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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Miyanishi K, Sugiki T, Matsui T, Ozawa R, Hatanaka Y, Enozawa H, Nakamura Y, Murata T, Kagawa A, Morita Y, Fujiwara T, Kitagawa M, Negoro M. Protein-Ligand Interaction Analyses with Nuclear Magnetic Resonance Spectroscopy Enhanced by Dissolution Triplet Dynamic Nuclear Polarization. J Phys Chem Lett 2023:6241-6247. [PMID: 37401781 DOI: 10.1021/acs.jpclett.3c01002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Solution-state nuclear magnetic resonance spectroscopy (NMR) is a powerful method for the analysis of intermolecular interactions within a biomolecular system. However, low sensitivity is one of the major obstacles of NMR. We improved the sensitivity of solution-state 13C NMR for the observation of intermolecular interactions between protein and ligand using hyperpolarized solution samples at room temperature. Eutectic crystals composed of 13C-salicylic acid and benzoic acid doped with pentacene were hyperpolarized by dynamic nuclear polarization using photoexcited triplet electrons, and a 13C nuclear polarization of 0.72 ± 0.07% was achieved after dissolution. The binding of human serum albumin and 13C-salicylate was observed with several hundred times sensitivity enhancement under mild conditions. The established 13C NMR was applied for pharmaceutical NMR experiments by observation of the partial return of the 13C chemical shift of salicylate by competitive binding with other non-isotope-labeled drugs.
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Affiliation(s)
- K Miyanishi
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
- Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - T Sugiki
- Institute for Protein Research, Osaka University, Suita, Osaka 565-0871, Japan
| | - T Matsui
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
| | - R Ozawa
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
| | - Y Hatanaka
- Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - H Enozawa
- Department of Applied Chemistry, Faculty of Engineering, Aichi Institute of Technology, Toyota, Aichi 470-0392, Japan
| | - Y Nakamura
- Department of Applied Chemistry, Faculty of Engineering, Aichi Institute of Technology, Toyota, Aichi 470-0392, Japan
| | - T Murata
- Department of Applied Chemistry, Faculty of Engineering, Aichi Institute of Technology, Toyota, Aichi 470-0392, Japan
| | - A Kagawa
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
- Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - Y Morita
- Department of Applied Chemistry, Faculty of Engineering, Aichi Institute of Technology, Toyota, Aichi 470-0392, Japan
| | - T Fujiwara
- Institute for Protein Research, Osaka University, Suita, Osaka 565-0871, Japan
| | - M Kitagawa
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
- Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - M Negoro
- Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology, 4-9-1, Anagawa, Inage-Ku, Chiba 263-8555, Japan
- Premium Research Institute for Human Metaverse Medicine (WPI-PRIMe), Osaka University, Suita, Osaka 565-0871, Japan
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4
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Numata M, Haginoya N, Shiroishi M, Hirata T, Sato-Otsubo A, Yoshikawa K, Takata Y, Nagase R, Kashimoto Y, Suzuki M, Schulte N, Polier G, Kurimoto A, Tomoe Y, Toyota A, Yoneyama T, Imai E, Watanabe K, Hamada T, Kanada R, Watanabe J, Kagoshima Y, Tokumaru E, Murata K, Baba T, Shinozaki T, Ohtsuka M, Goto K, Karibe T, Deguchi T, Gocho Y, Yoshida M, Tomizawa D, Kato M, Tsutsumi S, Kitagawa M, Abe Y. A novel Menin-MLL1 inhibitor, DS-1594a, prevents the progression of acute leukemia with rearranged MLL1 or mutated NPM1. Cancer Cell Int 2023; 23:36. [PMID: 36841758 PMCID: PMC9960487 DOI: 10.1186/s12935-023-02877-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/17/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Mixed lineage leukemia 1-rearranged (MLL1-r) acute leukemia patients respond poorly to currently available treatments and there is a need to develop more effective therapies directly disrupting the Menin‒MLL1 complex. Small-molecule-mediated inhibition of the protein‒protein interaction between Menin and MLL1 fusion proteins is a potential therapeutic strategy for patients with MLL1-r or mutated-nucleophosmin 1 (NPM1c) acute leukemia. In this study, we preclinically evaluated the new compound DS-1594a and its salts. METHODS We evaluated the preclinical efficacy of DS-1594a as well as DS-1594a·HCl (the HCl salt of DS-1594a) and DS-1594a·succinate (the succinic acid salt of DS-1594a, DS-1594b) in vitro and in vivo using acute myeloid leukemia (AML)/acute lymphoblastic leukemia (ALL) models. RESULTS Our results showed that MLL1-r or NPM1c human leukemic cell lines were selectively and highly sensitive to DS-1594a·HCl, with 50% growth inhibition values < 30 nM. Compared with cytrabine, the standard chemotherapy drug as AML therapy, both DS-1594a·HCl and DS-1594a·succinate mediated the eradication of potential leukemia-initiating cells by enhancing differentiation and reducing serial colony-forming potential in MLL1-r AML cells in vitro. The results were confirmed by flow cytometry, RNA sequencing, RT‒qPCR and chromatin immunoprecipitation sequencing analyses. DS-1594a·HCl and DS-1594a·succinate exhibited significant antitumor efficacy and survival benefit in MOLM-13 cell and patient-derived xenograft models of MLL1-r or NPM1c acute leukemia in vivo. CONCLUSION We have generated a novel, potent, orally available small-molecule inhibitor of the Menin-MLL1 interaction, DS-1594a. Our results suggest that DS-1594a has medicinal properties distinct from those of cytarabine and that DS-1594a has the potential to be a new anticancer therapy and support oral dosing regimen for clinical studies (NCT04752163).
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Affiliation(s)
- Masashi Numata
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Noriyasu Haginoya
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd, Tokyo, Japan
| | - Machiko Shiroishi
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Tsuyoshi Hirata
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd, Tokyo, Japan
| | - Aiko Sato-Otsubo
- grid.63906.3a0000 0004 0377 2305Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan ,grid.26999.3d0000 0001 2151 536XDepartment of Pediatrics, University of Tokyo, Tokyo, Japan
| | - Kenji Yoshikawa
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Yoshimi Takata
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Reina Nagase
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Yoshinori Kashimoto
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd, Tokyo, Japan
| | - Makoto Suzuki
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd, Tokyo, Japan
| | - Nina Schulte
- grid.488273.20000 0004 0623 5599Daiichi Sankyo Europe GmbH, Munich, Germany
| | - Gernot Polier
- grid.488273.20000 0004 0623 5599Daiichi Sankyo Europe GmbH, Munich, Germany
| | - Akiko Kurimoto
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Yumiko Tomoe
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Akiko Toyota
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Tomoko Yoneyama
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd, Tokyo, Japan
| | - Emi Imai
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd, Tokyo, Japan
| | - Kenji Watanabe
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Tomoaki Hamada
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Ryutaro Kanada
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Jun Watanabe
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Yoshiko Kagoshima
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Eri Tokumaru
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Kenji Murata
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Takayuki Baba
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Taeko Shinozaki
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Masami Ohtsuka
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Koichi Goto
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Tsuyoshi Karibe
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Takao Deguchi
- grid.63906.3a0000 0004 0377 2305Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshihiro Gocho
- grid.63906.3a0000 0004 0377 2305Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masanori Yoshida
- grid.63906.3a0000 0004 0377 2305Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- grid.63906.3a0000 0004 0377 2305Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- grid.63906.3a0000 0004 0377 2305Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan ,grid.26999.3d0000 0001 2151 536XDepartment of Pediatrics, University of Tokyo, Tokyo, Japan ,grid.63906.3a0000 0004 0377 2305Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shinji Tsutsumi
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
| | - Mayumi Kitagawa
- Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005, Japan.
| | - Yuki Abe
- grid.410844.d0000 0004 4911 4738Shinagawa R&D Center, Daiichi Sankyo Co., Ltd, 1-2-5 Hiromachi, Shinagawa-Ku, Tokyo, 140-0005 Japan
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Sekiguchi N, Shiozawa N, Ishikawa C, Kitagawa M, Nakayama T, Ito D. Myxoid meningioma in a dog. J Small Anim Pract 2023; 64:118. [PMID: 36428278 DOI: 10.1111/jsap.13576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/25/2022] [Accepted: 10/13/2022] [Indexed: 11/27/2022]
Affiliation(s)
- N Sekiguchi
- Laboratory of Veterinary Neurology and Neurosurgery, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - N Shiozawa
- Laboratory of Veterinary Neurology and Neurosurgery, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology and Neurosurgery, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - M Kitagawa
- Laboratory of Veterinary Neurology and Neurosurgery, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - T Nakayama
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - D Ito
- Laboratory of Veterinary Neurology and Neurosurgery, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan.,Laboratory of Veterinary Radiology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Ito R, Kitagawa M, Sugawara M, Chiba T, Ryuzaki S, Yoshino Y, Kobayashi Y. Prognosis of hypertrophic cardiomyopathy in Japanese patients with an implantable cardioverter defibrillator -focus on apical hypertrophic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with hypertrophic cardiomyopathy (HCM) are at high risk of lethal arrhythmias, and implantable cardioverter defibrillators (ICD) are widely used for prevention of sudden cardiac death (SCD). Apical HCM is a phenotype variant of HCM, with hypertrophy predominantly affecting apex, that was initially described 30 years ago. Apical HCM patients may have different clinical prognosis compared with other subsets of HCM. In previous studies, apical HCM patients seem to have a more benign prognosis than other types of HCM. However, little is known about the long-term outcomes of apical HCM patients and there are many unclear points. Moreover, there are few reports about the clinical prognosis in apical HCM patients with an ICD.
