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Takehara K, Koga Y, Hachisu Y, Utsugi M, Sawada Y, Saito Y, Yoshimi S, Yatomi M, Tsurumaki H, Shin Y, Wakamatsu I, Kasahara N, Yamaguchi K, Umetsu K, Kouno S, Nakagawa J, Sunaga N, Maeno T, Hisada T. Glasgow prognostic score and body mass index predict short-term discontinuation of the antifibrotic agents pirfenidone and nintedanib. Respir Investig 2024; 62:388-394. [PMID: 38460356 DOI: 10.1016/j.resinv.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/19/2024] [Accepted: 02/17/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND The antifibrotic agents pirfenidone and nintedanib have been shown to be effective in patients with idiopathic pulmonary fibrosis (IPF). However, discontinuation of antifibrotic drugs is a major clinical concern because of the lack of alternative treatment options. Therefore, we identified factors that may be useful for predicting the termination of antifibrotic agents. METHODS We retrospectively recruited 280 IPF patients treated with antifibrotic drugs between 2009 and 2018 from seven regional core hospitals in Gunma prefecture, Japan. RESULTS At four months, the short-term discontinuation group exhibited a significantly worse prognosis in the pirfenidone group and a poorer prognosis in the nintedanib group compared to that in the continuation group. The discontinuation group of pirfenidone at 4 months exhibited lower albumin and higher C-reactive protein (CRP) levels in the sera compared to the group that continued treatment for more than 4 months. In multivariate analysis, the Glasgow prognostic score (GPS), well known as a predictor of cancer prognosis, which comprises serum CRP and albumin levels, predicted early discontinuation and prognosis in the pirfenidone group, whereas the body mass index (BMI) predicted early discontinuation of nintedanib. A high GPS, with both albumin <3.5 g/dL and CRP >1.0 mg/dL, was associated with a poorer prognosis in the pirfenidone group. CONCLUSION GPS and BMI were significant factors for short-term pirfenidone and nintedanib discontinuation, respectively. Initial evaluation of GPS and BMI prior to antifibrotic therapy may contribute to less interrupted IPF management, thus leading to better prognostic outcomes in patients with IPF.
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Affiliation(s)
- Kazutaka Takehara
- Department of Respiratory Medicine, Public Tomioka General Hospital, 2073-1, Tomioka, Tomioka, Gunma 370-2393, Japan; Department of Respiratory Medicine, Kiryu Kosei General Hospital, 6-3, Orihime-machi, Kiryu, Gunma 376-0024, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan.
| | - Yoshimasa Hachisu
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Mitsuyoshi Utsugi
- Department of Respiratory Medicine, Kiryu Kosei General Hospital, 6-3, Orihime-machi, Kiryu, Gunma 376-0024, Japan; Department of Respiratory Medicine, Gunma Saiseikai Maebashi Hospital, 564-1, Kamishindenmachi, Maebashi, Gunma, 371-0821, Japan
| | - Yuri Sawada
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Yasuyuki Saito
- Department of Respiratory Medicine, Isesaki Municipal Hospital, Tsunatorihonchou 12-1, Isesaki, Gunma 372-0817, Japan
| | - Seishi Yoshimi
- Department of Respiratory Medicine, Tone Chuo Hospital, 910-1 Numasu-machi, Numata, Gunma 378-0012, Japan
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Yuki Shin
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Ikuo Wakamatsu
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Norimitsu Kasahara
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Koichi Yamaguchi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Kazue Umetsu
- Department of Respiratory Medicine, Fujioka General Hospital, 813-1, Nakakurisu Fujioka, Gunma 375-8503, Japan
| | - Shunichi Kouno
- Department of Respiratory Medicine, Fujioka General Hospital, 813-1, Nakakurisu Fujioka, Gunma 375-8503, Japan
| | - Junichi Nakagawa
- Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki, Gunma, 370-0829, Japan
| | - Noriaki Sunaga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Toshitaka Maeno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, 3-39-22 sho-wa machi Maebashi, Gunma 371-8514, Japan
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Yatomi M, Akasaka K, Sato S, Chida M, Kanbe M, Sawada H, Yokota I, Wakamatsu I, Muto S, Sato M, Yamaguchi K, Miura Y, Tsurumaki H, Sakurai R, Hara K, Koga Y, Sunaga N, Yamakawa H, Matsushima H, Yamazaki S, Endo Y, Motegi SI, Hisada T, Maeno T. A case of autoimmune pulmonary alveolar proteinosis during the course of treatment of rapidly progressive interstitial pneumonia associated with anti-MDA5 antibody-positive dermatomyositis. BMC Pulm Med 2024; 24:170. [PMID: 38589870 PMCID: PMC11003183 DOI: 10.1186/s12890-024-02989-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Autoimmune pulmonary alveolar proteinosis (APAP) is a diffuse lung disease that causes abnormal accumulation of lipoproteins in the alveoli; however, its pathogenesis remains unclear. Recently, APAP cases have been reported during the course of dermatomyositis. The combination of these two diseases may be coincidental; however, it may have been overlooked because differentiating APAP from a flare-up of interstitial pneumonia associated with dermatomyositis is challenging. This didactic case demonstrates the need for early APAP scrutiny. CASE PRESENTATION A 50-year-old woman was diagnosed with anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive dermatitis and interstitial pneumonia in April 2021. The patient was treated with corticosteroids, tacrolimus, and cyclophosphamide pulse therapy for interstitial pneumonia complicated by MDA5 antibody-positive dermatitis, which improved the symptoms and interstitial pneumonia. Eight months after the start of treatment, a new interstitial shadow appeared that worsened. Therefore, three additional courses of cyclophosphamide pulse therapy were administered; however, the respiratory symptoms and interstitial shadows did not improve. Respiratory failure progressed, and 14 months after treatment initiation, bronchoscopy revealed turbid alveolar lavage fluid, numerous foamy macrophages, and numerous periodic acid-Schiff-positive unstructured materials. Blood test results revealed high anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) antibody levels, leading to a diagnosis of APAP. The patient underwent whole-lung lavage, and the respiratory disturbance promptly improved. Anti-GM-CSF antibodies were measured from the cryopreserved serum samples collected at the time of diagnosis of anti-MDA5 antibody-positive dermatitis, and 10 months later, both values were significantly higher than normal. CONCLUSIONS This is the first report of anti-MDA5 antibody-positive dermatomyositis complicated by interstitial pneumonia with APAP, which may develop during immunosuppressive therapy and be misdiagnosed as a re-exacerbation of interstitial pneumonia. In anti-MDA5 antibody-positive dermatomyositis, APAP comorbidity may have been overlooked, and early evaluation with bronchoalveolar lavage fluid and anti-GM-CSF antibody measurements should be considered, keeping the development of APAP in mind.
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Affiliation(s)
- Masakiyo Yatomi
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan.
| | - Keiichi Akasaka
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-Ku, Saitama, 330-8553, Japan
| | - Shintaro Sato
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-Ku, Saitama, 330-8553, Japan
| | - Mizuki Chida
- Department of Dermatology, Gunma University Graduate School of Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Mio Kanbe
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Hiru Sawada
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Itaru Yokota
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Ikuo Wakamatsu
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Sohei Muto
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Mari Sato
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Kochi Yamaguchi
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Yosuke Miura
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Hiroaki Tsurumaki
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Reiko Sakurai
- Oncology Center, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371-, 8511, Japan
| | - Kenichiro Hara
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Yasuhiko Koga
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Noriaki Sunaga
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Hideaki Yamakawa
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-Ku, Saitama, 330-8553, Japan
| | - Hidekazu Matsushima
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-Ku, Saitama, 330-8553, Japan
| | - Sahori Yamazaki
- Department of Dermatology, Gunma University Graduate School of Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Yukie Endo
- Department of Dermatology, Gunma University Graduate School of Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Gunma University Graduate School of Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8514, Japan
| | - Toshitaka Maeno
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15 Showa-Machi, Maebashi, Gunma, 371- 8511, Japan
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Sunaga N, Miura Y, Sakurai R, Ohshima S, Uno S, Muto S, Sato M, Tsurumaki H, Yatomi M, Koga Y, Ohtaki Y, Nagashima T, Okano N, Kubo N, Maeno T, Hisada T. Sustained antitumor response to lenvatinib with weekend-off and alternate-day administration in chemotherapy-refractory thymic carcinoma: a case report. Anticancer Drugs 2023; 34:605-608. [PMID: 36729850 DOI: 10.1097/cad.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Lenvatinib is a multitargeted kinase inhibitor and maintaining its dose intensity has been shown to be beneficial in patients with thyroid and hepatocellular carcinomas. However, most patients require lenvatinib interruption and dose reduction due to the high incidence of adverse events (AEs). Lenvatinib was recently approved in Japan for patients with unresectable thymic carcinoma; however, real-world evidence of its clinical benefit is limited. Here, we report the case of chemotherapy-refractory thymic carcinoma in a patient who was administered a starting dose of lenvatinib using a 5-day on/2-day off (weekend-off) protocol, followed by alternate-day administration after fatigue onset derived from overt or subclinical hypothyroidism. Consequently, the patient exhibited a durable response to lenvatinib, with a 17-month progression-free survival without any severe or intolerable AEs. The present case suggests that maintaining lenvatinib dose intensity using such alternative administration regimens contributes to favorable clinical outcomes in thymic carcinoma.
