiyama A, Nishida Y, Kubota Y, Hirata T, Sugiyama D, Kuwabara K, Miyamoto Y, Okamura T. Age-related and seasonal change in serum osmolarity and water intake in a healthy population. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.445] [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: 11/14/2022] Open
Abstract
Abstract
Background and aim
Few studies have clarified the seasonal and age-related change of serum osmolarity and water intake, which is thought to be associated with heat stroke and ischemic stroke. We investigated the association between them in a healthy population.
Methods
We conducted a cross-sectional study using database from Kobe Orthopedic and Biomedical Epidemiologic (KOBE) Study. Among 1138 healthy Japanese participants in the baseline survey, 1010 (women 704 and men 306) participants were eligible for the present study. Daily non-alcohol drink (NAD) intake was estimated according to food frequency questionnaire. Alcohol beverage and water in the meal or soup were excluded from the counting. Serum osmolarity (Osm/L) was calculated by Worthley’s formula: 2 (serum sodium (mEq/L)) + (blood urea nitrogen (mg/dL))/2.8 + (glucose (mg/dL))/18. The seasons the surveys were conducted were categorized into 4 groups, March-May (Spring), June-August (Summer), September-November (Autumn), and December-February (Winter). The association between serum osmolarity and daily NAD intake was analyzed using linear regression models.
Results
The seasonal change was observed in the serum osmolarity and daily NAD intake; serum osmolarity increased in spring and summer and daily NAD intake increased in summer. The serum osmolarity increased by aging in any seasons, while daily water intake didn’t. There was no significant association observed between serum osmolarity and the daily NAD intake, even after adjusting for sex, age, and season.
Conclusions
Serum osmolarity showed seasonal and age-related changes, but the serum osmolarity in subjects who had the daily habit of high NAD intake was not necessarily low.
Key messages
Serum osmolarity increased by aging and in spring and summer. Serum osmolarity was not associated with non-alcohol drink intake.
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Affiliation(s)
- T Nishikawa
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Faculty of Health Science, Kyoto Koka Women’s University, Kyoto, Japan
| | - N Miyamatsu
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Japan
| | - A Higashiyama
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Preventive Medicine and Epidemiologic Informat, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Nishida
- Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Y Kubota
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - T Hirata
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku M, Tohoku University, Sendai, Japan
| | - D Sugiyama
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Faculty of Nursing And Medical Care, Keio University, Tokyo, Japan
| | - K Kuwabara
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
| | - Y Miyamoto
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Preventive Medicine and Epidemiologic Informat, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Okamura
- Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
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Ishikawa H, Tsuji D, Miyagi T, Kawasaki Y, Yamamoto K, Nakao M, Nakagaki S, Hayashi T, Ayuhara H, Harada T, Tamaki S, Maeda A, Ohashi Y, Arakawa Y, Fujita Y, Miyamoto Y, Yano T, Tanaka R, Itou K. Irinotecan and cisplatin therapy-induced neutropenia as a prognostic factor in patients with extensive-disease small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz420.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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43
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Makiyama A, Oki E, Miyamoto Y, Kotaka M, Kawanaka H, Miwa K, Kabashima A, Noguchi T, Yuge K, Kashiwada T, Shimokawa M, Saeki H, Akagi Y, Baba H, Mori M. Bevacizumab plus trifluridine/tipiracil in elderly patients with previously untreated metastatic colorectal cancer (KSCC 1602): A single-arm, phase II study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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44
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Akao M, Ogawa H, Suzuki S, Yamashita T, Kodani E, Tsuda T, Hayashi K, Furusho H, Sawano M, Fukuda K, Nakai M, Miyamoto Y, Tomita H, Okumura K. P3755Left atrial enlargement as an independent risk factor for ischemic stroke in Japanese atrial fibrillation patients: pooled analysis of five major Japanese atrial fibrillation registries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) increases the risk of ischemic stroke. It remains unknown whether left atrial diameter determined by routine trans-thoracic echocardiography is a risk factor for ischemic stroke in non-valvular AF (NVAF) patients.
Purpose
The aim of this study is to investigate the impact of left atrial enlargement (LAE) on the incidence of ischemic stroke in a large-scale cohort of Japanese NVAF patients.
