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Ikubo Y, Sanada TJ, Hosomi K, Park J, Naito A, Shoji H, Misawa T, Suda R, Sekine A, Sugiura T, Shigeta A, Nanri H, Sakao S, Tanabe N, Mizuguchi K, Kunisawa J, Suzuki T, Tatsumi K. Altered gut microbiota and its association with inflammation in patients with chronic thromboembolic pulmonary hypertension: a single-center observational study in Japan. BMC Pulm Med 2022; 22:138. [PMID: 35395844 PMCID: PMC8994357 DOI: 10.1186/s12890-022-01932-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background The pathogenesis of chronic thromboembolic pulmonary hypertension (CTEPH) is considered to be associated with chronic inflammation; however, the underlying mechanism remains unclear. Recently, altered gut microbiota were found in patients with pulmonary arterial hypertension (PAH) and in experimental PAH models. The aim of this study was to characterize the gut microbiota in patients with CTEPH and assess the relationship between gut dysbiosis and inflammation in CTEPH. Methods In this observational study, fecal samples were collected from 11 patients with CTEPH and 22 healthy participants. The abundance of gut microbiota in these fecal samples was assessed using 16S ribosomal ribonucleic acid (rRNA) gene sequencing. Inflammatory cytokine and endotoxin levels were also assessed in patients with CTEPH and control participants. Results The levels of serum tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-8, and macrophage inflammatory protein (MIP)-1α were elevated in patients with CTEPH. Plasma endotoxin levels were significantly increased in patients with CTEPH (P < 0.001), and were positively correlated with TNF-α, IL-6, IL-8, and MIP-1α levels. The 16S rRNA gene sequencing and the principal coordinate analysis revealed the distinction in the gut microbiota between patients with CTEPH (P < 0.01) and control participants as well as the decreased bacterial alpha-diversity in patients with CTEPH. A random forest analysis for predicting the distinction in gut microbiota revealed an accuracy of 80.3%. Conclusion The composition of the gut microbiota in patients with CTEPH was distinct from that of healthy participants, which may be associated with the elevated inflammatory cytokines and endotoxins in CTEPH. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01932-0.
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Affiliation(s)
- Yumiko Ikubo
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Takayuki Jujo Sanada
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan.
| | - Koji Hosomi
- Laboratory of Vaccine Materials, Center for Vaccine and Adjuvant Research and Laboratory of Gut Environmental System, National Institutes of Biomedical Innovation, Health, and Nutrition, Osaka, Japan
| | - Jonguk Park
- Laboratory of Bioinformatics, Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Akira Naito
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Hiroki Shoji
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Tomoko Misawa
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Rika Suda
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan.,Department of Respirology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Ayumi Sekine
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Ayako Shigeta
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Hinako Nanri
- Section of Energy Metabolism, Department of Nutrition and Metabolism, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan.,Department of Respirology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Kenji Mizuguchi
- Laboratory of Bioinformatics, Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan.,Institute for Protein Research, Osaka University, Osaka, Japan
| | - Jun Kunisawa
- Laboratory of Vaccine Materials, Center for Vaccine and Adjuvant Research and Laboratory of Gut Environmental System, National Institutes of Biomedical Innovation, Health, and Nutrition, Osaka, Japan
| | - Takuji Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba City, 260-8670, Japan
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2
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Ikubo Y, Sanada TJ, Tanabe N, Naito A, Shoji H, Nagata J, Kuriyama A, Yanagisawa A, Kobayashi T, Yamamoto K, Kasai H, Suda R, Sekine A, Sugiura T, Shigeta A, Ishida K, Sakao S, Masuda M, Tatsumi K. The extent of enlarged bronchial arteries is not correlated with the development of reperfusion pulmonary edema after pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension. Pulm Circ 2020; 10:2045894020968677. [PMID: 33282195 PMCID: PMC7682219 DOI: 10.1177/2045894020968677] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/03/2020] [Indexed: 11/16/2022] Open
Abstract
This study investigated whether dilated bronchial arteries are associated with reperfusion pulmonary edema in patients with chronic thromboembolic pulmonary hypertension. Results showed that the extent of enlarged bronchial arteries was not associated with the development of reperfusion pulmonary edema, whereas the residual pulmonary hypertension had a significant association.