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Affiliation(s)
- Noriaki Sunaga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Yosuke Miura
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | | | | | - Shogo Uno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Sohei Muto
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Mari Sato
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | | | | | - Naoko Okano
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
| | - Toshitaka Maeno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, Maebashi, Japan
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4
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Sato M, Yatomi M, Wakamatsu I, Uno S, Hanazato C, Masuda T, Yamaguchi K, Aoki-Saito H, Kasahara N, Miura Y, Tsurumaki H, Hara K, Koga Y, Sunaga N, Okada T, Ikota H, Hisada T, Maeno T. Effective treatment with mepolizumab in a patient with severe eosinophilic granulomatosis with polyangiitis complicated with small intestine perforation. Respir Med Case Rep 2023; 43:101818. [PMID: 36950026 PMCID: PMC10025129 DOI: 10.1016/j.rmcr.2023.101818] [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: 08/16/2022] [Revised: 01/29/2023] [Accepted: 02/08/2023] [Indexed: 02/27/2023] Open
Abstract
Eosinophilic granulomatosis with polyangiitis (EGPA) is systemic vasculitis caused by eosinophilia affecting small to medium-sized blood vessels, which damages the organs. Antineutrophil cytoplasmic antibody-associated vasculitis EGPA treatment guidelines added anti-interleukin-5 antibody mepolizumab to the standard treatment protocol for active-non-severe EGPA based on the MIRRA study. Nevertheless, the role of mepolizumab in treating patients with active severe EGPA has not been established. We treated a patient with EGPA complicated with small intestine perforation using steroid pulse intravenous, high-dose glucocorticoids, intravenous high-dose immunoglobulin therapy, and mepolizumab without immunosuppression agents; the patient went into remission, suggesting that mepolizumab is an effective therapeutic agent that could lead to remission in severe EGPA.
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Affiliation(s)
- Mari Sato
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Masakiyo Yatomi
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
- Corresponding author.
| | - Ikuo Wakamatsu
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Shogo Uno
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Chiharu Hanazato
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Tomomi Masuda
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Koichi Yamaguchi
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Haruka Aoki-Saito
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Norimitsu Kasahara
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Yosuke Miura
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Hiroaki Tsurumaki
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Kenichiro Hara
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Yasuhiko Koga
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Noriaki Sunaga
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Takuhisa Okada
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, 3-39-22, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
| | - Hayato Ikota
- Department of Diagnostic Pathology, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8514, Japan
| | - Toshitaka Maeno
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371- 8511, Japan
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Kanbe M, Sunaga N, Hara K, Sawada H, Wakamatsu I, Hara K, Muto S, Sawada Y, Masubuchi H, Sato M, Miura Y, Tsurumaki H, Yatomi M, Sakurai R, Koga Y, Ohtaki Y, Nagashima T, Okano N, Kubo N, Maeno T, Hisada T. Durable response to afatinib rechallenge in a long-term survivor of non-small cell lung cancer harboring EGFR L858R and L747V mutations. Thorac Cancer 2022; 13:3225-3228. [PMID: 36193787 PMCID: PMC9663673 DOI: 10.1111/1759-7714.14678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 01/07/2023] Open
Abstract
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors are standard therapeutic agents for non-small cell lung cancer (NSCLC) patients with major EGFR mutations such as exon 19 deletions and a L858R mutation, whereas treatment strategies for cases with uncommon EGFR mutations remain to be fully established. Here, we report a long-term (≥20 years from initial diagnosis) NSCLC survivor carrying EGFR L858R and L747V mutations. The patient received gefitinib monotherapy, systemic chemotherapy/chemoimmunotherapy, and local consolidative therapies for oligometastatic lesions, and responded to afatinib rechallenge with a progression-free survival of 12 months. The current case suggests that afatinib is effective in NSCLC patients with EGFR L858R and L747V mutations and that a therapeutic approach combining appropriately timed systemic therapies with local consolidative therapies for oligometastatic lesions improves long-term survival.
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Affiliation(s)
- Mio Kanbe
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Noriaki Sunaga
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Kenichiro Hara
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Hiiru Sawada
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Ikuo Wakamatsu
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Kentaro Hara
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Sohei Muto
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Yuri Sawada
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Hiroaki Masubuchi
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Mari Sato
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Yosuke Miura
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Hiroaki Tsurumaki
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Masakiyo Yatomi
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Reiko Sakurai
- Oncology CenterGunma University HospitalMaebashiGunmaJapan
| | - Yasuhiko Koga
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Yoichi Ohtaki
- Department of General Surgical ScienceGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Toshiteru Nagashima
- Department of General Surgical ScienceGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Naoko Okano
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Nobuteru Kubo
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Toshitaka Maeno
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Takeshi Hisada
- Gunma University Graduate School of Health SciencesMaebashiGunmaJapan
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6
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Kanbe M, Yatomi M, Wakamatsu I, Uno S, Hanazato C, Aoki-Saito H, Masuda T, Yamaguchi K, Kasahara N, Miura Y, Tsurumaki H, Hara K, Koga Y, Sunaga N, Higeta D, Kameda T, Hisada T, Maeno T. A pregnant woman with severe dyspnoea. Breathe (Sheff) 2022; 18:220012. [DOI: 10.1183/20734735.0012-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/06/2022] [Indexed: 11/05/2022] Open
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Koga Y, Aoki-Saito H, Kamide Y, Sato M, Tsurumaki H, Yatomi M, Ishizuka T, Hisada T. Perspectives on the Efficacy of Benralizumab for Treatment of Eosinophilic Granulomatosis With Polyangiitis. Front Pharmacol 2022; 13:865318. [PMID: 35359852 PMCID: PMC8960447 DOI: 10.3389/fphar.2022.865318] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/22/2022] [Indexed: 01/22/2023] Open
Abstract
Two types of interleukin (IL)-5 antibody biologics, anti-IL-5 antibodies (mepolizumab) and anti-IL-5α receptor antibodies (benralizumab), are indicated for severe asthma. While high-dose mepolizumab is also indicated for EGPA, benralizumab is indicated only for severe asthma. Benralizumab is characterized by antibody-dependent cell-mediated cytotoxicity activity, giving them specific and rapid anti-IL-5α receptor binding abilities and the ability to target a high number of eosinophils in tissues as well as peripheral blood. Recently, reports on the efficacy of benralizumab as a treatment for EGPA have been published, along with reports on some cases that are difficult to treat with existing oral corticosteroids and mepolizumab. Therefore, we focus on the perspective of the efficacy and safety of benralizumab as a treatment for EGPA patients with steroid dependence in this review. A total of 41 patients with EGPA were treated with benralizumab. After the introduction of benralizumab, oral corticosteroids could be reduced to 10 mg/day or less in all cases and to less than 5 mg/day in 80% or more of the cases. Discontinuation of oral corticosteroids was achieved in more than 40% of patients with EGPA. Benralizumab was effective in patients with mepolizumab-refractory EGPA and intractable cardiac and neuropathy complications. Efficient elimination of eosinophils is expected to improve the remission rate of EGPA with benralizumab treatment. Although the total number of patients was small, benralizumab was safe and tolerable in a wide range of age groups, suggesting efficacy in severe cases with EGPA.