Objective
The aim of this study is to identify the difference between the prognosis of apical and the other types of HCM patients with an ICD.
Methods
We retrospectively analyzed the database of our ICD clinic. All subjects underwent ICD implantation between October 2006 and September 2018. We classified HCM patients into LV outflow tract obstruction (LVOTO) and midventricular obstruction (MVO), apical HCM and other non-obstructive types. We divided all the patients into apical and other types of HCM, and examined their background, incidence of appropriate ICD therapies, hospitalization for heart failure, electrical storm and death.
Results
A total of consecutive 64 Japanese HCM patients with an ICD (follow-up period, 86±24 months; age, 65±14 years; male sex, 83%; left ventricular ejection fraction, 56±14%; LV max wall-thickness, 19±7mm; LV apical aneurysm, 9.4%; 5-year risk of SCD, 4.4±2.1) were enrolled in this study. We classified them into 14 apical HCM and 50 other types of HCM patients. The clinical characteristics and major clinical events of these patients are shown in the Table 1. During the follow-up periods, there were no significant differences in the incidence of electrical storm, hospitalization for heart failure and death between the 2 groups (p=0.11; p=0.60; p=0.39). Appropriate ICD therapies occurred in 6 of 14 (43%) patients with apical HCM and 5 of 50 (10%) patients with other types of HCM (p=0.010). The risk factors of patients with apical HCM patients are shown in Table 2.
Conclusions
Appropriate ICD therapy was more prevalent in patients with apical HCM, compared to patients with other types of HCM. Aggressive intervention such as catheter ablation for ventricular tachycardia and ventricular fibrillation may be considered in patients with apical HCM and higher score of 5-year risk of SCD. Further studies are needed to clarify the manifestations and long-term outcome of apical HCM patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics , Chiba , Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics , Chiba , Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - S Ryuzaki
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - Y Yoshino
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine , Chiba , Japan
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7
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Sugawara M, Kondo Y, Yoshino Y, Ryuzaki S, Chiba T, Kitagawa M, Ito R, Nakano MI, Kajiyama T, Nakano MA, Kobayashi Y. Long-term clinical course and prognostic factors of heart failure with reduced ejection fraction (HFrEF) patients underwent primary prophylactic implantable cardioverter defibrillator (ICD). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
For decades, ICD is a well-established therapy for improving prognosis of structural heart disease with severe cardiac dysfunction, and ICD for primary prophylaxis against sudden cardiac death were routinely provided. However, long-term prognosis and clinical course are different in each individual patient with an ICD, and it is moreover unclear what kind of factors might have influences on their clinical outcomes.
Purpose
The aim of this study is to clarify long-term prognosis and predictors of future major adverse cardiac events (MACEs) in HFrEF patients with an ICD as primary prophylaxis in Japanese population.
Methods
We retrospectively analyzed our ICD database. Patients underwent primary prophylactic ICD implantation from 2006 to 2020 at our institute and met the criteria of ICD recommendation of the latest Japanese guideline. Its requirements are receiving optimal medication therapy, symptomatic heart failure (New York Heart Association classification II or greater), and severe cardiac dysfunction (left ventricular ejection fraction (LVEF) is 35% or less). Additionally, prior NSVT is considered Class I ICD recommendation. In the case of ischemic cardiomyopathy (ICM), ICD implantation was done at least 40 days after myocardial infarction and at least 90 days after revascularization. MACEs were defined as composite outcome of cardiovascular death, heart failure hospitalization, and appropriate ICD therapies.
Results
A total of 148 consecutive patients were enrolled (male, 120 (81%); age, 62.1±11.8 years; LVEF, 23.0±5.86%; left ventricular end-diastolic diameter (LVDd), 67.6±9.26mm; paroxysmal or persistent atrial fibrillation (AF), 38 (26%); NSVT, 113 (76%); use of class III antiarrhythmic drugs, 48 (32%); ICM, 49 (33%); cardiac resynchronization therapy (CRT), 63 (43%)). One hundred twenty patients (81%) were programmed with a shock-only zone over 200 beats per minute. The median follow-up duration was 58.5 months. Among those 148 patients, MACEs were occurred to 60 patients (41%). As a result of dividing all patients into two groups by the occurrence of MACE, LVEF and LVDd were worse in MACE(+) group, whereas, MACE(−) had greater number of co morbidities. The results of cox-regression analysis showed LVDd (HR: 1.07, 95% CI: 1.03–1.12, p<0.001), AF (HR: 2.88, 95% CI: 1.56–5.31, p<0.001) and ICM (HR: 1.78, 95% CI: 1.00–3.16, p=0.049) were the independent predictors of MACEs (Table). However, initial ICD programming was not related to the occurrence of MACE.
Conclusions
The incidence of MACEs in patients with an ICD and severe HFrEF was substantially high in this Japanese population. Etiology of ICM, left ventricle size, and AF were the potential risk factors for future MACEs.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Sugawara
- Chiba University Hospital , Chiba , Japan
| | - Y Kondo
- Chiba University Hospital , Chiba , Japan
| | - Y Yoshino
- Chiba University Hospital , Chiba , Japan
| | - S Ryuzaki
- Chiba University Hospital , Chiba , Japan
| | - T Chiba
- Chiba University Hospital , Chiba , Japan
| | - M Kitagawa
- Chiba University Hospital , Chiba , Japan
| | - R Ito
- Chiba University Hospital , Chiba , Japan
| | - M I Nakano
- Chiba University Hospital , Chiba , Japan
| | - T Kajiyama
- Chiba University Hospital , Chiba , Japan
| | - M A Nakano
- Chiba University Hospital , Chiba , Japan
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8
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Ito D, Ishikawa C, Sekiguchi N, Kitagawa M. Syringomyelia fluid flow on time-spatial labeling inversion pulse (Time-SLIP) images in a dog. J Small Anim Pract 2022; 63:911. [PMID: 36096494 DOI: 10.1111/jsap.13551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/11/2022] [Accepted: 08/12/2022] [Indexed: 11/27/2022]
Affiliation(s)
- D Ito
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - N Sekiguchi
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - M Kitagawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
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9
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Sekiguchi N, Ito D, Ishikawa C, Tanaka N, Kitagawa M. Heavily T2-weighted imaging findings of spinal cord swelling in dogs with intervertebral disc extrusion. J S Afr Vet Assoc 2022. [DOI: 10.36303/jsava.2022.93.1.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
- N Sekiguchi
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - D Ito
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - N Tanaka
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - M Kitagawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
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10
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Sekiguchi N, Ito D, Ishikawa C, Tanaka N, Kitagawa M. Heavily T2-weighted imaging findings of spinal cord swelling in dogs with intervertebral disc extrusion. J S Afr Vet Assoc 2022; 93:16-24. [PMID: 35950805] [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: 06/15/2023] Open
Abstract
This study investigated causes of attenuation of cerebrospinal fluid (CSF) signal on heavily T2-weighted (T2W) images in dogs with thoracolumbar disc extrusion. Medical records and magnetic resonance images were retrospectively reviewed. Dogs were classified into the following grades; grade 1, non-ambulatory paraparesis; grade 2, paraplegia with deep pain perception and grade 3, paraplegia without deep pain perception. The length of intramedullary T2W hyperintensity of the spinal cord, cranial/ caudal expansion of extradural compressive materials (ECM), and the CSF signal attenuation were measured. Ratios to the second lumbar vertebra (L2) were calculated for the length of intramedullary T2W hyperintensity (T2W:L2), cranial/caudal expansion of ECM (ECML:L2), and CSF signal attenuation (CSF:L2). The dogs were classified into focal or extended T2W hyperintensity groups according to the length [focal, shorter than length of L2; extended, longer than L2]. The area of EMC and the spinal canal were measured on transverse images at the lesion deriving occupancy ratio. The correlation between CSF:L2 and other data were analysed, and CSF:L2 was compared between the grades. In dogs with intramedullary T2W hyperintensity, the locations of CSF attenuation and the hyperintensity were compared if those locations were matched. Fifty-five dogs were included, 36 of which showed intramedullary T2W hyperintensity. Twenty-two of 36 dogs were considered as match of the location of the CSF attenuation and hyperintensity. CSF:L2 was significantly correlated with T2W:L2 in dogs with extended T2W hyperintensity (p = 0.0002), while CSF:L2 was significantly correlated with ECML:L2 in dogs with focal or no T2W hyperintensity (p = 0.0103 and p = 0.0364, respectively). CSF:L2 in grade 3 was significantly greater than those in patients who were grade 1 or 2 (both p < 0.001). In conclusion, higher CSF:L2, which was frequently seen in grade 3, would be most consistent with a higher T2W:L2 which might indicate spinal cord swelling.