Methods
We combined the data of 5 major AF registries in Japan, J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and Hokuriku AF Registry. After excluding patients without echocardiographic data, 7,672 NVAF patients were analyzed in the present study (mean age, 69.3±12.3 years; mean CHADS2 score, 1.6±1.3). We compared clinical characteristics and the incidence of ischemic stroke between NVAF patients with LAE (left atrial diameter >45 mm; LAE group) and those without (non-LAE group).
Results
The mean left atrial diameter was 43.1±8.6 mm, and the LAE group accounted for 40.0% (n=3,066) of the entire cohort. Compared with non-LAE group (60.0%, n=4,606), the LAE group was older (LAE vs. non-LAE; 70.3±12.0 vs. 68.0±12.5, p<0.01), more often non-paroxysmal type (73.7% vs. 32.1%, p<0.01), had higher CHADS2 (1.86±1.34 vs. 1.46±1.29, p<0.01) and CHA2DS2-VASc (3.02±1.83 vs. 2.53±1.78, p<0.01) scores, and more frequently received oral anticoagulant (72.9% vs. 55.0%, p<0.01).
During the median follow-up period of 774.5 days (interquartile range: 567–1466 days), ischemic stroke occurred in 241 patients (131 vs. 110 patients; 1.52 vs. 0.82 per 100 person-years). In Kaplan Meier analysis, LAE was associated with a higher incidence of ischemic stroke (unadjusted hazard ratio (HR): 1.83, 95% confidence interval (CI): 1.42–2.36; log rank p<0.01) (Figure). LAE was independently associated with increased risk of ischemic stroke (adjusted HR: 1.63, 95% CI: 1.25–2.11; p<0.01) after adjustment by the components of CHADS2 score and the use of oral anticoagulant, on multivariate Cox proportional hazard analysis.
Conclusion
In this large-scale cohort of Japanese patients with AF, LAE was an independent predictor of ischemic stroke, suggesting that this simple echocardiographic parameter could refine thromboembolic risk stratification of NVAF patients.
Acknowledgement/Funding
Japan Agency for Medical Research and Development, AMED
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Affiliation(s)
- M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Ogawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - S Suzuki
- Cardiovascular Institute, Tokyo, Japan
| | | | - E Kodani
- Nippon Medical School, Tama-Nagayama Hospital, Tama, Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - K Hayashi
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - H Furusho
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | | | | | - M Nakai
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - H Tomita
- Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - K Okumura
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
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Yamaguchi T, Nakai M, Sumita Y, Miyamoto Y, Matsuda H, Inoue Y, Yoshino H, Okita Y, Minatoya K, Ueda Y, Ogino H. P5599Prognostic impact of quality indicators on outcomes of acute aortic dissection in Japan. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Despite recent advances in diagnosis and management, the mortality of acute aortic dissection (AAD) remains high.
Purpose
This study aims to develop quality indicators (QIs) for the management of AAD, and to evaluate the associations between QIs and outcomes of AAD in a Japanese nationwide administrative database.
Methods
A total of 18,348 patients suffered from AAD (Type A: 10,131, Type B: 8,217) in the Japanese Registry of All Cardiac and Vascular Diseases database between 2012 and 2015 were studied. A systematic review was performed to establish initial index items for QIs. Evaluation was performed through the expert consensus meeting using a Delphi method. Associations between developed QIs and the mortality were determined by multivariate mixed logistic regression analyses.
Results
A total of nine QIs (five structural and four processatic) were developed. Achievements of developed QIs (High: 7–9, Middle: 4–6, Low: 0–3) were significantly associated with lower in-hospital mortality even after adjustment for covariates in both type A (Middle: odds ratio [OR], 0.257; 95% confidence interval [CI], 0.211–0.312; P<0.001; High: OR, 0.064; 95% CI, 0.047–0.086; P<0.001 vs. Low) and type B (Middle: OR, 0.447; 95% CI, 0.338–0.590; P<0.001; High: OR, 0.128; 95% CI, 0.077–0.215; P<0.001 vs. Low). Additionally, achievements of structural and processatic QIs were consistently associated with reduced in-hospital mortality.
QIs and in-hospital mortality
Conclusions
Developed QIs for AAD management were significantly associated with lower in-hospital mortality. Evaluation of each hospital's management with QIs could be helpful to equalize quality of treatment and to fill the evidence-to-practice gaps in the real-world treatment.