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Affiliation(s)
- Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
- *Correspondence: Yasuhiko Koga,
| | - Haruka Aoki-Saito
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yosuke Kamide
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Makiko Sato
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, Maebashi, Japan
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8
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Wakamatsu I, Yatomi M, Uno S, Oishi Y, Ikeuchi H, Hanazato C, Sawada Y, Saito H, Yamaguchi K, Kasahara N, Miura Y, Tsurumaki H, Hara K, Koga Y, Sunaga N, Hisada T, Hiromura K, Maeno T. A case of a patient with neurofibromatosis type I who developed pneumothorax and eosinophilic pleural effusion after suffering from COVID-19 pneumonia. Radiol Case Rep 2021; 16:3504-3508. [PMID: 34422150 PMCID: PMC8367777 DOI: 10.1016/j.radcr.2021.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 01/03/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has become a global pandemic since its discovery in December 2019, and as the disease continues to evolve, varying complications associated with it continue to arise. In this regard, computed tomography has played an extremely important role in the diagnosis and evaluation of COVID-19 pneumonia and its complications. We encountered a case of a male patient with neurofibromatosis (type I) who developed concurrent pneumothorax and pleural effusion during his recovery period from severe COVID-19 pneumonia. Pulmonary fibrosis and emphysema were also confirmed. Furthermore, an eosinophil pleural effusion appeared and was prolonged during the healing process of COVID-19. This clinical presentation suggests that fibrosis and emphysema formation due to neurofibromatosis may have caused pneumothorax and pleural effusion.
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Affiliation(s)
- Ikuo Wakamatsu
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Masakiyo Yatomi
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan,Corresponding author.
| | - Shogo Uno
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Yuko Oishi
- Division of Nephrology and Rheumatology, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Hidekazu Ikeuchi
- Division of Nephrology and Rheumatology, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Chiharu Hanazato
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Yuri Sawada
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Haruka Saito
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Koichi Yamaguchi
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Norimitsu Kasahara
- Innovative Medical Research Center, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Yosuke Miura
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Hiroaki Tsurumaki
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Kenichiro Hara
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Yasuhiko Koga
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Noriaki Sunaga
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Keiju Hiromura
- Division of Nephrology and Rheumatology, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Toshitaka Maeno
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan
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9
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Kasahara N, Sunaga N, Kuwako T, Naruse I, Imai H, Jingu A, Tsukagoshi Y, Masuda T, Kitahara S, Tsurumaki H, Yatomi M, Hara K, Koga Y, Sakurai R, Mori K, Kaira K, Maeno T, Asao T, Hisada T. Administration of docetaxel plus ramucirumab with primary prophylactic pegylated-granulocyte colony-stimulating factor for pretreated non-small cell lung cancer: a phase II study. Support Care Cancer 2020; 28:4825-4831. [PMID: 31982960 DOI: 10.1007/s00520-020-05317-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Although docetaxel plus ramucirumab has shown superior treatment efficacy over docetaxel monotherapy for patients with non-small cell lung cancer (NSCLC), the high rate of febrile neutropenia (FN) presents a clinical problem. This study aimed to validate the primary prophylactic use of pegfilgrastim with docetaxel and ramucirumab treatment in Japanese patients with NSCLC. METHODS Patients with NSCLC with progression after at least one round of chemotherapy were enrolled and administered docetaxel (60 mg/m2) plus ramucirumab (10 mg/kg) intravenously on day 1, followed by pegylated-granulocyte colony-stimulating factor (3.6 mg) on day 2 of a 21-day treatment cycle. The primary study endpoint was the percentage of patients who developed FN. Secondary endpoints included overall survival, progression-free survival, overall response rate, and safety. RESULTS Overall, 20 patients (15 men and 5 women) were enrolled, of whom one developed FN, resulting in an overall FN rate of 5%. The response and disease control rates were 40% and 85%, respectively. The median progression-free survival was 6.6 (95% confidence interval [CI], 0.5-NR) months. The median overall survival was 18.4 (95% CI, 2.2-11.0) months. Six patients aged over 75 years were included in this study, and although most adverse events were durable, ramucirumab-associated adverse events occurred more frequently in these patients. CONCLUSIONS We observed a 5% FN rate using primary prophylactic pegylated-granulocyte colony-stimulating factor with docetaxel plus ramucirumab in Japanese patients with NSCLC. While most adverse events were durable, elderly patients should be closely monitored.
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Affiliation(s)
- Norimitsu Kasahara
- Innovative Medical Research Center, Gunma University Hospital, Maebashi, Gunma, 371-8511, Japan.
| | - Noriaki Sunaga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tomohito Kuwako
- Department of Respiratory Medicine, Shibukawa Medical Center, Shibukawa, Gunma, Japan
| | - Ichiro Naruse
- Department of Respiratory Medicine, Hidaka Hospital, Takasaki, Gunma, Japan
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Gunma, Japan
| | - Asuka Jingu
- Department of Respiratory Medicine, Shibukawa Medical Center, Shibukawa, Gunma, Japan
| | - Yusuke Tsukagoshi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tomomi Masuda
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Shinsuke Kitahara
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Kenichiro Hara
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Reiko Sakurai
- Oncology Center, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Keita Mori
- Clinical Research Center, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
| | - Toshitaka Maeno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Takayuki Asao
- Innovative Medical Research Center, Gunma University Hospital, Maebashi, Gunma, 371-8511, Japan
| | - Takeshi Hisada
- Graduate School of Health Sciences, Gunma University, Maebashi, Gunma, Japan
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10
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Hachisu Y, Murata K, Takei K, Tsuchiya T, Tsurumaki H, Koga Y, Horie T, Takise A, Hisada T. Prognostic nutritional index as a predictor of mortality in nontuberculous mycobacterial lung disease. J Thorac Dis 2020; 12:3101-3109. [PMID: 32642232 PMCID: PMC7330762 DOI: 10.21037/jtd-20-803] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Although the association between nontuberculous mycobacterial lung disease (NTM-LD) and malnutrition is known, there are a few reports on the association between the nutritional score and death in patients with NTM-LD. This study investigated the association between the nutrition data at the time of NTM-LD diagnosis and death. Methods A retrospective study was conducted for patients with NTM-LD who visited the Maebashi Red Cross Hospital from January 2014 to December 2018. The patients were divided into the survival and death groups and analyzed statistically. Results The diagnostic criteria for NTM-LD were met by 150 patients. The median age was 70 years (range, 20–94 years). There were 51 (34.0%) men and 99 (66.0%) women. In the death group, the body mass index was significantly low, and there were significantly more patients with asthma. Further, computed tomography at the first visit revealed significantly fewer cases of the nodular bronchiectasis type. In the hematologic examination at the time of NTM-LD diagnosis, the white blood cell, neutrophil, and platelet counts and C-reactive protein and serum calcium levels were significantly higher in the death group, while the serum albumin level was significantly lower. In the death group, the prognostic nutritional index (PNI), calculated from the hematologic findings, was significantly lower, while the Glasgow Prognostic Score (GPS) was significantly higher. A logistic regression analysis was performed on items with significant differences, and the PNI and platelet count were independent factors predicting death. Conclusions PNI might be effective as a prognostic factor for NTM-LD.
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Affiliation(s)
- Yoshimasa Hachisu
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Keisuke Murata
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Kousuke Takei
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Takuma Tsuchiya
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takeo Horie
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Atsushi Takise
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, Maebashi, Japan
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11
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Sato M, Aoki-Saito H, Fukuda H, Ikeda H, Koga Y, Yatomi M, Tsurumaki H, Maeno T, Saito T, Nakakura T, Mori T, Yanagawa M, Abe M, Sako Y, Dobashi K, Ishizuka T, Yamada M, Shuto S, Hisada T. Resolvin E3 attenuates allergic airway inflammation via the interleukin-23-interleukin-17A pathway. FASEB J 2019; 33:12750-12759. [PMID: 31469599 DOI: 10.1096/fj.201900283r] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We investigated the effects of resolvin E (RvE) 1, RvE2, and RvE3 on IL-4- and IL-33-stimulated bone marrow-derived dendritic cells (BMDCs) from house dust mite (HDM)-sensitized mice. We also investigated the role of RvE3 in a murine model of HDM-induced airway inflammation. In vitro, BMDCs from HDM-sensitized mice were stimulated with IL-4 and IL-33 and then treated with RvE1, RvE2, RvE3, or vehicle. RvE1, RvE2, and RvE3 suppressed IL-23 release from BMDCs. In vivo, RvE3 administrated to HDM-sensitized and challenged mice in the resolution phase promoted a decline in total numbers of inflammatory cells and eosinophils, reduced levels of IL-23 and IL-17 in lavage fluid, and suppressed IL-23 and IL-17A mRNA expression in lung and peribronchial lymph nodes. RvE3 also reduced resistance in the lungs of HDM-sensitized mice. A NanoBiT β-arrestin recruitment assay using human embryonic kidney 293 cells revealed that pretreatment with RvE3 suppressed the leukotriene B4 (LTB4)-induced β-arrestin 2 binding to LTB4 receptor 1 (BLT1R), indicating that RvE3 antagonistically interacts with BLT1R. Collectively, these findings indicate that RvE3 facilitates the resolution of allergic airway inflammation, partly by regulating BLT1R activity and selective cytokine release by dendritic cells. Our results accordingly identify RvE3 as a potential therapeutic target for the management of asthma.-Sato, M., Aoki-Saito, H., Fukuda, H., Ikeda, H., Koga, Y., Yatomi, M., Tsurumaki, H., Maeno, T., Saito, T., Nakakura, T., Mori, T., Yanagawa, M., Abe, M., Sako, Y., Dobashi, K., Ishizuka, T., Yamada, M., Shuto, S., Hisada, T. Resolvin E3 attenuates allergic airway inflammation via the interleukin-23-interleukin-17A pathway.