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Affiliation(s)
- N Sekiguchi
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Japan
| | - D Ito
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Japan
| | - N Tanaka
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Japan
| | - M Kitagawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Japan
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Chiba T, Kajiyama T, Yutaka Y, Ryuzaki S, Sugawara M, Kitagawa M, Ito R, Nakano M, Nakano M, Kondo Y, Kobayashi Y. Association between right ventricular dysfunction and appropriate icd therapy. Europace 2022. [DOI: 10.1093/europace/euac053.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Right ventricular fractional area change (RVFAC) as right ventricular function is recently referred as an independent predictor of sudden cardiac death (SCD). The purpose of this study was to evaluate the association of RVFAC and appropriate ICD therapy in order to determine the cut-off value of RVFAC.
Methods
Consecutive patients who underwent initial ICD implantation for any diseases except for non-dilated phase hypertrophic cardiomyopathy and channelopathy were retrospectively enrolled from 2012 to 2018. Primary endpoint was an initial appropriate ICD therapy. Transthoracic echocardiographic parameters before ICD implantation were evaluated by one physician and one echocardiologist to be validated. Right ventricular dimensions and function were also measured to be analyzed.
Results
In total, 172 patients (60.3±13.6 years, 131 males) including 63 ischemic cardiomyopathy were enrolled. Ninety patients received an ICD as a secondary prophylaxis. Mean LVEF and RVFAC were 38.3±14.3% and 35.8±8.82%, respectively. There was little correlation between RVFAC and LVEF (correlation coefficient =0.274). Regarding appropriate ICD therapy events, the best cut-off value of RVFAC was 34.8%. The odds ratio of low RVFAC was 2.731 (95%CI: 1.456-5.121, P=0.00174). Secondary prophylactic cohort with low RVFAC showed highest incidence of appropriate ICD therapy as shown in the figure. In multivariate analysis, only low RVFAC is an independent predictor of appropriate ICD therapy (HR: 3.53, 95%CI:1.78- 6.99, P=0.0003).
Conclusion
Low RVFAC seemed independently associated with increased appropriate ICD therapy.
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Affiliation(s)
- T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - Y Yutaka
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - S Ryuzaki
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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12
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Sugawara M, Kondo Y, Ryuzaki S, Yoshino Y, Chiba T, Kitagawa M, Ito R, Nakano MI, Kajiyama T, Nakano MA, Kobayashi Y. Negative prognostic implications of non-sustained ventricular tachycardias in patients after prophylactic defibrillator implantation. Europace 2022. [DOI: 10.1093/europace/euac053.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Non-sustained ventricular tachycardia (NSVT) is frequent phenomenon in severe heart failure with reduced ejection fraction (HFrEF) patients, and causes any negative impacts on such patients. In the Japanese Circulation Society (JCS) and Japanese Heart Rhythm Society (JHRS) guidelines, NSVT is regarded as a major component of indication for implantable cardioverter defibrillator (ICD) implantation. However, the long-term prognostic significance of NSVT in severe HFrEF is incompletely resolved.
Purpose
The aim of this study is to investigate the relation between prior NSVT episodes and major adverse cardiac events (MACEs) in HFrEF patients with an ICD as primary prophylaxis.
Methods
We retrospectively analyzed our ICD database. Patients underwent primary prophylactic ICD implantation from 2007 to 2018 following ICD recommendation of JCS and JHRS guidelines. Patients met the criteria of receiving optimal medication therapy, symptomatic heart failure (New York Heart Association classification II or greater), and severe cardiac dysfunction (left ventricular ejection fraction (LVEF) is 35% or less). In the case of ischemic cardiomyopathy (ICM), implantation of ICD was done at least 40 days after myocardial infarction and at least 90 days after revascularization. Incidence of NSVT episodes were identified through daily electrocardiogram (ECG), Holter ECG or monitor ECG in the hospital. MACEs were defined as composite outcome of cardiovascular death, heart failure hospitalization, and appropriate ICD therapies.
Results
A total of 148 consecutive patients were enrolled (male, 120 (81%); age, 62.1±11.8 years; LVEF, 23.0±5.86%; left ventricular end-diastolic diameter (LVDd), 67.6±9.26mm; paroxysmal or persistent atrial fibrillation (AF), 38 (26%); NSVT, 113 (76%); use of class III antiarrhythmic drugs, 48 (32%); ICM, 49 (33%); cardiac resynchronization therapy (CRT), 63 (43%)). The median follow-up duration was 58.5 months. As a result of comparison of the Kaplan-Meier curve between NSVT group (n=113) and non-NSVT group (n=35), cardiovascular death, heart failure hospitalization, and appropriate ICD therapy were not statistically different (Figures). Of those, MACEs were occurred to 60 patients (41%). The results of cox-regression analysis showed LVDd (HR: 1.07, 95% CI: 1.03-1.12, p<0.001), AF (HR: 2.88, 95% CI: 1.56-5.31, p<0.001) and ICM (HR: 1.78, 95% CI: 1.00-3.16, p=0.049) were the independent predictors of MACEs, however NSVT was not (Table).
Conclusions
In this Japanese population, the long-term prognosis of severe HFrEF patients is considered to be comparable regardless of prior NSVT episodes. However, the incidence of MACEs in patients with severe HFrEF after ICD implantation was substantially high. ICM, left ventricle size, and atrial fibrillation were the potential risk factors for MACEs as the previous reports showed.
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Affiliation(s)
| | - Y Kondo
- Chiba University Hospital, Chiba, Japan
| | - S Ryuzaki
- Chiba University Hospital, Chiba, Japan
| | - Y Yoshino
- Chiba University Hospital, Chiba, Japan
| | - T Chiba
- Chiba University Hospital, Chiba, Japan
| | | | - R Ito
- Chiba University Hospital, Chiba, Japan
| | - MI Nakano
- Chiba University Hospital, Chiba, Japan
| | | | - MA Nakano
- Chiba University Hospital, Chiba, Japan
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13
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Miyanishi K, Mizukami W, Motoyama M, Ichijo N, Kagawa A, Negoro M, Kitagawa M. Prediction of 1H Singlet Relaxation via Intermolecular Dipolar Couplings Using the Molecular Dynamics Method. J Phys Chem B 2022; 126:3530-3538. [PMID: 35538043 DOI: 10.1021/acs.jpcb.1c10799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Dissolution dynamic nuclear polarization has been applied in various fields, including chemistry, biology, and medical science. To expand the scope of these applications, the nuclear singlet state, which is decoherence-free against dipolar relaxation between spin pairs, has been studied experimentally, theoretically, and numerically. The singlet state composed of proton spins is used in several applications, such as enhanced polarization preservation, molecular tagging to probe slow dynamic processes, and detection of ligand-protein complexes. In this study, we predict the lifetimes of the nuclear spin states composed of proton spin pairs using the molecular dynamics method and quantum chemistry simulations. We consider intramolecular dipolar, intermolecular dipolar between solvent and solute, chemical shift anisotropy, and spin-rotation interactions. In particular, the relaxation rate of intermolecular dipolar interactions is calculated using the molecular dynamics method for various solvents. The calculated values and the experimental values are of the same order of magnitude. Our program would provide insight into the molecular design of several NMR applications and would be helpful in predicting the nuclear spin relaxation time of synthetic molecules in advance.
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Affiliation(s)
- K Miyanishi
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan.,Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
| | - W Mizukami
- Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-8531, Japan.,JST, PRESTO, Kawaguchi, Saitama 332-0012, Japan
| | - M Motoyama
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
| | - N Ichijo
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
| | - A Kagawa
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan.,Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-8531, Japan.,JST, PRESTO, Kawaguchi, Saitama 332-0012, Japan
| | - M Negoro
- Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-8531, Japan.,Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology, 4-9-1, Anagawa, Inage-Ku, Chiba 263-8555, Japan
| | - M Kitagawa
- Division of Advanced Electronics and Optical Science, Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan.,Center for Quantum Information and Quantum Biology, Osaka University, 1-2 Machikaneyama, Toyonaka, Osaka 560-8531, Japan
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14
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Ito R, Takahira H, Kitagawa M, Sugawara M, Chiba T, Kobayashi Y. Prognosis of apical hypertrophic cardiomyopathy in patients with an implantable cardioverter defibrillator. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Prophylactic use of implantable cardioverter-defibrillators (ICDs) to prevent sudden cardiac death (SCD) is widely spread all over the world in patients with hypertrophic cardiomyopathy (HCM). Apical HCM is a phenotype variant of HCM, with hypertrophy predominantly affecting apex, that was initially described 30 years ago. Apical HCM patients may have different clinical prognosis compared with other subsets of HCM. In previous studies, apical HCM patients seem to have a more benign prognosis than other types of HCM. However, little is known about the long-term outcomes of apical HCM and there are many unclear points. Moreover, there are few reports about the clinical prognosis in apical HCM patients with an ICD.
Objective
The aim of this study is to identify the difference between the prognosis of apical and the other HCM patients with an ICD.
Methods
We retrospectively analyzed the database of our ICD clinic. All subjects had been implanted with an ICD from October 2006 to August 2017. We classified HCM patients into LV outflow tract obstruction (LVOTO) and midventricular obstruction (MVO), apical HCM and other non-obstructive types. We divided all the patients into apical and other types of HCM, and examined their background, incidence of appropriate ICD therapies, hospitalization for heart failure, electrical storm and death.