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Affiliation(s)
- Yumiko Ikubo
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Takayuki J Sanada
- Department of Respirology, Graduate School of Medicine, Chiba, Japan.,Department of Pulmonology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba, Japan.,Department of Respirology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Akira Naito
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Hiroki Shoji
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Jun Nagata
- Department of Respirology, Graduate School of Medicine, Chiba, Japan.,Department of Respirology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Ayaka Kuriyama
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Asako Yanagisawa
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | | | - Keiko Yamamoto
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Hajime Kasai
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Rika Suda
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Ayumi Sekine
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba, Japan.,Department of Respirology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Ayako Shigeta
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Keiichi Ishida
- Department of Cardiovascular Surgery, Chiba University, Chiba, Japan.,Department of Cardiovascular Surgery, Eastern Chiba Medical Center, Togane, Japan
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
| | - Masahisa Masuda
- Department of Cardiovascular Surgery, Chiba University, Chiba, Japan.,Department of Cardiovascular Surgery, Eastern Chiba Medical Center, Togane, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba, Japan
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3
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Takahashi Y, Yamamoto K, Tanabe N, Suda R, Koshikawa K, Ikubo Y, Suzuki E, Shoji H, Naito A, Kasai H, Nishimura R, Sanada TJ, Sugiura T, Shigeta A, Sakao S, Tatsumi K. Characteristics of Japanese elderly patients with pulmonary arterial hypertension. Pulm Circ 2020; 10:2045894020954158. [PMID: 33841797 DOI: 10.1177/2045894019873546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/06/2019] [Indexed: 11/17/2022] Open
Abstract
Previous nationwide Japanese data suggested that pulmonary arterial hypertension (PAH) predominantly affects young women. However, the number of elderly patients diagnosed with PAH has been increasing in western countries. There have been no reports on elderly PAH patients in Asian countries. This study aimed to investigate the clinical characteristics of elderly PAH patients in a Japanese cohort. Idiopathic/heritable PAH (I/H-PAH) was included in the national research project on intractable diseases. The patients were required to submit a clinical research form completed by their attending physicians. We analyzed the characteristics of Japanese I/H-PAH using the newly registered forms in 2013 (Study 1, n = 148). Also, we did a retrospective, observational cohort study at Chiba University Hospital (Study 2, n = 42). We compared the characteristics of elderly PAH patients (≥65 years old) with younger patients (<65) in both studies. Study 1 revealed a predominance of males (51% male), better hemodynamics and poorer exercise capacity in the elderly group (n = 72), compared with the younger group (n = 76) in study 1. In Study 2, elderly patients showed a male predominance (63% male), a higher ratio of smokers, a lower % carbon monoxide diffusing capacity, and poorer exercise tolerance. Elderly patients in Study 2 showed less improvement in hemodynamics with therapy. There was no significant difference in disease-specific survival between elderly and younger patients. Japanese elderly patients with I/H-PAH showed poorer exercise capacity and impaired gas exchange, but better pulmonary hemodynamics than younger patients.
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Affiliation(s)
- Yukiko Takahashi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Keiko Yamamoto
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Respirology, Chibaken Saiseikai Narashino Hospital, Chiba, Japan
| | - Rika Suda
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ken Koshikawa
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yumiko Ikubo
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiko Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroki Shoji
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akira Naito
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hajime Kasai
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Rintaro Nishimura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayuki Jujo Sanada
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ayako Shigeta
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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4
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Sanada TJ, Hosomi K, Shoji H, Park J, Naito A, Ikubo Y, Yanagisawa A, Kobayashi T, Miwa H, Suda R, Sakao S, Mizuguchi K, Kunisawa J, Tanabe N, Tatsumi K. Gut microbiota modification suppresses the development of pulmonary arterial hypertension in an SU5416/hypoxia rat model. Pulm Circ 2020; 10:2045894020929147. [PMID: 32922743 PMCID: PMC7457673 DOI: 10.1177/2045894020929147] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/01/2020] [Indexed: 02/06/2023] Open
Abstract