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Affiliation(s)
- Makiko Sato
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan.,Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Haruka Aoki-Saito
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hayato Fukuda
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroyuki Ikeda
- Faculty of Pharmaceutical Sciences and Center for Research and Education on Drug Discovery, Hokkaido University, Hokkaido, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Toshitaka Maeno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tsugumichi Saito
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | | | - Tetsuya Mori
- Laboratory of Allergy and Immunology, Faculty of Pharmacy, Takasaki University of Health and Welfare, Gunma, Japan
| | - Masataka Yanagawa
- Cellular Informatics Laboratory, Riken Cluster for Pioneering Research, Saitama, Japan
| | - Mitsuhiro Abe
- Cellular Informatics Laboratory, Riken Cluster for Pioneering Research, Saitama, Japan
| | - Yasushi Sako
- Cellular Informatics Laboratory, Riken Cluster for Pioneering Research, Saitama, Japan
| | - Kunio Dobashi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Satoshi Shuto
- Faculty of Pharmaceutical Sciences and Center for Research and Education on Drug Discovery, Hokkaido University, Hokkaido, Japan
| | - Takeshi Hisada
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Gunma, Japan.,Gunma University Graduate School of Health Sciences, Gunma, Japan
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12
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Tsurumaki H, Matsuyama T, Ezawa K, Koga Y, Yatomi M, Aoki-Saito H, Chikamatsu K, Hisada T. Rapid Effect of Benralizumab for Hypereosinophilia in a Case of Severe Asthma with Eosinophilic Chronic Rhinosinusitis. ACTA ACUST UNITED AC 2019; 55:medicina55070336. [PMID: 31277327 PMCID: PMC6681373 DOI: 10.3390/medicina55070336] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022]
Abstract
A 56-year-old man with severe asthma underwent bronchial thermoplasty (BT). However, his asthma exacerbated and hypereosinophilia developed 2 months later, thus necessitating oral corticosteroid (OCS) therapy. Six months after BT, a diagnosis of severe asthma with eosinophilic chronic rhinosinusitis (ECRS) was made and benralizumab treatment was initiated; the blood eosinophil count subsequently decreased and lung function improved, thereby permitting OCS dose tapering. Surprisingly, benralizumab both reduced nasal polyps and ameliorated ECRS. Thus, benralizumab may be a useful drug for the rapid treatment of severe asthma with ECRS, especially in patients with hypereosinophilia.
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Affiliation(s)
- Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan.
| | - Toshiyuki Matsuyama
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
| | - Kazuma Ezawa
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
| | - Haruka Aoki-Saito
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
| | - Kazuaki Chikamatsu
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, Maebashi 371-8514, Japan
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13
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Kasahara N, Kaira K, Yamaguchi K, Masubuchi H, Tsurumaki H, Hara K, Koga Y, Sakurai R, Higuchi T, Handa T, Oyama T, Yokobori T, Shimizu K, Asao T, Hisada T. Fluorodeoxyglucose uptake is associated with low tumor-infiltrating lymphocyte levels in patients with small cell lung cancer. Lung Cancer 2019; 134:180-186. [PMID: 31319979 DOI: 10.1016/j.lungcan.2019.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 03/25/2019] [Revised: 05/27/2019] [Accepted: 06/09/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Positron emission tomography (PET) using 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) is a clinically useful modality for cancer evaluation. The mechanism of 18F-FDG uptake within cancer cells involves the glucose transporter 1 (GLUT1) and hypoxia-inducible factor-1 α (HIF-1α). Although recent research has shown its clinical efficacy in small-cell lung cancer (SCLC), no suitable biomarker has been identified. We conducted a clinicopathological study to examine the relationship between tumor immunity and 18F-FDG uptake in patients with SCLC. MATERIALS AND METHODS Tumor sections were stained by immunohistochemistry for GLUT1, HIF-1α, PD-L1, CD4, CD8, and Foxp3. The relationship between clinicopathological features and 18F-FDG uptake was analyzed. Student's t-test, χ2 test, non-parametric Spearman's rank test, and Kaplan-Meier method were used to evaluate associations between the variables. RESULTS A total of 98 patients 78 men and 20 women who underwent 18F-FDG PET, were enrolled in this study. PD-L1 was expressed in 36.7% (36/98) of all patients; this was significantly associated with GLUT1 expression (p = 0.04). The accumulation of 18F-FDG was significantly higher in patients with low CD8 and CD4 TILs than in those with high TILs (p = 0.03 and p = 0.01, respectively). The uptake of 18F-FDG was not significantly associated with the expression of either Foxp3 or PD-L1. Multivariate analysis demonstrated that advanced stage, poor ECOG-PS, and high SUVmax were independent predictors of poor OS. Among patients with limited-stage disease, multivariate analysis confirmed high PD-L1 expression and a high SUVmax to be independent predictors of poor OS. However, only ECOG-PS was found to be an independent predictor of poor OS among patients with extensive-stage tumors. CONCLUSION High SUVmax on 18F-FDG-PET is correlated with low expression of CD8(+) and CD4(+) TILs, but is an independent prognostic factor for OS, particularly in those with limited disease. Further studies are warranted to validate our findings.
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Affiliation(s)
- Norimitsu Kasahara
- Innovative Medical Research Center, Gunma University Hospital, Maebashi, Gunma 371-8511, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama 350-1298, Japan.
| | - Koichi Yamaguchi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Hiroaki Masubuchi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Kenichiro Hara
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Reiko Sakurai
- Oncology Center, Gunma University Hospital, Maebashi, Gunma 371-8511, Japan
| | - Tetsuya Higuchi
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Tadashi Handa
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Tetsunari Oyama
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Takehiko Yokobori
- Department of Innovative Cancer Immunotherapy, Gunma University 3-39-22 Showamachi, Maebashi 371-8511, Japan; Division of Integrated Oncology Research, Gunma University Initiative for Advanced Research (GIAR) 3-39-22 Showamachi, Maebashi 371-8511 Japan
| | - Kimihiro Shimizu
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Takayuki Asao
- Innovative Medical Research Center, Gunma University Hospital, Maebashi, Gunma 371-8511, Japan
| | - Takeshi Hisada
- Graduate School of Health Sciences, Gunma University, Maebashi, Gunma 371-8514, Japan
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14
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Koga Y, Hachisu Y, Tsurumaki H, Yatomi M, Kaira K, Ohta S, Ono J, Izuhara K, Dobashi K, Hisada T. Pirfenidone Improves Familial Idiopathic Pulmonary Fibrosis without Affecting Serum Periostin Levels. ACTA ACUST UNITED AC 2019; 55:medicina55050161. [PMID: 31108995 PMCID: PMC6572615 DOI: 10.3390/medicina55050161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/16/2019] [Accepted: 05/16/2019] [Indexed: 11/16/2022]
Abstract
Background: Antifibrotic agents have been approved for the treatment of idiopathic pulmonary fibrosis (IPF). However, the efficacy of these drugs in the treatment of familial IPF (FIPF) has not been previously reported. Case presentation: We report the case of a 77-year-old man with FIPF, successfully treated with pirfenidone. His uncle died due to IPF, and his niece was diagnosed with the disease. He had worsening dyspnea two months prior to admission to our hospital. Upon admission, he had desaturation when exercising and broad interstitial pneumonia. Administration of pirfenidone improved his dyspnea, desaturation, and the reticular shadow on his chest radiograph. Increased fibrotic marker levels KL-6 and SP-D were also normalized in six months; treatment had no effect on his serum periostin level. Pirfenidone has been effective for over two years. Conclusion: Antifibrotic agents such as pirfenidone may be useful for the management of FIPF, as well as cases of sporadic IPF.
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Affiliation(s)
- Yasuhiko Koga
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Yoshimasa Hachisu
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Hiroaki Tsurumaki
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Masakiyo Yatomi
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama 350-0495, Japan.
| | - Shoichiro Ohta
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501, Japan.
| | - Junya Ono
- Shino-Test Corporation, 2-29-14 Oonodai Minami-ku, Sagamihara, Kanagawa, 252-0331, Japan.