Results
A total of consecutive 62 Japanese HCM patients with an ICD (follow-up period, 86±25 months; age, 67±14 years; male sex, 85%; left ventricular ejection fraction, 57±12%; LV max wall-thickness, 19±5mm; LV apical aneurysm, 9.7%; HCM Risk-SCD, 4.4±3.0) were enrolled in this study. We classified them into 14 apical HCM and 48 other types of HCM patients. The clinical characteristics and major events of these patients are shown in the Figure. During the follow-up periods, there were no significant differences in the incidence of hospitalization for heart failure, electrical storm and death between the 2 groups (p=0.40; p=0.22; p=0.23). Appropriate therapies occurred in 5 of 14 (36%) patients with apical HCM and 4 of 48 (8.3%) patients with other types of HCM (p=0.022).
Conclusions
Appropriate ICD therapy was more prevalent in patients with apical HCM, compared to patients with other types of HCM. However, the incidences of hospitalization for heart failure, electrical storm and death were not significantly different between two groups.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Ito R, Takahira H, Kitagawa M, Sugawara M, Chiba T, Kobatashi Y. Risk stratification for ischemic stroke and major bleeding in patients without atrial fibrillation – application of CHA2DS2-VASc and HAS-BLED scores. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most common arrhythmia. AF-related stroke tends to be more severe, and the mortality rate is higher compared with stroke without AF. Recent cardiac implantable electronic devices (CIEDs) have led to an improvement in the early detection of AF episodes. Previous studies showed that AF episodes detected by CIEDs are associated with ischemic stroke. However, little is known about the relationship between new-onset AF and ischemic stroke events in Japanese patients with CIEDs who have no prior AF and take no anticoagulant therapy. ESC guidelines for the management of AF recommend the use of CHA2DS2-VASc score as class I to predict the risk of ischemic stroke in patients with AF. However, the validity of the CHA2DS2-VASc and HAS-BLED scores to predict ischemic stroke and major bleeding events in patients without AF remains unclear.
Objective
The purpose of this study was to identify the incidence of ischemic stroke and major bleeding events in CIEDs patients without AF and assess the validity of CHA2DS2-VASc and HAS-BLED scores in this population.
Methods
We retrospectively analyzed the database of our CIEDs clinic. Every 6 months, CIEDs were checked using remote monitoring system. We examined the characteristics and incidence of ischemic stroke and bleeding events. In addition, we investigated the relationship between CHA2DS2-VASc and HAS-BLED scores and the incidence of these events.
Results
We enrolled 620 consecutive patients who were followed up at our CIED clinic. We excluded patients who had a history of AF or had received anticoagulant therapies, 348 patients (follow-up period, 65±58 months; age, 70±16 years; male sex; 64%; defibrillator, 55%) were included in this study. The mean CHA2DS2-VASc and HAS-BLED scores were 2.8±1.5 points and 1.7±1.6 points, respectively. During the follow-up, 23 (6.6%) and 12 (3.4%) of 348 patients had ischemic stroke and major bleeding events, respectively. The incidence of ischemic stroke and major bleeding events stratified by the CHA2DS2-VASc and HAS-BLED scores were shown in Figure 1.
Conclusion
The risk stratification for ischemic stroke and major bleeding using the CHA2DS2-VASc and HAS-BLED scores is valid in patients without AF.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobatashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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16
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Eguchi K, Shirai S, Matsushima M, Kano T, Yamazaki K, Hamauchi S, Sasamori T, Seki T, Hirata K, Kitagawa M, Otsuki M, Shiga T, Houkin K, Sasaki H, Yabe I. Correlation of active contact location with weight gain after subthalamic nucleus deep brain stimulation: a case series. BMC Neurol 2021; 21:351. [PMID: 34517835 PMCID: PMC8436541 DOI: 10.1186/s12883-021-02383-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/01/2021] [Indexed: 12/16/2022] Open
Abstract
Background Weight gain (WG) is a frequently reported side effect of subthalamic deep brain stimulation; however, the underlying mechanisms remain unclear. The active contact locations influence the clinical outcomes of subthalamic deep brain stimulation, but it is unclear whether WG is directly associated with the active contact locations. We aimed to determine whether WG is associated with the subthalamic deep brain stimulation active contact locations. Methods We enrolled 14 patients with Parkinson’s disease who underwent bilateral subthalamic deep brain stimulation between 2013 and 2019. Bodyweight and body mass index were measured before and one year following the surgery. The Lead-DBS Matlab toolbox was used to determine the active contact locations based on magnetic resonance imaging and computed tomography. We also created sweet spot maps for WG using voxel-wise statistics, based on volume of tissue activation and the WG of each patient. Fluorodeoxyglucose-positron emission tomography data were also acquired before and one year following surgery, and statistical parametric mapping was used to evaluate changes in brain metabolism. We examined which brain regions’ metabolism fluctuation significantly correlated with increased body mass index scores and positron emission tomography data. Results One year after surgery, the body mass index increase was 2.03 kg/m2. The sweet spots for WG were bilateral, mainly located dorsally outside of the subthalamic nucleus (STN). Furthermore, WG was correlated with increased metabolism in the left limbic and associative regions, including the middle temporal gyrus, inferior frontal gyrus, and orbital gyrus. Conclusions Although the mechanisms underlying WG following subthalamic deep brain stimulation are possibly multifactorial, our findings suggest that dorsal stimulation outside of STN may lead to WG. The metabolic changes in limbic and associative cortical regions after STN-DBS may also be one of the mechanisms underlying WG. Further studies are warranted to confirm whether dorsal stimulation outside of STN changes the activities of these cortical regions.
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Affiliation(s)
- Katsuki Eguchi
- Department of Neurology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan.
| | - Shinichi Shirai
- Department of Neurology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Masaaki Matsushima
- Department of Neurology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Takahiro Kano
- Department of Neurology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Kazuyoshi Yamazaki
- Department of Neurosurgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Shuji Hamauchi
- Department of Neurosurgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Toru Sasamori
- Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Kita 22, Higashi 1, Higashi-ku, 065-0022, Sapporo, Japan
| | - Toshitaka Seki
- Department of Neurosurgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Kenji Hirata
- Department of Diagnostic Imaging, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Mayumi Kitagawa
- Sapporo Teishinkai Hospital, Kita 33, Higashi 1, Higashi-ku, 065-0033, Sapporo, Japan
| | - Mika Otsuki
- Faculty of Health Sciences, Graduate School of Health Sciences, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Tohru Shiga
- Department of Nuclear Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Kiyohiro Houkin
- Department of Neurosurgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Hidenao Sasaki
- Department of Neurology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Ichiro Yabe
- Department of Neurology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
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17
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Eguchi K, Shirai S, Matsushima M, Kano T, Ichikawa T, Yamazaki K, Hamauchi S, Sasamori T, Seki T, Kitagawa M, Shiraishi H, Houkin K, Sasaki H, Yabe I. Chronic deep brain stimulation reduces cortical β-γ phase amplitude-coupling in patients with Parkinson's disease. Parkinsonism Relat Disord 2021; 89:148-150. [PMID: 34303200 DOI: 10.1016/j.parkreldis.2021.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/03/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
We compared β-γ phase amplitude coupling (PAC) before and one year after chronic deep brain stimulation (DBS) in patients with Parkinson's disease using EEG and observed significant post-operative reduction of PAC values. Our findings suggest that the reduction in PAC due to DBS can be observed after chronic stimulation, which is not a transient phenomenon just after the start of DBS.
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Affiliation(s)
- Katsuki Eguchi
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Shinichi Shirai
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Masaaki Matsushima
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Takahiro Kano
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Tomohiro Ichikawa
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Japan.
| | - Kazuyoshi Yamazaki
- Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Shuji Hamauchi
- Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Toru Sasamori
- Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, 1-40, Kita 22, Higashi 1, Higashi-ku, Sapporo, 065-0022, Japan.
| | - Toshitaka Seki
- Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Mayumi Kitagawa
- Sapporo Teishinkai Hospital, Kita 33, Higashi 1, Higashi-ku, Sapporo, 065-0033, Japan.