The pathogenesis of pulmonary arterial hypertension is closely associated with dysregulated inflammation. Recently, abnormal alterations in gut microbiome composition and function were reported in a pulmonary arterial hypertension experimental animal model. However, it remains unclear whether these alterations are a result or the cause of pulmonary arterial hypertension. The purpose of this study was to investigate whether alterations in the gut microbiome affected the hemodynamics in SU5416/hypoxia rats. We used the SU5416/hypoxia rat model in our study. SU5416/hypoxia rats were treated with a single SU5416 injection (30 mg/kg) and a three-week hypoxia exposure (10% O2). Three SU5416/hypoxia rats were treated with a combination of four antibiotics (SU5416/hypoxia + ABx group) for four weeks. Another group was exposed to hypoxia (10% O2) without the SU5416 treatment, and control rats received no treatment. Fecal samples were collected from each animal, and the gut microbiota composition was analyzed by 16S rRNA sequencing. The antibiotic treatment significantly suppressed the vascular remodeling, right ventricular hypertrophy, and increase in the right ventricular systolic pressure in SU5416/hypoxia rats. 16S rRNA sequencing analysis revealed gut microbiota modification in SU5416/hypoxia + ABx group. The Firmicutes-to-Bacteroidetes ratio in SU5416/hypoxia rats was significantly higher than that in control and hypoxia rats. Compared with the control microbiota, 14 bacterial genera, including Bacteroides and Akkermansia, increased, whereas seven bacteria, including Rothia and Prevotellaceae, decreased in abundance in SU5416/hypoxia rats. Antibiotic-induced modification of the gut microbiota suppresses the development of pulmonary arterial hypertension. Dysbiosis may play a causal role in the development and progression of pulmonary arterial hypertension.
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Affiliation(s)
- Takayuki J. Sanada
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
- Department of Pulmonology, Institute for
Cardiovascular Research (ICaR-VU)/VU University Medical Center, Amsterdam, the
Netherlands
| | - Koji Hosomi
- Center for Vaccine and Adjuvant Research and
Laboratory of Gut Environmental System, National Institutes of Biomedical Innovation,
Health, and Nutrition, Osaka, Japan
| | - Hiroki Shoji
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
| | - Jonguk Park
- Artificial Intelligence Center for Health and
Biomedical Research, National Institutes of Biomedical Innovation, Health, and Nutrition,
Osaka, Japan
| | - Akira Naito
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
| | - Yumiko Ikubo
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
| | - Asako Yanagisawa
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
| | | | - Hideki Miwa
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
| | - Rika Suda
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
| | - Kenji Mizuguchi
- Artificial Intelligence Center for Health and
Biomedical Research, National Institutes of Biomedical Innovation, Health, and Nutrition,
Osaka, Japan
- Institute for Protein Research,
Osaka
University, Osaka, Japan
| | - Jun Kunisawa
- Center for Vaccine and Adjuvant Research and
Laboratory of Gut Environmental System, National Institutes of Biomedical Innovation,
Health, and Nutrition, Osaka, Japan
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
- Department of Respirology,
Chibaken
Saiseikai Narashino Hospital, Narashino, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of
Medicine, Chiba, Japan
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5
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Ikubo Y, Kasai H, Sugiura T, Saito T, Shoji H, Sakao S, Kasahara Y, Tanabe N, Tatsumi K. Pulmonary Hypertension that Developed During Treatment for Hepatopulmonary Syndrome and Pulmonary Arteriovenous Malformation. Intern Med 2019; 58:1765-1769. [PMID: 30799344 PMCID: PMC6630123 DOI: 10.2169/internalmedicine.1993-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hepatopulmonary syndrome (HPS) and pulmonary arteriovenous malformation (PAVM) are hypoxemic diseases caused by right-to-left shunting but are rarely concomitant with pulmonary hypertension (PH). A 66-year-old woman with chronic hepatitis C was scheduled to undergo liver transplantation. She was referred to our department for hypoxia and an abnormal shadow in the right lung found on a preoperative examination. She was diagnosed with HPS and a PAVM in the right middle lobe. After liver transplantation, PH temporarily developed, but the pulmonary arterial pressure normalized after coil embolization. Combined HPS and PAVM may cause unique changes in pulmonary hemodynamics during treatment.
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Affiliation(s)
- Yumiko Ikubo
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
| | - Hajime Kasai
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
| | - Takahiko Saito
- Department of Medicine, School of Medicine, Chiba University, Japan
| | - Hiroki Shoji
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
| | - Yasunori Kasahara
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
- Department of Respiratory Medicine, Eastern Chiba Medical Center, Japan
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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