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501, Japan.
| | - Kunio Dobashi
- Jobu Hospital for Respiratory Diseases, 586-1 Taguchi-machi, Maebashi, Gunma, 371-0048, Japan.
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, 3-39-22 sho-wa machi Maebashi, Gunma 371-8514, Japan.
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Hachisu Y, Murata K, Takei K, Tsuchiya T, Tsurumaki H, Koga Y, Horie T, Takise A, Hisada T. Possible Serological Markers to Predict Mortality in Acute Exacerbation of Idiopathic Pulmonary Fibrosis. ACTA ACUST UNITED AC 2019; 55:medicina55050132. [PMID: 31086028 PMCID: PMC6571816 DOI: 10.3390/medicina55050132] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/10/2019] [Accepted: 05/10/2019] [Indexed: 11/16/2022]
Abstract
Background and objectives: Idiopathic pulmonary fibrosis (IPF) has a particularly poor prognosis, and most IPF-related deaths are due to acute exacerbation (AE) of this condition. Few reports about biomarkers to predict prognosis of AE-IPF have been published since the release of the new AE-IPF criteria in 2016. The present study investigated relationships between serological markers and in-hospital mortality after the onset of AE-IPF. Methods: Demographic, serological, and imaging data from patients hospitalized at the Maebashi Red Cross Hospital (Gunma, Japan) between 1 January 2013, and 31 December 2017, were retrospectively reviewed. Subjects fulfilling the diagnostic criteria for AE-IPF were divided into those who survived or died; statistical analysis of risk factors was performed using data from these two groups. Results: Diagnostic criteria for AE-IPF were fulfilled by 84 patients (59 males (70.2%)), with a median age of 78 years (range, 56-95 years). IPF was diagnosed before hospitalization in 50 (59.5%) patients and 38 (45.2%) died in hospital. Among the serological markers at hospitalization in the deceased group, C-reactive protein (CRP) was significantly higher than in the survivor group (p = 0.002), while total serum protein (p = 0.031), albumin (p = 0.047) and total cholesterol (p = 0.039) were significantly lower. Cox hazard analysis of factors predicting mortality, corrected for age, sex and BMI, revealed the following: CRP (hazard ratio (HR) 1.080 (95% confidence interval (CI) 1.022-1.141); p = 0.006), LDH (HR 1.003 (95% CI 1.000-1.006); p = 0.037), and total cholesterol (HR 0.985 (95% CI 0.972-0.997); p = 0.018). Conclusions: Our data suggest that CRP, LDH, and total cholesterol may be biomarkers predicting mortality in patients with AE-IPF. However, only prospective controlled studies can confirm or not our observation as a generalizable one.
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Affiliation(s)
- Yoshimasa Hachisu
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, Japan.
| | - Keisuke Murata
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, Japan.
| | - Kousuke Takei
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, Japan.
| | - Takuma Tsuchiya
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, Japan.
| | - Hiroaki Tsurumaki
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan.
| | - Yasuhiko Koga
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan.
| | - Takeo Horie
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, Japan.
| | - Atsushi Takise
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma 371-0811, Japan.
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, 3-39-22, Showa-machi, Maebashi, Gunma 371-8514, Japan.
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16
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Koga Y, Tsurumaki H, Aoki-Saito H, Sato M, Yatomi M, Takehara K, Hisada T. Roles of Cyclic AMP Response Element Binding Activation in the ERK1/2 and p38 MAPK Signalling Pathway in Central Nervous System, Cardiovascular System, Osteoclast Differentiation and Mucin and Cytokine Production. Int J Mol Sci 2019; 20:ijms20061346. [PMID: 30884895 PMCID: PMC6470985 DOI: 10.3390/ijms20061346] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/08/2019] [Accepted: 03/13/2019] [Indexed: 11/26/2022] Open
Abstract
There are many downstream targets of mitogen-activated protein kinase (MAPK) signalling that are involved in neuronal development, cellular differentiation, cell migration, cancer, cardiovascular dysfunction and inflammation via their functions in promoting apoptosis and cell motility and regulating various cytokines. It has been reported that cyclic AMP response element-binding protein (CREB) is phosphorylated and activated by cyclic AMP signalling and calcium/calmodulin kinase. Recent evidence also points to CREB phosphorylation by the MAPK signalling pathway. However, the specific roles of CREB phosphorylation in MAPK signalling have not yet been reviewed in detail. Here, we describe the recent advances in the study of this MAPK-CREB signalling axis in human diseases. Overall, the crosstalk between extracellular signal-related kinase (ERK) 1/2 and p38 MAPK signalling has been shown to regulate various physiological functions, including central nervous system, cardiac fibrosis, alcoholic cardiac fibrosis, osteoclast differentiation, mucin production in the airway, vascular smooth muscle cell migration, steroidogenesis and asthmatic inflammation. In this review, we focus on ERK1/2 and/or p38 MAPK-dependent CREB activation associated with various diseases to provide insights for basic and clinical researchers.
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Affiliation(s)
- Yasuhiko Koga
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Hiroaki Tsurumaki
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Haruka Aoki-Saito
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Makiko Sato
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Masakiyo Yatomi
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Kazutaka Takehara
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi Maebashi, Gunma 371-8511, Japan.
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, 3-39-22 sho-wa machi Maebashi, Gunma 371-8514, Japan.
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17
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Sasaki Y, Koga Y, Kasahara N, Hachisu Y, Murata K, Tsurumaki H, Yatomi M, Tsukagoshi Y, Sawada Y, Sakurai R, Ono A, Sunaga N, Kaira K, Hirato J, Maeno T, Dobashi K, Hisada T. Small Cell Lung Cancer with Sarcoidosis in Spontaneous Remission: A Case Report. J NIPPON MED SCH 2018; 85:291-296. [PMID: 30464148 DOI: 10.1272/jnms.jnms.2018_85-47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 69-year-old woman was diagnosed with sarcoidosis, which was not treated with corticosteroid therapy. Her levels of angiotensin converting enzyme decreased significantly over 4 years and a mass lesion was detected near the lower part of her left main bronchus, and diagnosed as small cell lung cancer (SCLC). Treatment of the SCLC with a series of chemotherapeutic agents produced excellent results. The pulmonary sarcoidosis did not show any deterioration despite the frequent use of amrubicin, which is known to be a cause of interstitial pneumonia. This is a case report of SCLC complicated with sarcoidosis in a stage of spontaneous remission, possibly suggesting an association between sarcoidosis and tumor immunity, since recent reports have suggested that immune checkpoint inhibitors might be involved in the development of sarcoidosis.
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Affiliation(s)
- Yumeka Sasaki
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Yasuhiko Koga
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Norimitsu Kasahara
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Yoshimasa Hachisu
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Keisuke Murata
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Hiroaki Tsurumaki
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Masakiyo Yatomi
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Yusuke Tsukagoshi
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Yuri Sawada
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Reiko Sakurai
- Oncology Center, Gunma University Graduate School of Medicine
| | - Akihiro Ono
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Noriaki Sunaga
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | - Kyoichi Kaira
- Department of Oncology Clinical Development, Gunma University Graduate School of Medicine
| | - Junko Hirato
- Department of Pathology, Gunma University Hospital
| | - Toshitaka Maeno
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
| | | | - Takeshi Hisada
- Department of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine
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18
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Hachisu Y, Koga Y, Sunaga N, Kashiwagi C, Sawada Y, Saito Y, Tsukagoshi Y, Kasahara N, Sakurai R, Tsurumaki H, Yatomi M, Kaira K, Ono A, Maeno T, Hisada T. The Onset of Eosinophilic Pneumonia Preceding Anti-synthetase Syndrome. Intern Med 2018; 57:247-251. [PMID: 29093389 PMCID: PMC5820045 DOI: 10.2169/internalmedicine.8955-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 66-year-old man had been treated with prednisolone for eosinophilic pneumonia for 8 years. His slowly progressing cough and dyspnea were accompanied by elevated levels of fibrotic serological markers and an increased reticular shadow on chest computed tomography images. The patient had recently tested positive for anti-EJ antibodies, a type of anti-aminoacyl-tRNA synthetase antibody; therefore, we diagnosed him with an exacerbation of interstitial pneumonia due to anti-synthetase syndrome (ASS). He was treated with tacrolimus and an increased prednisolone dosage. We herein present the first reported case of eosinophilic pneumonia preceding anti-EJ antibody-positive ASS.