| | - Hideaki Shiraishi
- Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Kiyohiro Houkin
- Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Hidenao Sasaki
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Ichiro Yabe
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
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18
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Numata M, Shiroishi M, Yoshikawa K, Haginoya N, Hirata T, Takata Y, Nagase R, Takashima K, Kurimoto A, Tanzawa F, Tomoe Y, Hamada T, Kanada R, Watanabe J, Kagoshima Y, Tokumaru E, Murata K, Baba T, Shinozaki T, Hashimoto K, Kato M, Tsutsumi S, Kitagawa M, Fujiwara K, Abe Y. Abstract 1132: Development and characterization of a novel orally bioavailable menin-MLL inhibitor for treatment of acute leukemia patients with MLL-rearrangement or NPM1 mutation. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
DS-M1 is a novel, potent, orally bioavailable small molecule inhibitor of the binding of MLL1 fusion proteins and wild-type MLL1 to Menin in development for the treatment of patients with MLL1-rearranged (MLL1-r) or NPM1-mutated (NPM1-mu) acute leukemia. The interaction of MLL1 fusion proteins with menin plays an important role to enhance the proliferation and block the differentiation of hematopoietic cells, ultimately leading to acute leukemia. Furthermore, patients with MLL1-r acute leukemia respond poorly to currently available treatments, emphasizing the urgent need to develop more effective therapies directly disrupting the menin-MLL1 complex. Here we describe the characterization of DS-M1 and this study demonstrates the mechanism of action of DS-M1 as well as supports the oral dosing regimen planned for the initial clinical studies. DS-M1 selectively inhibited the cellular growth of MLL1-r or NPM1-mu human leukemic cell lines and primary cells from patients with GI50 of less than about 100 nM along with the cellular differentiation in vitro. RNA-seq and ChIP-seq analysis revealed that DS-M1 reduced the expression levels of MEIS1, PBX3 and HOXA9 genes in a concentration-dependent manner and dissociated the menin-MLL1 complex from the MEIS1 gene locus in MV-4-11, MOLM-13, and patient derived AML cells with MLL1-rearrangement. Interestingly, DS-M1 reduced the number of CD34+/CD38- leukemic stem cells (LSCs) in patient derived AML cells and induction of differentiation was also confirmed as measured by increased CD11b or CD14 expression. These results suggest that enhanced differentiation and loss of LSCs via the reduction of MEIS1, HOXA9, and PBX3 gene expression by DS-M1 is one of the main mechanisms of action for the antitumor activity of DS-M1. DS-M1 demonstrates significant survival benefit along with inhibition of MEIS1, HOXA9 and PBX3 expression in aggressive disseminated leukemia models intravenously inoculated with MV-4-11 and MOLM-13 cells as well as in patient-derived xenograft (PDX) models of MLL1-r or NPM1-mu acute leukemia. In disseminated MOLM-13 xenografts, treatment with 100 mg/kg qd of DS-M1 for 19 days produced durable response with event free survival >100 days after last dose (5 out of 6 mice, increase in life span (ILS) >515%). Furthermore, MLL1-r pediatric B-ALL-PDX mice treated with 50 mg/kg bid for 28 days and NPM1-mu AML-PDX mice treated with 100 mg/kg bid for 35 days were all survived (ILS >254% and >300%) without any detectable leukemic blast cells in bone marrow at 120 and 60 days after cessation of therapy, respectively. These data indicate that DS-M1 has a high potency as an antitumor drug with the potential to provide survival advantage in acute leukemia patients with MLL-r and NPM1-mu. Currently, a Phase 1/2 clinical study of DS-M1 is planned in AML and ALL patients with MLL-r or NPM1-mu.
Citation Format: Masashi Numata, Machiko Shiroishi, Kenji Yoshikawa, Noriyasu Haginoya, Tsuyoshi Hirata, Yoshimi Takata, Reina Nagase, Kohei Takashima, Akiko Kurimoto, Fumie Tanzawa, Yumiko Tomoe, Tomoaki Hamada, Ryutaro Kanada, Jun Watanabe, Yoshiko Kagoshima, Eri Tokumaru, Kenji Murata, Takayuki Baba, Taeko Shinozaki, Kazuyuki Hashimoto, Motohiro Kato, Shinji Tsutsumi, Mayumi Kitagawa, Kosaku Fujiwara, Yuki Abe. Development and characterization of a novel orally bioavailable menin-MLL inhibitor for treatment of acute leukemia patients with MLL-rearrangement or NPM1 mutation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1132.
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Affiliation(s)
- Masashi Numata
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Machiko Shiroishi
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | | | - Noriyasu Haginoya
- 3Medicinal Chemistry Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | | | - Yoshimi Takata
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Reina Nagase
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Kohei Takashima
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Akiko Kurimoto
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Fumie Tanzawa
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Yumiko Tomoe
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Tomoaki Hamada
- 3Medicinal Chemistry Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Ryutaro Kanada
- 3Medicinal Chemistry Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Jun Watanabe
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Yoshiko Kagoshima
- 3Medicinal Chemistry Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Eri Tokumaru
- 5Modality Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Kenji Murata
- 5Modality Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | | | - Taeko Shinozaki
- 6Analytical & Quality Evaluation Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | | | - Motohiro Kato
- 7Children's Cancer Center, National Center for Child Health and Development, Department of Pediatrics, the University of Tokyo, Tokyo, Japan
| | | | - Mayumi Kitagawa
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | | | - Yuki Abe
- 1Oncology Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan
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Chiba T, Kajiyama T, Sugawara M, Kitagawa M, Takahira H, Ito R, Nakano M, Nakano M, Kondo Y, Kobayashi Y. Right ventricular function as a predictor of appropriate therapy of implantable cardioverter defibrillator. Europace 2021. [DOI: 10.1093/europace/euab116.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Aim
The purpose of this study was to evaluate the association of RV function and appropriate therapy of ICD.Methods: This study was a single-center retrospective cohort study. Consecutive patients who underwent ICD implantation for any diseases were enrolled except for non-dilated phase hypertrophic cardiomyopathy and channelopathy. Transthoracic echocardiographic parameters including left ventricular ejection fraction (LVEF), RV basal diameter, RV end-diastolic area, and right ventricular fractional area change (RVFAC) were evaluated. RV systolic dysfunction was defined as RVFAC <35%. Cox regression analysis was used to analyze the effects of those parameters on appropriate ICD therapy after the implantation.
Results
In total, 151 patients (60.9 ± 13.6 years, 117 males) consisting of 67 old myocardial infarction, 34 dilated cardiomyopathy, 19 cardiac sarcoidosis, and 31 others were enrolled. Eighty patients received an ICD as a secondary prophylaxis. Mean LVEF and RVFAC were 37.8 ± 13.9% and 33.2 ± 10.8%, respectively. RV systolic dysfunction was present in 86 (57.0%) patients, which was significantly associated with ICD therapy (odds ratio 2.313; 95% confidence interval 1.067-5.014; P = 0.034) according to a univariate analysis. There was no correlation between RVFAC and LVEF (correlation coefficient =0.064). Regarding the subjects LVEF > 35%, RV systolic dysfunction was an independent predictor of ICD therapy in a multivariate analysis.
Conclusion
RV systolic dysfunction was independently associated with increased ICD therapy despite of relatively preserved LVEF.
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Affiliation(s)
- T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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20
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Sasagawa A, Enatsu R, Kitagawa M, Mikami T, Nakayama-Kamada C, Kuribara T, Hirano T, Arihara M, Mikuni N. Target Selection of Directional Lead in Patients with Parkinson's Disease. Neurol Med Chir (Tokyo) 2020; 60:622-628. [PMID: 33162470 PMCID: PMC7803701 DOI: 10.2176/nmc.tn.2020-0210] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Several structures including subthalamic nucleus (STN), the caudal zona incerta (cZI), the prelemniscal radiation (Raprl), and the thalamic ventral intermediate nucleus (Vim) have been reported to be useful for improving symptoms of Parkinson’s disease (PD). However, the effect of each target is still unclear. Therefore, we investigated each structure’s effects and adverse effects using a directional lead implanted in the posterior STN adjacent to the cZI and Raprl in two patients with tremor-dominant PD. In Case 1, maximal reduction of tremor was obtained by stimulation toward the Vim, and stimulation toward the thalamic reticular nucleus (TRN) reduced verbal fluency, but did not induce dysarthria. In Case 2, maximal reduction of tremor was obtained by stimulation toward the dorsal STN and Raprl. Maximal reduction of rigidity was achieved by stimulation toward the dorsal STN, Raprl, and cZI. Bradykiensia was improved by stimulation in all directions, but dyskinesia and dysarthria were evoked by stimulation toward the dorsal STN and cZI. The directional lead may elucidate the stimulation effect of each structure and broaden target selection depending on patients’ symptoms and adverse effects.
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Affiliation(s)
- Ayaka Sasagawa
- Department of Neurosurgery, Sapporo Medical University School of Medicine
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University School of Medicine
| | | | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University School of Medicine
| | | | - Tomoyoshi Kuribara
- Department of Neurosurgery, Sapporo Medical University School of Medicine
| | - Tsukasa Hirano
- Department of Neurosurgery, Sapporo Medical University School of Medicine
| | - Masayasu Arihara
- Department of Neurosurgery, Sapporo Medical University School of Medicine
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University School of Medicine
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21
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Ito D, Ishikawa C, Sekiguchi N, Jeffery ND, Kitagawa M. Utility of "MR myelography" in diagnosis of a presumed spinal subarachnoid diverticulum. J Small Anim Pract 2020; 61:782. [PMID: 33045762 DOI: 10.1111/jsap.13208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/01/2022]
Affiliation(s)
- D Ito
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - N Sekiguchi
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - N D Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - M Kitagawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
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22
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Ito D, Ishikawa C, Jeffery ND, Kitagawa M. Intraventricular carcinoma in a dog. J Small Anim Pract 2020; 62:234. [PMID: 32989762 DOI: 10.1111/jsap.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/18/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- D Ito
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, 1866 Kameino, Fujisawa, Kanagawa, 252-0880, Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, 1866 Kameino, Fujisawa, Kanagawa, 252-0880, Japan
| | - N D Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, 77843, USA
| | - M Kitagawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, 1866 Kameino, Fujisawa, Kanagawa, 252-0880, Japan
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23
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Enatsu R, Kitagawa M, Morishita T, Sasagawa A, Kuribara T, Hirano T, Arihara M, Mikami T, Mikuni N. Effect of Cycling Thalamosubthalamic Stimulation on Tremor Habituation and Rebound in Parkinson Disease. World Neurosurg 2020; 144:64-67. [PMID: 32841798 DOI: 10.1016/j.wneu.2020.08.141] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Deep brain stimulation is an effective treatment for severe tremor in essential tremor and Parkinson disease (PD). However, progressive loss of the beneficial effects of deep brain stimulation may occur due to several factors. CASE DESCRIPTION We assessed the effects of different temporal patterns of cycling stimulation in the posterior subthalamic area, subthalamic nucleus, and the ventral intermediate nucleus of the thalamus in 3 PD patients with early decline of tremor suppression associated with severe tremor rebound. CONCLUSIONS Certain temporal patterns of cycling (10 seconds on/1 second off or 30 seconds on/5 seconds off, soft start off) were useful for treating tremor habituation and rebound and showed long-term tremor suppression. Cycling stimulation may prevent tremor habituation in PD patients with severe tremor rebound.