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Affiliation(s)
- T Yamaguchi
- Toranomon Hospital, Cardiovascular center, Tokyo, Japan
| | - M Nakai
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Sumita
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - H Matsuda
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - H Yoshino
- Kyorin University School of Medicine, Tokyo, Japan
| | - Y Okita
- Kobe University, Kobe, Japan
| | | | - Y Ueda
- Nara Prefecture General Medical Center, Nara, Japan
| | - H Ogino
- Tokyo Medical University Hospital, Tokyo, Japan
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46
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Nakao K, Yasuda S, Noguchi T, Nakai M, Sumita Y, Nakao YM, Nishimura K, Miyamoto Y, Ogawa H. 6131Association between hospital care quality and readmission among Japanese patients with heart failure. From JROAD-DPC study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Measuring the process of care has become a widely used practice to improve a quality of care. Recently, some studies have demonstrated poor to no correlation between 30-day readmission rates and quality of care for heart failure (HF) among hospitalized HF patients. However the investigation about relationships of care quality for HF and 1 year outcome is limited.
Purpose
To investigate the relationship between quality of care in each hospitals and readmission among HF patients in Japan.
Methods
From Japanese Registry of All cardiac and vascular diseases (JROAD-DPC) database in 2014, 84,325 HF patients hospitalized to 741 certificated hospitals by Japanese Circulation Society were analyzed. A primary endpoint was readmission for HF in one year. Five performance measures were defined as prescription rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB), prescription rate of beta blocker and prescription rate of spironolactone, measurement rate of echocardiography and measurement rate of B-type natriuretic peptide (BNP) during hospitalization. For each of the five measures, a composite score was created by giving points ranging from 1 to 4 from the lower quartile of rates, with the score ranging from 5 to 20 points. Hazard ratios (HR) indicating the effects of the performance measures were estimated using Cox proportional hazard models. Covariates included age, gender, Charson score, and NYHA class.
Results
In Japanese HF patients (age; 78.1 years old, man 52%), the HF readmission rate in one year was 14,520 (17.2%). The readmission rate decreased with higher quartiles of prescription rate in each medications and performance rates. The highest quartile of each measurements was significantly lower risk for readmission compared to the lowest quartile (ACE/ARB, adjusted HR 0.87 [95% CI, 0.83–0.91], p<0.001; beta-blocker, 0.83 [0.79–0.88], p<0.001; spironolactone, 0.88 [0.83–0.92], p<0.001; echocardiography, 0.90 [0.86–0.94], p<0.001; BNP, 0.92 [0.87–0.96], p<0.001). Kaplan-Meier curves showed that readmission rates were better among higher composite score, compared to lower composite score (Log-rank test=p<0.001). (Figure) Higher composite scores were associated with statistically significant risk reduction of 23% for HF readmission (HR 0.77, 95% CI [0.73–0.81], p<0.001).
Figure 1
Conclusion
The hospital performance measures were associated with a significant risk reduction of readmission in Japanese patients with HF.
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Affiliation(s)
- K Nakao
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - M Nakai
- National Cerebral and Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information, Suita, Japan
| | - Y Sumita
- National Cerebral and Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information, Suita, Japan
| | - Y M Nakao
- National Cerebral and Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information, Suita, Japan
| | - K Nishimura
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information, Suita, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center, Suita, Japan
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47
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Yamashita T, Sakamoto K, Tsujita K, Nakao K, Ozaki Y, Kimura K, Ako J, Noguchi T, Suwa S, Fujimoto K, Okura H, Nishimura K, Miyamoto Y, Ogawa H, Ishihara M. P3392Potential of imaging-guided PCI for event suppression in Japanese acute myocardial infarction patients: J-MINUET substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Intravascular ultrasound (IVUS) and Optical Coherence Tomography (OCT) has been widely used in clinical settings. Although favorable results of imaging-guided percutaneous coronary intervention (PCI) compared with angio-guided PCI were observed in several studies, impacts of institutional-based usage frequency, about imaging-guided PCI, have not been well elucidated.