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Affiliation(s)
- Yoshimasa Hachisu
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Yasuhiko Koga
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Noriaki Sunaga
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
- Oncology Center, Gunma University Hospital, Gunma University Graduate School of Medicine, Japan
| | - Chiharu Kashiwagi
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Yuri Sawada
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Yasuyuki Saito
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Yusuke Tsukagoshi
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Norimitsu Kasahara
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Reiko Sakurai
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Hiroaki Tsurumaki
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Masakiyo Yatomi
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Kyoichi Kaira
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
- Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Japan
| | - Akihiro Ono
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Toshitaka Maeno
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
| | - Takeshi Hisada
- Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
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19
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Koga Y, Satoh T, Kaira K, Koka M, Hisada T, Hirato J, Altan B, Yatomi M, Ono A, Kamide Y, Shimizu Y, Aoki-Saito H, Tsurumaki H, Shimizu K, Mogi A, Ishizuka T, Yamada M, Dobashi K. Elemental and immunohistochemical analysis of the lungs and hilar lymph node in a patient with asbestos exposure, a pilot study. Environ Health Prev Med 2016; 21:492-500. [PMID: 27699693 DOI: 10.1007/s12199-016-0576-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 08/08/2016] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Studies have shown that inhaled mine dust, such as asbestos, can be translocated to various organs including the lymph nodes. Recently, we have established a protocol that enables us to identify inhaled elements using paraffin embedded lung specimens by in-air microparticle-induced X-ray emission (micro-PIXE). However, little research has examined the concentration of these inhaled fibers in various organs or the mechanisms of their translocation. In this study, we compared the concentration of inhaled fibers in the lung parenchyma to the concentration in the hilar lymph node as well as to determine the elemental spatial distribution of the inhaled fibers in a patient with occupational asbestos exposure. METHODS Lung tissues and hilar lymph node in a patient with asbestos exposure were used in this study. Elemental analysis was performed by in-air micro-PIXE. Immunohistochemical analysis was performed using anti CD163, smooth muscle actin, vimentin and β-catenin antibody. RESULTS The analysis revealed that the amount of inhaled silicon was approximately 6 times higher in the lymph node than in the lungs. The spatial analysis showed that silicon, iron and aluminium were co-localized in the hilar lymph node. The immunohistochemical analysis showed localized agreement of the inhaled fibers with macrophages, smooth muscle actin, and vimentin in the hilar lymph node. CONCLUSIONS This study showed that in-air micro-PIXE could be useful for analyzing the elemental distribution and quantification of inhaled fibers in the human body. Furthermore, immunohistochemistry in combination with in-air micro-PIXE analyses may help to determine the mechanism of mine dust distribution in vivo.
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Affiliation(s)
- Yasuhiko Koga
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan.
| | - Takahiro Satoh
- Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma, 370-1292, Japan
| | - Kyoichi Kaira
- Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Masashi Koka
- Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma, 370-1292, Japan
| | - Takeshi Hisada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Junko Hirato
- Department of Pathology, Gunma University Hospital, 3-39-22 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Bolag Altan
- Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Masakiyo Yatomi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Akihiro Ono
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Yosuke Kamide
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan.,Department of Allergy, Sagamihara National Hospital, 18-1 Sakuradai minami-ku, Sagamihara, Kanagawa, 252-0392, Japan
| | - Yasuo Shimizu
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Tochigi, 321-0293, Japan
| | - Haruka Aoki-Saito
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Hiroaki Tsurumaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Kimihiro Shimizu
- Department of Thoracic Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Akira Mogi
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 sho-wa machi, Maebashi, Gunma, 371-8511, Japan
| | - Kunio Dobashi
- Gunma University Graduate School of Health Sciences, 3-39-22 sho-wa machi, Maebashi, Gunma, 371-8514, Japan.
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20
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Koga Y, Hisada T, Ishizuka T, Utsugi M, Ono A, Yatomi M, Kamide Y, Aoki-Saito H, Tsurumaki H, Dobashi K, Yamada M. CREB regulates TNF-α-induced GM-CSF secretion via p38 MAPK in human lung fibroblasts. Allergol Int 2016; 65:406-413. [PMID: 27118435 DOI: 10.1016/j.alit.2016.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/13/2016] [Accepted: 03/15/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a cytokine that mediates eosinophilic differentiation, migration and survival, causing respiratory tract inflammation. GM-CSF is also known to be secreted from respiratory tract structural cells. However, the mechanisms of GM-CSF secretion have not been well established. METHODS Human fetal lung fibroblasts and human primary asthmatic lung fibroblasts were used for the study of tumor necrosis factor alpha (TNF-α)-induced GM-CSF secretion. GM-CSF secretion and mRNA expression were measured by enzyme-linked immunosorbent assay and quantitative real-time reverse transcription polymerase chain reaction, respectively. Knockdown of cAMP response element-binding protein (CREB) in fibroblasts was carried out by using specific small interfering RNAs of CREB. RESULTS Among respiratory tract structural cells, pulmonary fibroblasts exhibited increased GM-CSF secretion and mRNA expression after stimulation with TNF-α in a concentration-dependent manner. Moreover, a p38 mitogen-activated protein kinase (MAPK) inhibitor controlled TNF-α-induced GM-CSF secretion, and roflumilast and rolipram, inhibitors of phosphodiesterase-4, suppressed TNF-α-induced GM-CSF secretion. Consistent with this, forskolin also completely blocked GM-CSF secretion, and similar results were observed in response to cAMP treatment, suggesting that cAMP signaling suppressed TNF-α-induced GM-CSF secretion in human lung fibroblasts. Furthermore, CREB was phosphorylated through p38 MAPK but not cAMP signaling after TNF-α stimulation, and GM-CSF secretion was inhibited by CREB knockdown. Finally, these effects were also demonstrated in human primary lung fibroblasts in a patient with asthma. CONCLUSIONS CREB signaled independent of cAMP signaling and was phosphorylated by p38 MAPK following TNF-α stimulation, playing a critical role in GM-CSF secretion in human lung fibroblasts.
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Affiliation(s)
- Yasuhiko Koga
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Takeshi Hisada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Mitsuyoshi Utsugi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Respiratory Medicine, Kiryu Kosei General Hospital, Gunma, Japan
| | - Akihiro Ono
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Masakiyo Yatomi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Yosuke Kamide
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan; Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Haruka Aoki-Saito
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hiroaki Tsurumaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Kunio Dobashi
- Gunma University Graduate School of Health Sciences, Gunma, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
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21
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Yatomi M, Hisada T, Ishizuka T, Koga Y, Ono A, Kamide Y, Seki K, Aoki-Saito H, Tsurumaki H, Sunaga N, Kaira K, Dobashi K, Yamada M, Okajima F. 17(R)-resolvin D1 ameliorates bleomycin-induced pulmonary fibrosis in mice. Physiol Rep 2015; 3:3/12/e12628. [PMID: 26660549 PMCID: PMC4760456 DOI: 10.14814/phy2.12628] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a destructive inflammatory disease with limited therapeutic options. Inflammation plays an integral role in the development of pulmonary fibrosis. Unresolved inflammatory responses can lead to substantial tissue injury, chronic inflammation, and fibrosis. The resolvins are a family of endogenous ω‐3 fatty acid derived‐lipid mediators of inflammation resolution. Resolvin D1 (RvD1) displays potent anti‐inflammatory, pro‐resolving activity, without causing immunosuppression. Its epimer, 17(R)‐resolvin D1 (17(R)‐RvD1), exhibits equivalent functionality to RvD1. In addition, 17(R)‐RvD1 is resistant to rapid inactivation by eicosanoid oxidoreductases. In the present study, we tested the hypothesis that 17(R)‐RvD1 can provide a therapeutic benefit in IPF by reducing inflammation and pulmonary fibrosis, while leaving the normal immune response intact. Mice were exposed to bleomycin (BLM) via micro‐osmotic pump to induce pulmonary fibrosis, and were then treated with 17(R)‐RvD1 or vehicle by intraperitoneal injection. Administration of 17(R)‐RvD1 from the start of BLM treatment attenuated neutrophil alveolar infiltration, lung collagen content, and Interleukin‐1β (IL‐1β), transforming growth factor‐β1 (TGF‐β1), connective tissue growth factor (CTGF), and type I collagen mRNA expression, along with subsequent reduction in histologically detectable fibrosis. The 17(R)‐RvD1‐induced infiltration of inflammatory cells was inhibited by an antagonist of lipoxin A4 receptor/formyl peptide receptor 2 (ALX/FPR2). The administration of 17(R)‐RvD1 at the later fibrotic stage also improved the lung failure. These results suggest that 17(R)‐RvD1 attenuates pulmonary fibrosis by promoting the resolution of neutrophilic inflammation and also provides pulmonary restoration. These data highlight the therapeutic potential of 17(R)‐RvD1 in the management of this intractable disease.