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Affiliation(s)
- Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Mayumi Kitagawa
- Department of Neurology, Sapporo Teishinkai Hospital, Sapporo, Japan
| | - Takashi Morishita
- Department of Neurosurgery, Fukuoka University Faculty of Medicine, Sapporo, Japan
| | - Ayaka Sasagawa
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomoyoshi Kuribara
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsukasa Hirano
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masayasu Arihara
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
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24
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Kojoh A, Enatsu R, Kitagawa M, Mikami T, Sasagawa A, Kuribara T, Hirano T, Arihara M, Mikuni N. Combined deep brain stimulation and thalamotomy for tremor-dominant Parkinson's disease. J Clin Neurosci 2020; 74:244-247. [PMID: 32070669 DOI: 10.1016/j.jocn.2020.02.014] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
Although deep brain stimulation (DBS) is an established treatment for Parkinson's disease, the long-term suppression of tremor is still a challenging issue. We report two patients with tremor-dominant Parkinson's disease (PD) treated with unilateral thalamotomy of the ventralis intermedius nucleus (Vim) combined with the subthalamic nucleus (STN)-DBS or the posterior subthalamic area (PSA)-DBS. One year after the surgery, thalamotomy of the area from the Vim to the PSA showed improvement not only in tremor but also in rigidity and akinesia. PSA- or STN-DBS with low intensity stimulation eliminated residual PD symptoms. Combined DBS and thalamotomy may provide long-term improvement of the majority of PD symptoms using lower therapeutic stimulation voltages.
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Affiliation(s)
- Akimaro Kojoh
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Mayumi Kitagawa
- Department of Neurology, Sapporo Teishinkai Hospital, Sapporo, Japan
| | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ayaka Sasagawa
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomoyoshi Kuribara
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsukasa Hirano
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masayasu Arihara
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
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25
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Ito D, Ishikawa C, Jeffery ND, Oshima A, Nakayama T, Kitagawa M. 'T-SLIP' MRI imaging of cerebrospinal fluid flow through the mesencephalic aqueduct. J Small Anim Pract 2020; 61:206-207. [PMID: 31930501 DOI: 10.1111/jsap.13106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/12/2019] [Accepted: 11/25/2019] [Indexed: 11/26/2022]
Affiliation(s)
- D Ito
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - N D Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - A Oshima
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - T Nakayama
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - M Kitagawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
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26
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Mikage H, Kitagawa M, Wada M. Development of a magnetic quadrupole lens for low energy heavy ion beam transport. Rev Sci Instrum 2020; 91:015107. [PMID: 32012590 DOI: 10.1063/1.5128580] [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] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/15/2019] [Indexed: 06/10/2023]
Abstract
A magnetic quadrupole lens system coupled to a 30° bending deflection magnet was designed and constructed to realize a beam focusing of Xe+ ions with the energy less than 200 eV. Compared to a triplet electrostatic quadrupole lens system, the quadrupole doublet magnetic lens system showed a larger beam transmission, indicating the mitigation of the space charge in the beam transport region free of the electrostatic field. The misalignment of the magnetic field axis was observed probably due to a slow change in magnetization of magnetic materials to construct the magnetic circuit of the quadrupole lens. A countermeasure to realign the beam axis by coupling the permanent magnets to trim coil electromagnets is proposed.
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Affiliation(s)
- H Mikage
- Graduate School of Science and Engineering, Doshisha University, Kyoto 610-0321, Japan
| | - M Kitagawa
- Graduate School of Science and Engineering, Doshisha University, Kyoto 610-0321, Japan
| | - M Wada
- Graduate School of Science and Engineering, Doshisha University, Kyoto 610-0321, Japan
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Shintani T, Fujii T, Yamasaki N, Kitagawa M, Iwata T, Saito S, Okada M, Ogawa I, Unei H, Hamamoto K, Nakaoka M, Kurihara H, Shiba H. Oral environment and taste function of Japanese HIV-infected patients treated with antiretroviral therapy. AIDS Care 2019; 32:829-834. [PMID: 31426660 DOI: 10.1080/09540121.2019.1656327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the study was to evaluate the oral environment and the taste function of Japanese HIV-infected patients treated with antiretroviral therapy. Their median age of 73 patients taking anti-HIV drugs was 46 years. The median period of taking anti-HIV drugs was 30 months. The oral condition was evaluated by measurement of oral moisture, amount of saliva secretion, the number of oral bacteria, presence of oral candida, a taste test, and the number of missing teeth. The levels of oral moisture and secreted saliva were significantly lower in the HIV-infected group than in the healthy volunteer (control) group. The HIV-infected group showed a more robust decrease in taste sensation than the control group. The number of missing teeth was significantly higher in the HIV-infected group than in the control group. Furthermore, all of the evaluated oral conditions were worse in the HIV-infected patients whose CD4+ T lymphocyte counts were less than 500/mm3 than in the control group. It became clear that the patients taking anti-HIV drugs, especially the CD4+ count < 500/mm3 group, had a deteriorated oral environment and dysgeusia, suggesting that the management of oral hygiene is necessary to maintain oral health, which leads to systemic health.
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Affiliation(s)
- T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - N Yamasaki
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Kitagawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Iwata
- Department of Periodontal Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - S Saito
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Okada
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - I Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - H Unei
- Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, Japan
| | - K Hamamoto
- AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Nakaoka
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - H Kurihara
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.,Department of Periodontal Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Sciences, Hiroshima, Japan
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Saitoh T, Enatsu R, Kitagawa M, Morishita T, Suzuki Y, Mikami T, Mikuni N. Choreo-ballistic movement after thalamotomy in a patient with Lewy body dementia. J Clin Neurosci 2019; 66:264-266. [DOI: 10.1016/j.jocn.2019.05.048] [Citation(s) in RCA: 3] [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: 04/03/2019] [Accepted: 05/28/2019] [Indexed: 11/25/2022]
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Enatsu R, Kitagawa M, Mikami T, Kanno A, Komura S, Mikuni N. A Case Report of Multitrack Recording of Posterior Subthalamic Nucleus, Caudal Zona Incerta, and Prelemniscal Radiation: Which Is Most Effective for Bradykinesia? NMC Case Rep J 2019; 6:91-93. [PMID: 31417839 PMCID: PMC6692598 DOI: 10.2176/nmccrj.cr.2018-0277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/13/2018] [Accepted: 02/22/2019] [Indexed: 12/30/2022] Open
Abstract
Deep brain stimulation (DBS) of the posterior subthalamic nucleus (pSTN), caudal zona incerta (cZI), and prelemniscal radiation (Raprl) has been shown to improve Parkinsonian motor symptoms. We herein report neurophysiological and functional differences among the cZI, Raprl, and pSTN in a 68-year-old male patient with Parkinson's disease (PD). The stereotactic implantation of DBS electrodes in the right STN was performed. Thereafter, a transfrontal trajectory for the left cZI was planned for left side implantation, with the expectation that the electrode entered the pSTN in the case of a posterior brain shift. In the implantation of the DBS lead in the cZI, three microelectrodes were simultaneously placed in an array with the central, medial, and anterior positions placed 2 mm apart to delineate the cZI, Raprl, and pSTN, respectively. A maximal reduction in bradykinesia was obtained from the stimulation of the pSTN at the lowest voltage thresholds, and the voltage threshold for abolishing tremors was lower in the Raprl and cZI than in the pSTN. The left DBS lead was implanted in the pSTN because right-sided bradykinesia was more severe than tremor. The multitrack recording of cZI, Raprl, and pSTN might broaden target selection depending on patients' symptoms.