Methods
To elucidate the impact of imaging-guided PCI and the effects of frequency of its usage, we analyzed data of the Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET). This was a prospective and multicenter registry consisting of 3,283 AMI patients, who were hospitalized within 48 hours of onset from July 2012 to March 2014. Clinical follow-up data was obtained for 3 years. In this sub-study, a total of 2,788 patients who underwent urgent PCI having detailed procedural information were enrolled. We analyzed the differences of utilization rates of imaging-guided PCI among the participating institutions and the impacts for the clinical events. The participating institutions were divided into 3 groups by the frequency of IVUS usage: low frequency institutions: under 50%; moderate frequency institutions: 50% to 90%; and, high frequency institutions: over 90%.
Results
In this cohort registry, patients were enrolled from 28 institutions. The utilization rate of coronary imaging varied widely depending on each institution from 15.4% to 100% (mean 85.7%±24.3, median 97.4%). When the institutions were divided into 3 groups by the frequency of intravascular imaging usage, four low frequency institutions enrolled 295 patients, five moderate frequency institutions enrolled 624 patients, and 19 high frequency institutions enrolled 1,491 patients. Although the incidence of MACE (death, MI, stroke, cardiac failure, or revascularization for unstable angina) decreased stepwise (33.2%, 23.7%, and 19.7%) (gray bar in the Figure), the event rates of the imaging-guided PCI cases among the 3 groups were comparable (21.6%, 21.9%, and 19.6%) (white bar in the Figure). On the other hand, a gradual event reduction between the 3 groups was observed in the angio-guided PCI cases (black bar in the Figure). In comparison of MACE rate between imaging-guided and angio-guided PCI, there were statistically significant differences in the low frequency and moderate frequency institutions (p=0.001 and p=0.012, respectively). In contrast, comparable event rates were observed in the high frequency institutions (p=0.441).
MACE rate by imaging usage frequency
Conclusions
In Japanese ACS patients treated with imaging-guided PCI, better suppression of clinical events during 3-year was found in the institutions with the more frequent use of intravascular imaging, mainly due to stepwise event suppression in the cases of angio-guided PCI. On the other hand, the clinical benefit of coronary imaging was obtained independently of the frequency of use and its experience.
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Affiliation(s)
- T Yamashita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Sakamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - K Kimura
- Yokohama City University Medical Center, Yokohama, Japan
| | - J Ako
- Kitasato University, tokyo, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Suwa
- Juntendo University, Tokyo, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Kumamoto, Japan
| | - H Okura
- Gifu Universiry, Gifu, Japan
| | - K Nishimura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
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48
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Matsumoto M, Hagiwara K, Komuro H, Miyamoto Y, Yamamoto H, Shirahashi K, Doi K, Iwata H. P1.17-41 Preoperative Prognostic Nutritional Index (PNI) as a Prognostic Factor in Patients with Clinical Stage I Non-Small-Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1314] [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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49
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Ishii M, Seki T, Sakamoto K, Kaikita K, Miyamoto Y, Tsujita K, Masuda I, Kawakami K. P4334Effects of Asian dust on blood pressure and blood cell counts: a cross-sectional study of health check-up data. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Asian dust (AD) is one of the health care problems because AD increases risk for mortality, respiratory, and cardiovascular disease. Previous animal studies showed that particulate matter from AD induced oxidative stress and systemic inflammation, increased blood pressure and heart rate, and decreased cardiac contraction. However, few reports show association of AD with increased blood pressure in human healthy subjects.
Purpose
The aim of this study was to investigate effects of AD on blood pressure and blood cell counts in human.
Methods
Using generalized linear models, we estimated the association between short-term exposure to AD and systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and white blood cell (WBC) count in 296,168 participants aged 20 and older (men n=168,579, 56.9%) who underwent medical check-ups and had no anti-hypertensive agents between April 2005 and March 2015 in a health check-up center in Japan. AD days were the days on which AD events occurred, which were defined as decreased visibility (<10km) due to AD monitored by local meteorological observatory. Propensity score matching analysis was performed to reduce the effects of possible confounders such as age, sex, mean temperature, humidity. In multivariable generalized linear models, data of other air pollutant such as SO2, NO2, Ox or suspended particulate matter was used as covariate.