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Affiliation(s)
- Masakiyo Yatomi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Takeshi Hisada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun Fukui, Japan
| | - Yasuhiko Koga
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akihiro Ono
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yosuke Kamide
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kaori Seki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Haruka Aoki-Saito
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Hiroaki Tsurumaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Noriaki Sunaga
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kyoichi Kaira
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kunio Dobashi
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Fumikazu Okajima
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
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22
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Kamide Y, Ishizuka T, Tobo M, Tsurumaki H, Aoki H, Mogi C, Nakakura T, Yatomi M, Ono A, Koga Y, Sato K, Hisada T, Dobashi K, Yamada M, Okajima F. Acidic environment augments FcεRI-mediated production of IL-6 and IL-13 in mast cells. Biochem Biophys Res Commun 2015. [PMID: 26196745 DOI: 10.1016/j.bbrc.2015.07.077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 02/08/2023]
Abstract
Although blood pH is maintained in a narrow range of around pH 7.4 in living organisms, inflammatory loci are characterized by acidic conditions. Mast cells tend to reside close to the surface of the body in areas such as the mucosa and skin where they may be exposed to exogenous acids, and they play an important role in immune responses. However, little is known about the effects of extracellular acidification on the functions of mast cell. Here, we found that extracellular acidification increased the dinitrophenyl-conjugated human serum albumin (DNP-HSA)-induced production of interleukin (IL)-6 and IL-13 in MC/9 cells or bone marrow-derived mouse mast cells sensitized with anti-DNP IgE. Extracellular acidification also inhibited migration of MC/9 cells toward DNP-HSA. In addition, acidic pH stimulated antigen-induced activation of p38 mitogen-activated protein kinase (MAPK) and protein kinase B (Akt). These findings suggest that extracellular acidification augmented antigen/IgE-induced and FcεRI-mediated production of IL-6 and IL-13 in mast cells, and that this was associated with the enhancement of p38 MAPK and Akt activation.
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Affiliation(s)
- Yosuke Kamide
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan; Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masayuki Tobo
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Hiroaki Tsurumaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan; Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Haruka Aoki
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Chihiro Mogi
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Takashi Nakakura
- Department of Anatomy, Graduate School of Medicine, Teikyo University, Tokyo, Japan
| | - Masakiyo Yatomi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akihiro Ono
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yasuhiko Koga
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Koichi Sato
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Takeshi Hisada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kunio Dobashi
- Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Fumikazu Okajima
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
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23
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Aoki H, Mogi C, Hisada T, Nakakura T, Kamide Y, Ichimonji I, Tomura H, Tobo M, Sato K, Tsurumaki H, Dobashi K, Mori T, Harada A, Yamada M, Mori M, Ishizuka T, Okajima F. Proton-sensing ovarian cancer G protein-coupled receptor 1 on dendritic cells is required for airway responses in a murine asthma model. PLoS One 2013; 8:e79985. [PMID: 24244587 PMCID: PMC3823589 DOI: 10.1371/journal.pone.0079985] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 10/07/2013] [Indexed: 01/17/2023] Open
Abstract
Ovarian cancer G protein-coupled receptor 1 (OGR1) stimulation by extracellular protons causes the activation of G proteins and subsequent cellular functions. However, the physiological and pathophysiological roles of OGR1 in airway responses remain largely unknown. In the present study, we show that OGR1-deficient mice are resistant to the cardinal features of asthma, including airway eosinophilia, airway hyperresponsiveness (AHR), and goblet cell metaplasia, in association with a remarkable inhibition of Th2 cytokine and IgE production, in an ovalbumin (OVA)-induced asthma model. Intratracheal transfer to wild-type mice of OVA-primed bone marrow-derived dendritic cells (DCs) from OGR1-deficient mice developed lower AHR and eosinophilia after OVA inhalation compared with the transfer of those from wild-type mice. Migration of OVA-pulsed DCs to peribronchial lymph nodes was also inhibited by OGR1 deficiency in the adoption experiments. The presence of functional OGR1 in DCs was confirmed by the expression of OGR1 mRNA and the OGR1-sensitive Ca2+ response. OVA-induced expression of CCR7, a mature DC chemokine receptor, and migration response to CCR7 ligands in an in vitro Transwell assay were attenuated by OGR1 deficiency. We conclude that OGR1 on DCs is critical for migration to draining lymph nodes, which, in turn, stimulates Th2 phenotype change and subsequent induction of airway inflammation and AHR.
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Affiliation(s)
- Haruka Aoki
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Chihiro Mogi
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Takeshi Hisada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takashi Nakakura
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Yosuke Kamide
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Isao Ichimonji
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Hideaki Tomura
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Masayuki Tobo
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Koichi Sato
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Hiroaki Tsurumaki
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kunio Dobashi
- Gunma University School of Health Sciences, Maebashi, Japan
| | - Tetsuya Mori
- Laboratory of Allergy and Immunology, Faculty of Pharmacy, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Akihiro Harada
- Department of Cell Biology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masatomo Mori
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- * E-mail: (FO); (TI)
| | - Fumikazu Okajima
- Laboratory of Signal Transduction, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
- * E-mail: (FO); (TI)
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24
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Suzuki J, Tomizawa Y, Yoshii A, Tsuchiya T, Tsurumaki H, Iijima H, Saito R. [A case of sarcoidosis with bilateral pleural effusion treated with high-dose steroids]. Nihon Kokyuki Gakkai Zasshi 2011; 49:287-292. [PMID: 21591458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 25-year-old man was admitted with elevated fever, dyspnea, cough, dorsal chest pain, and multiple nodular shadows and pleural effusion found on chest X-ray films. There were multiple swollen superficial lymph nodes, and non-caseating epithelioid cell granulomas with Langhans giant cells were detected on a biopsy specimen of a right inguinal lymph node. Bronchoscopy findings demonstrated mucosal irregularity, telangiectasia and small nodules, and another biopsy specimen was similar to that of the inguinal lymph node. The number of lymphocytes and the CD4/CD8 ratio were elevated in his bronchoalveolar lavage fluid, and serum ACE and lysozymes levels were also elevated. These findings are compatible with sarcoidosis. Although his symptoms and pleural effusion improved with the administration of 30 mg/day prednisolone (PSL), these findings recurred after about 4 weeks. Therefore, we increased the PSL dose to 60 mg/day, and his symptoms, pleural effusions and laboratory data improved again. There were no signs of relapse after tapering and discontinuance of PSL.
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Affiliation(s)
- Jun Suzuki
- Department of Respiratory Medicine, National Hospital Organization Nishigunma Hospital
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25
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Tsurumaki H, Tomizawa Y, Tsuchiya T, Suzuki J, Iijima H, Yoshii A, Watanabe S, Sato K, Kamide Y, Mori M, Saito R. [A case of non-small cell lung cancer responding to S-1 over a year]. Gan To Kagaku Ryoho 2010; 37:2147-2149. [PMID: 21084815] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 71-year-old woman was admitted to our hospital, because of an abnormality on her chest radiograph findings. After extensive examination, she was diagnosed with primary lung adenocarcinoma (cT4N2M1, stage IV). She was treated by carboplatin+gemcitabine, gefitinib and docetaxel and the responses were stable disease in any treatment. As the fourth-line treatment, she received oral chemotherapy using S-1 at 100 mg/day (80 mg/m2 day) for 28 days, followed by withdrawal for 14 days. Tumor size was reduced 29.2% after 1 course, 62.5% after 5 courses and 83.3% after 10 courses (14 months). Hematologic and non-hematologic toxicities were mild with the S-1 administration. We experienced a case of continuation of tumor shrinkage over a year without serious adverse events by S-1 treatment. Therefore, oral administration of S-1 could be useful for the treatment of recurrent non-small cell lung cancer over a long time.