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Affiliation(s)
- Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Mayumi Kitagawa
- Department of Neurology, Sapporo Teishinkai Hospital, Sapporo, Hokkaido, Japan
| | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Aya Kanno
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Shoichi Komura
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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See CS, Kitagawa M, Liao PJ, Lee KH, Wong J, Lee SH, Dymock BW. Prodrugs of the cancer cell selective anti-cancer agent (Z)-2-(1H-indol-3-yl)-3-(isoquinolin-5-yl)acrylonitrile (A131) are orally efficacious in a mouse model of resistant colon cancer. Bioorg Med Chem Lett 2019; 29:216-219. [DOI: 10.1016/j.bmcl.2018.11.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/08/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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Saitoh T, Enatsu R, Mikami T, Suzuki Y, Kanno A, Kitagawa M, Mikuni N. Peri-electrode edema after deep brain stimulation. J Clin Neurosci 2018; 59:29-31. [PMID: 30472347 DOI: 10.1016/j.jocn.2018.11.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/05/2018] [Indexed: 10/27/2022]
Abstract
Peri-electrode edema can occur after deep brain stimulation (DBS). The diagnosis and management of peri-electrode edema may be challenging. We herein report non-infectious peri-electrode edema after the placement of DBS electrodes in patients with Parkinson's disease (PD). Fifteen patients who underwent DBS surgery between 2010 and 2018 at Sapporo Medical University were included to identify post-operative peri-electrode edema. Pre- and post-operative CT and MRI were retrospectively analyzed. Six patients showed hyperintensity around the electrodes on FLAIR/T2 MRI without neurological deficits. Two patients showed limited FLAIR and DWI hyperintensities in deep white matter, and microvessels may have been occluded in these patients. In five patients, MRI revealed extensive FLAIR or T2 hyperintensity in surface white matter around the electrodes without vessel injury, whereas DWI showed no abnormal signals. The eosinophil count was increased in one of these five patients. Peri-electrode edema after DBS surgery is not an uncommon phenomenon, and includes two types: (1) limited edema in deep white matter and (2) extensive edema in surface white matter. Different mechanisms may be associated with these types of edemas.
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Affiliation(s)
- Takuro Saitoh
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yuto Suzuki
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Aya Kanno
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mayumi Kitagawa
- Department of Neurology, Sapporo Teishinkai Hospital, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
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Fukushima Y, Someya M, Nakata K, Hori M, Kitagawa M, Hasegawa T, Tsuchiya T, Gocho T, Ikeda H, Hirohashi Y, Torigoe T, Sugita S, Hasegawa T, Himi T, Sakata K. Influence of PD-L1 Expression in Immune Cells on the Response to Radiation Therapy in Patients with Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kitagawa M, Uesugi Y, Kawata N, Shimamura Y. The food characteristics of unpalatable meal contents and difference by operation types for post gastrectomy patients- comparison between total gastrectomy and distal gastrectomy. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kawasaki A, Mizushima Y, Matsui S, Hoshino K, Yano S, Kitagawa M. A Case of T-Cell Lymphoma Accompanying Marked Eosinophilia, Chronic Eosinophilic Pneumonia and Eosinophilic Pleural Effusion. A Case Report. Tumori 2018; 77:527-30. [PMID: 1803719 DOI: 10.1177/030089169107700616] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 57-year-old woman was admitted to our hospital for lumbago, weight loss and weakness of her right lower extremity. Leukocytosis was evident with marked eosinophilia (65.5 % = 46,000/mm3), and the chest roentgenogram showed diffuse reticular shadows throughout both lung fields and a left pleural effusion. The pleural effusion contained 22.4 % eosinophils with no immature cells. Biopsy of a thumb-sized mass on the chest wall revealed a T-cell lymphoma of pleomorphic type. The diffuse pulmonary shadow was diagnosed as chronic eosinophilic pneumonia by autopsy. This was a relatively rare case of T-cell lymphoma, in which an eosinophilic pneumonia and eosinophilic pleural effusion were observed.
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Affiliation(s)
- A Kawasaki
- First Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan
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35
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Ito D, Ishikawa C, Jeffery ND, Ono K, Tsuboi M, Uchida K, Yamato O, Kitagawa M. Two-Year Follow-Up Magnetic Resonance Imaging and Spectroscopy Findings and Cerebrospinal Fluid Analysis of a Dog with Sandhoff's Disease. J Vet Intern Med 2018; 32:797-804. [PMID: 29478290 PMCID: PMC5867010 DOI: 10.1111/jvim.15041] [Citation(s) in RCA: 4] [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: 11/06/2017] [Revised: 12/07/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022] Open
Abstract
A 13‐month‐old female Toy Poodle was presented for progressive ataxia and intention tremors of head movement. The diagnosis of Sandhoff's disease (GM2 gangliosidosis) was confirmed by deficient β‐N‐acetylhexosaminidase A and B activity in circulating leukocytes and identification of the homozygous mutation (HEXB: c.283delG). White matter in the cerebrum and cerebellum was hyperintense on T2‐weighted and fluid‐attenuated inversion recovery magnetic resonance images. Over the next 2 years, the white matter lesions expanded, and bilateral lesions appeared in the cerebellum and thalamus, associated with clinical deterioration. Magnetic resonance spectroscopy showed progressive decrease in brain N‐acetylaspartate, and glycine‐myo‐inositol and lactate‐alanine were increased in the terminal clinical stage. The concentrations of myelin basic protein and neuron specific enolase in cerebrospinal fluid were persistently increased. Imaging and spectroscopic appearance correlated with histopathological findings of severe myelin loss in cerebral and cerebellar white matter and destruction of the majority of cerebral and cerebellar neurons.
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Affiliation(s)
- D Ito
- School of Veterinary Medicine, Nihon University, Kanagawa, Japan
| | - C Ishikawa
- School of Veterinary Medicine, Nihon University, Kanagawa, Japan
| | - N D Jeffery
- Veterinary Medicine and Biomedical Sciences, Texas A&M University, TX
| | - K Ono
- School of Veterinary Medicine, Nihon University, Kanagawa, Japan
| | - M Tsuboi
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - K Uchida
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - O Yamato
- Laboratory of Clinical Pathology of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - M Kitagawa
- School of Veterinary Medicine, Nihon University, Kanagawa, Japan
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Kitagawa M, Yabe I, Takahashi I, Matushima M, Sasaki H. The efficacy of istradefylline for treating mild wearing-off in Parkinson's disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Amano R, Shuta T, Yamane M, Kitagawa M, Hirokawa K, Uchihara T. Marinesco bodies are related to nuclear enlargement in pigment cells of sabstantia nigra. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.800] [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: 12/01/2022]
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38
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Uchihara T, Sango M, Takubo H, Komori T, Yoshimura N, Nohara C, Homma T, Wada A, Kodama M, Orimo S, Isozaki E, Kitagawa M, Hirokawa K, Toru S. Reduced MIBG uptake under relative preservation of cardiac sympathetic nerve in four autopsy patients of CBD-tau without lewy pathology. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Otaki N, Obayashi K, Saeki K, Kitagawa M, Tone N, Kurumatani N. Relationship between Breakfast Skipping and Obesity among Elderly: Cross-Sectional Analysis of the HEIJO-KYO Study. J Nutr Health Aging 2017; 21:501-504. [PMID: 28448079 DOI: 10.1007/s12603-016-0792-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Breakfast skipping is reported to be associated with obesity in children and younger populations; however, few studies report the association among elderly. The purpose of this study was to investigate the relationships between breakfast skipping and obesity prevalence among elderly. DESIGN Cross-sectional study. SETTING Community-dwelling elderly in Nara, Japan. PARTICIPANTS 1052 elderly participants (mean age: 71.6 years). MEASUREMENTS Obesity and breakfast skipping were defined as body mass index of ≥25 kg/m2 and skipping breakfast one or more times per week, respectively. RESULTS Two hundred and seventy-two participants (25.9%) were classified as obese and forty-one (3.9%) were as breakfast skippers. Obesity prevalence was significantly higher in breakfast skippers than in breakfast eaters (43.9% vs. 25.1%, P = 0.007). In multivariable logistic regression analysis adjusted for potential confounders (age, sex and alcohol consumption), breakfast skippers showed significantly higher odds ratio (OR) for obesity than breakfast eaters (OR, 2.23; 95% confidence interval, 1.17-4.27; P = 0.015), which continued to be significant after further adjustment for socioeconomic status. In addition, breakfast skippers showed significantly lower daily potassium (P <0.001) and dietary fibre intakes (P = 0.001) and lower subjective physical activity (P = 0.035) than breakfast eaters. CONCLUSIONS Breakfast skipping was significantly associated with obesity among elderly. Poor diet quality and physical inactivity may be potential intermediators underlying the association between breakfast skipping and obesity.
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Affiliation(s)
- N Otaki
- Keigo Saeki, MD, PhD, 840 Shijocho, Kashiharashi, Nara, 634-8521, Japan, Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan, E-mail: , Phone: +81-744-22-3051, Fax: +81-744-25-7657
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Ota Y, Yumori A, Ogawara Y, Furuno A, Kitagawa M, Okada Y, Sakakibara H, Yoshida H. Impact of Diagnosing Endometrial Cancer After Laparoscopic Surgery on the Pathological Examination. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.766] [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: 10/20/2022]
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Ogino I, Kitagawa M, Watanabe S, Aoki S, Yoshida H. Calcium Phosphate Cement Paste Injection as a Marker of Cervical Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1410] [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: 10/20/2022]
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Srinivas V, Kitagawa M, Wong J, Liao PJ, Lee SH. The Tumor Suppressor Cdkn3 Is Required for Maintaining the Proper Number of Centrosomes by Regulating the Centrosomal Stability of Mps1. Cell Rep 2015; 13:1569-77. [PMID: 26586430 DOI: 10.1016/j.celrep.2015.10.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/06/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022] Open
Abstract
Supernumerary centrosomes promote the assembly of abnormal spindles in many human cancers. The observation that modest changes in the centrosomal levels of Mps1 kinase can cause centrosome overduplication in human cells suggests the existence of a regulatory system that may tightly control its centrosomal stability. Here, we show that Cdkn3, a Cdk-associated phosphatase, prevents Mps1-mediated centrosome overduplication. We identify Cdkn3 as a direct binding partner of Mps1. The interaction between Mps1 and Cdkn3 is required for Mps1 to recruit Cdkn3 to centrosomes. Subsequently, Mps1-bound Cdkn3 forms a regulatory system that controls the centrosomal levels of Mps1 through proteasome-mediated degradation and thereby prevents Mps1-mediated centrosome overduplication. Conversely, knockdown of Cdkn3 stabilizes Mps1 at centrosomes, which promotes centrosome overduplication. We suggest that Mps1 and Cdkn3 form a self-regulated feedback loop at centrosomes to tightly control the centrosomal levels of Mps1, which prevents centrosome overduplication in human cells.