Results
During study period, 61 AD days were observed, and there were 4,670 participants undergoing medical check-ups on AD days. In the propensity score matched population (n=4,670, each), short-term exposure to AD was significantly associated with an increased risk of higher SBP, DBP, HR, or WBC count [β=1.303, 95% confidence interval (CI) 0.577 to 2.029 for SBP, β=0.630, 95% CI 0.122 to 1.138 for DBP, β=0.987, 95% CI 0.410 to 1.563 for HR, β=150.0, 95% CI 64.9 to 235.1 for WBC]. These significant associations were also observed in two-pollutant models. In subgroup analysis according to age, AD exposure had greater impact on SBP, DBP, and HR in younger people (20 to 40 years old), but WBC count in middle-high age (51 years and older).
GLM analysis according to age category
Conclusions
The present study showed that short-term exposure to AD was associated with higher SBP, DBP, HR and WBC count. Short-term exposure to AD may exacerbate sympathetic nervous system for the young and immune system for the elderly.
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Affiliation(s)
- M Ishii
- Kumamoto University Hospital, Kumamoto, Japan
| | - T Seki
- Kyoto University, Kyoto, Japan
| | - K Sakamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University Hospital, Kumamoto, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
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50
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Motozato K, Sakamoto K, Tsujita K, Nakao K, Ozaki Y, Kimura K, Ako J, Noguchi T, Suwa S, Fujimoto K, Nakama Y, Nishimura K, Miyamoto Y, Ogawa H, Ishihara M. P1954Prognostic value of the CHADS2 score for adverse cardiovascular events in acute myocardial infarction patients without atrial fibrillation: J-MINUET Substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The CHADS2score has mainly been used to predict the likelihood of cerebrovascular accidents in patients with atrial fibrillation. However, increasing attention is being paid to this scoring system for risk stratification of patients with coronary artery disease. We investigated the value of the CHADS2 score in predicting cardiovascular events in Japanese acute myocardial infarction (AMI) patients without atrial fibrillation.
Methods
To elucidate the prognostic value of CHADS2score in AMI patients, we analysed data of the Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET). This was a prospective and multicenter registry consisting of 3,283 AMI patients, who were hospitalized within 48-hours of onset from July 2012 to March 2014. We calculated the CHADS2 scores for 3,044 patients without clinical evidence of atrial fibrillation. The presence of heart failure was substituted by Killip classification>2 on admission. Clinical follow-up data was obtained for 3 years. In addition to the in-hospital mortality,we evaluated cardiovascular events, defined as all cause deathor non-fatal MI during 3-year follow up periods.
Results
In this study, enrolled patients were classified into low- (point 0–1), intermediate- (point 2–3), and high-score (point 4–6) groups by calculating CHADS2 score. Overall patients with low, intermediate and high score were divided into 1,395, 1,393 and 256 patients, respectively. In-hospital mortality among low, intermediate, and high score groups were 2.8%, 7.4% and 14.8%, respectively (P<0.001). The incidence of cardiovascular eventsamong low, intermediate, and high score groups were 7.8%, 16.3%, 29.3%, respectively (P<0.001). Kaplan-Meier analysis showed a significant difference between the groups (Figure). The event rates were significantly higher in both high score and intermediate score group than in low score group (P<0.001). Multivariate Cox hazard analysis identified CHADS2 score (per 1 point) as an independent predictor of cardiovascular events in addition to chronic kidney disease and lower body mass index. (hazard ratio, 1.344; 95% CI, 1.239–1.459; P<0.001). Among the factors constituting CHADS2 score, heart failure and age were identified as independent predictors for in-hospital mortality. With respect to the cardiovascular event during 3 years, heart failure, age, and previous stroke were revealed as significant independent predictors.
Conclusion
This large cohort study indicated that the CHADS2 score is useful for the prediction of in-hospital mortality and the cardiovascular events during 3-year follow up in Japanese AMI patients without atrial fibrillation.
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Affiliation(s)
- K Motozato
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Sakamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Y Ozaki
- Fujita Health University Hospital, Toyoake, Japan
| | - K Kimura
- Yokohama City University Medical Center, Yokohama, Japan
| | - J Ako
- Kitasato University, Sagamihara, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Kumamoto, Japan
| | - Y Nakama
- Hiroshima City Hospital, Hiroshima, Japan
| | - K Nishimura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
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