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Affiliation(s)
- Hiroaki Tsurumaki
- Dept. of Respiratory Medicine, National Hospital Organization Nishigunma Hospital
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26
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Kaira K, Sunaga N, Yanagitani N, Imai H, Utsugi M, Iwasaki Y, Shimizu K, Iijima H, Tsurumaki H, Tomizawa Y, Hisada T, Ishizuka T, Saito R, Mori M. Phase 2 study of S-1 plus carboplatin in patients with advanced non-small cell lung cancer. Lung Cancer 2010; 68:253-7. [DOI: 10.1016/j.lungcan.2009.06.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 06/08/2009] [Accepted: 06/30/2009] [Indexed: 10/20/2022]
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27
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Kaira K, Sunaga N, Tomizawa Y, Yanagitani N, Shimizu K, Imai H, Utsugi M, Iwasaki Y, Iijima H, Tsurumaki H, Yoshii A, Fueki N, Hisada T, Ishizuka T, Saito R, Mori M. A phase II study of amrubicin, a synthetic 9-aminoanthracycline, in patients with previously treated lung cancer. Lung Cancer 2009; 69:99-104. [PMID: 19853960 DOI: 10.1016/j.lungcan.2009.09.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Revised: 08/22/2009] [Accepted: 09/28/2009] [Indexed: 11/19/2022]
Abstract
PURPOSE This study was designed to confirm the efficacy and safety of amrubicin, a new anthracycline agent, in patients with previously treated non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). METHODS Eligible patients were required to have recurrent or refractory NSCLC and SCLC after one or two previous chemotherapy regimens. All patients received intravenous amrubicin 35 mg/m(2) on days 1-3 every 3 weeks. Overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. RESULTS Sixty-six patients (37 NSCLC and 29 SCLC) were assessable for efficacy and safety evaluation. Grade 3 or 4 neutropenia was observed in 39.4% of all patients (NSCLC, 37.8%; SCLC, 41.4%). Nonhematological toxicities were mild. No treatment-related death was observed. The ORRs were 13.5% (95% CI, 4.5-28.8%) in NSCLC and 44.8% (95% CI, 26.4-64.3%) in SCLC. In SCLC, ORRs were 60.0% in the sensitive relapse and 36.8% in the refractory relapse (p=0.2332). In NSCLC, the PFS, OS, and 1-year survival were 3.3 months, 12.0 months, and 35.3%, respectively. In SCLC, the PFS, OS, and 1-year survival were 4.0 months, 12.0 months, and 46.7%, respectively. CONCLUSIONS Amrubicin is an active and well-tolerated regimen in patients with previously treated lung cancer. Amrubicin 35 mg/m(2) seems to achieve similar efficacy with less toxicity than amrubicin 40 mg/m(2) in this patient population. These results warrant further evaluation in previously treated lung cancer.
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Affiliation(s)
- Kyoichi Kaira
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma 371-8511, Japan.
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Abstract
We measured polar angle (theta)-resolved time-of-flight spectra of D2 molecules desorbing from the Si(100)-(3x1) dideuteride surface. The desorbing D2 molecules exhibit a considerable translational heating with mean desorption kinetic energies of approximately 0.25 eV, which is mostly independent of the desorption angles for 0 degrees<or=theta<or=30 degrees. The observed desorption dynamics of deuterium was discussed along the principle of detailed balance to predict their adsorption dynamics onto the monohydride Si surface.
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Affiliation(s)
- T Niida
- Department of Electrical Engineering, Kyushu Institute of Technology, Kitakyushu 804-8550, Japan
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Matsuno T, Niida T, Tsurumaki H, Namiki A. Coverage dependent desorption dynamics of deuterium on Si(100) surfaces: Interpretation with a diffusion-promoted desorption model. J Chem Phys 2005; 122:024702. [PMID: 15638609 DOI: 10.1063/1.1829994] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We studied coverage dependence of time-of-flight (TOF) spectra of D2 molecules thermally desorbed from the D/Si(100) surface. The mean translational energies Et of desorbed D2 molecules were found to increase from 0.20+/-0.05 eV to 0.40+/-0.04 eV as the desorption coverage window was decreased from 1.0 ML> or =thetaD> or =0.9 ML to 0.2 ML> or =thetaD> or =0 ML, being consistent with the kinetics switch predicted in the interdimer mechanism. The measured TOF spectra were deconvoluted into 2H, 3H, and 4H components by a curve fitting method along the principle of detailed balance. As a result, it turned out that the desorption kinetics changes from the 4H to the 3H situation at high coverage above thetaD=0.9 ML, while the 2H desorption is dominant for a quite wide coverage region up to thetaD=0.8 ML. A dynamic desorption mechanism by which the desorption is promoted by D-atom diffusion to dangling bonds was proposed.
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Affiliation(s)
- T Matsuno
- Department of Electrical Engineering, Kyushu Institute of Technology, Kitakyushu 804-8550, Japan
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Rahman F, Kuroda M, Kiyonaga T, Khanom F, Tsurumaki H, Inanaga S, Namiki A. Modulated hydrogen beam study of adsorption-induced desorption of deuterium from Si(100)-3×1:D surfaces. J Chem Phys 2004; 121:3221-7. [PMID: 15291634 DOI: 10.1063/1.1772758] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We have studied the kinetic mechanism of the adsorption-induced-desorption (AID) reaction, H+D/Si(100) --> D2. Using a modulated atomic hydrogen beam, two different types of AID reaction are revealed: one is the fast AID reaction occurring only at the beam on-cycles and the other the slow AID reaction occurring even at the beam off-cycles. Both the fast and slow AID reactions show the different dependence on surface temperature Ts, suggesting that their kinetic mechanisms are different. The fast AID reaction overwhelms the slow one in the desorption yield for 300 K < or = Ts < or = 650 K. It proceeds along a first-order kinetics with respect to the incident H flux. Based on the experimental results, both two AID reactions are suggested to occur only on the 3x1 dihydride phase accumulated during surface exposure to H atoms. Possible mechanisms for the AID reactions are discussed.
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Affiliation(s)
- F Rahman
- Department of Electrical Engineering, Kyushu Institute of Technology, Kitakyushu 804-8550, Japan
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Hoshina H, Takagi R, Tsurumaki H, Nagashima K, Miyaura Y, Fujita H, Miyamoto T, Sohma Y, Iida A, Nagata M, Kaji M. [Clinical result of thermochemoradiotherapy for advanced head and neck cancer]. Gan To Kagaku Ryoho 2001; 28:331-6. [PMID: 11265400] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Since 1986, we have applied thermochemo (CDDP) therapy combined with radiotherapy to 18 patients with 25 advanced and/or recurrent head and neck cancers (thermochemoradiotherapy: TCR). In this report, the effects of TCR were compared with those of radiochemotherapy (RC) without hyperthermia for 22 patients with 27 cancers before 1985 in our department. Thermochemotherapy was performed twice a week, for a total of 8.8 times on average. Three kinds of heating system were used: a radiofrequency system, a microwave system, and a RF interstitial system. In the TCR group, 11 lesions (44.0%) showed a complete response (CR), 12 lesions (48.0%) a partial response (PR), and 2 lesions (8.0%) no change (NC). Therefore, the total response rate was 92.0%. After treatment with only RC, 5 lesions (18.5%) showed a CR, 12 lesions (44.5%) a PR, and 10 lesions (37.0%) NC, giving a total response rate of 63.0%. There was a significant difference in the CR and total response rate between these two groups. Furthermore, the 5-year cumulative local control and survival rates in the TCR group were 68.2% and 44.4%, and in the RC group were 22.2% and 18.2%, respectively. There was a significant difference in the local control rate between these two groups. In conclusion, thermochemoradiotherapy is an effective strategy for patients with advanced head and neck cancers.
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Affiliation(s)
- H Hoshina
- Second Dept. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Niigata University
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Abstract
The vibrational state distribution and the stereodynamics of product NO in the highly exothermic O(
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Iida A, Takagi R, Hoshina H, Ono K, Kaji M, Tsurumaki H, Fukuda J, Nagashima K, Miyaura Y, Hayatsu M, Miyamoto T. [5-FU concentration in the serum and the tumor tissue after administration of UFT 200 mg/day to patients over 80 years of age with oral cancer]. Gan To Kagaku Ryoho 2000; 27:1527-32. [PMID: 11015997] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
UFT was administered orally at a dosage of 200 mg/day, 2 times a day, to patients over 80 years of age with oral cancer. The concentration of 5-FU in the serum and tumor tissue, as well as the side effects, were investigated. The results were as follows: 1. The concentration of 5-FU in the serum peaked (0.017 to 0.066 microgram/ml) 1 or 2 hours after UFT administration. The concentration 8 hours after administration was relatively high (0.016 to 0.041 microgram/ml). 2. The 5-FU concentrations in the tumor tissues in 3 out of 5 cases were greater than 0.05 microgram/g, which is considered to be the effective level. The concentration tended to be higher with increased duration of administration. 3. A minor side effect, bone marrow dysfunction, was observed. No effect on the function of the liver or digestive system was observed.
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Affiliation(s)
- A Iida
- Second Dept. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Niigata University
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Nomura H, Ohashi Y, Hoshina H, Kaji M, Takagi R, Tsurumaki H, Suzuki M. Oral malignant melanoma: Report of five cases. Int J Oral Maxillofac Surg 1997. [DOI: 10.1016/s0901-5027(97)81491-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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