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Affiliation(s)
- Vinayaka Srinivas
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Mayumi Kitagawa
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Jasmine Wong
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Pei-Ju Liao
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Sang Hyun Lee
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore.
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Ouhara K, Iwasaki Y, Kajiya M, Savitri IJ, Kitagawa M, Tokunaga N, Shintani T, Ogawa I, Hino T, Fujita T, Shiba H, Kurihara H. The differential expression of mgl mRNA by Porphyromonas gingivalis affects the production of methyl mercaptan. Oral Dis 2015; 21:626-33. [PMID: 25703825 DOI: 10.1111/odi.12326] [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] [Received: 10/07/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE A large number of individuals have halitosis. The total amount of volatile sulfur compounds, which are the main cause of halitosis, has been correlated with periodontitis following bacterial infection. In this study, Porphyromonas gingivalis (Pg), a major periodontopathogenic bacterium, was isolated from patients with halitosis by the amplification of 16S rRNA, and the ability of isolated Pg to produce methyl mercaptan (CH3 SH) was determined to clarify the relationship between halitosis and Pg infection. MATERIALS AND METHODS CH3 SH concentrations were measured in patients using Oral Chroma. The production of CH3 SH by Pg standard and clinical strains was also measured in vitro. Real-time PCR was performed to compare the expression of mgl mRNA (which encoded l-methionine-a-deamino-g-mercaptomethane-lyase) among the Pg strains. The production of CH3 SH and the expression of mgl mRNA were also determined to assess the effects of oriental medicine. RESULTS The production of CH3 SH and the expression of mgl mRNA strongly correlated with each other in the presence of l-methionine. The expression of mgl mRNA by Pg W83 was strongly inhibited by magnoliaceae. CONCLUSION The production of CH3 SH was correlated with the expression of mgl. Furthermore, the oriental medicine, magnoliaceae, may represent a potential treatment for halitosis.
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Affiliation(s)
- K Ouhara
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Iwasaki
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kajiya
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - I J Savitri
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kitagawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - N Tokunaga
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - I Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Hino
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Fujita
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Kurihara
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.,Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
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Hori M, Someya M, Nakata K, Kitagawa M, Hasegawa T, Tsuchiya T, Gocho T, Fukushima Y, Takada Y, Sakata K. PO-1107 Comparative analysis of VMAT plans for prostate cancer with different MLCs, Elekta Agility and MLCi2. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kitagawa M, Lee SH. The chromosomal passenger complex (CPC) as a key orchestrator of orderly mitotic exit and cytokinesis. Front Cell Dev Biol 2015; 3:14. [PMID: 25798441 PMCID: PMC4350427 DOI: 10.3389/fcell.2015.00014] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/19/2015] [Indexed: 02/01/2023] Open
Abstract
Understanding the molecular network of orderly mitotic exit to re-establish a functional interphase nucleus is critical because disordered mitotic exit inevitably leads to genomic instability. In contrast to the mechanisms of the entrance to mitosis, however, little is known about what controls the orderly exit from mitosis, particularly in mammalian cells. The chromosomal passenger complex (CPC), which is composed of Aurora B, INCENP, Borealin and Survivin, is one of the most widely studied and highly conserved hetero-tetrameric complexes. The CPC orchestrates proper chromosome segregation with cytokinesis by targeting to specific locations at different stages of mitosis. Recent studies reveal that controlling CPC localization and Aurora B kinase activity also serves as a key surveillance mechanism for the orderly mitotic exit. This ensures the reformation of a functional interphase nucleus from condensed mitotic chromosomes by delaying mitotic exit and cytokinetic processes in response to defects in chromosome segregation. In this review, we will summarize the latest insight into the molecular mechanisms that regulate CPC localization during mitotic exit and discuss how targeting Aurora B activity to different locations at different times impacts executing multiple mitotic exit events in order and recently proposed surveillance mechanisms. Finally, we briefly discuss the potential implication of deregulated Aurora B in inducing genomic damage and tumorigenesis with current efforts in targeting Aurora B activity for anti-cancer therapy.
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Affiliation(s)
- Mayumi Kitagawa
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School Singapore Singapore
| | - Sang Hyun Lee
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School Singapore Singapore
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Daggett RN, Kurata M, Abe S, Onishi I, Miura K, Sawada Y, Tanizawa T, Kitagawa M. Expression dynamics of CXCL12 and CXCR4 during the progression of mycosis fungoides. Br J Dermatol 2014; 171:722-31. [PMID: 24725174 DOI: 10.1111/bjd.13054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Mycosis fungoides (MF) classically presents from patch stage to plaque stage over a number of years and finally progresses to tumour stage with nodal or visceral involvement. The mechanism of progression remains incompletely elucidated. Chemokines and their receptors are known to be involved in disease mechanisms, with CXCL12 and CXCR4 playing a critical role in carcinogenesis, invasion and cancer cell migration in various carcinomas. OBJECTIVES To investigate the expression of CXCL12 and CXCR4 in different cutaneous stages of MF. METHODS Formalin-fixed, paraffin-embedded skin samples from 40 patients with MF (21 patch stage, 10 plaque stage, nine tumour stage) and 30 non-neoplastic control skin samples were analysed. CXCL12 and CXCR4 were assessed by quantitative reverse-transcription polymerase chain reaction and immunohistochemical staining. RESULTS The expression level of mRNA for CXCL12 in plaque-stage MF was significantly higher than in control skin (P = 0.0035), or patch-stage (P = 0.0108) or tumour-stage disease (P = 0.0089). The CXCR4 mRNA expression level in plaque-stage disease was significantly higher than in control skin (P = 0.0090) or patch-stage disease (P = 0.0387). CXCL12- and CXCR4-positive cell rates in patch-stage and plaque-stage MF were significantly higher than those in control skin (P < 0.0001). CXCL12- and CXCR4-positive cell rates in tumour-stage MF were significantly lower than those in patch- and plaque-stage disease (P = 0.0274 and P = 0.0492, respectively). CONCLUSIONS Our data suggest that neoplastic T cells in MF are exposed to the microenvironment, given the abundance of CXCL12 during its progression, and also that neoplastic T cells express CXCR4, especially in the pretumour stage. We reveal that the CXCL12-CXCR4 axis plays a critical role in MF progression.
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Affiliation(s)
- R N Daggett
- Department of Comprehensive Pathology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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Kitagawa M, Yamada H, Ide K, Matsumoto K, Narushima D, Umegaki K. PP159-MON: Application of a Newly Designed Scale for the Evaluation of Causal Relationships of Adverse Events Associated with Dietary Supplements. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50493-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kitagawa M, Fung SYS, Hameed UFS, Goto H, Inagaki M, Lee SH. Cdk1 coordinates timely activation of MKlp2 kinesin with relocation of the chromosome passenger complex for cytokinesis. Cell Rep 2014; 7:166-79. [PMID: 24656812 DOI: 10.1016/j.celrep.2014.02.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/22/2013] [Accepted: 02/23/2014] [Indexed: 01/04/2023] Open
Abstract
The chromosome passenger complex (CPC) must relocate from anaphase chromosomes to the cell equator for successful cytokinesis. Although this landmark event requires the mitotic kinesin MKlp2, the spatiotemporal mechanistic basis remains elusive. Here, we show that phosphoregulation of MKlp2 by the mitotic kinase Cdk1/cyclin B1 coordinates proper mitotic transition with CPC relocation. We identified multiple Cdk1/cyclin B1 phosphorylation sites within the stalk and C-terminal tail that inhibit microtubule binding and bundling, oligomerization/clustering, and chromosome targeting of MKlp2. Specifically, inhibition of these abilities by Cdk1/cyclin B1 phosphorylation is essential for proper early mitotic progression. Upon anaphase onset, however, reversal of Cdk1/cyclin B1 phosphorylation promotes MKlp2-CPC complex formation and relocates the CPC from anaphase chromosomes for successful cytokinesis. Thus, we propose that phosphoregulation of MKlp2 by Cdk1/cyclin B1 ensures that activation of MKlp2 kinesin and relocation of the CPC occur at the appropriate time and space for proper mitotic progression and genomic stability.
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Affiliation(s)
- Mayumi Kitagawa
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Suet Yin Sarah Fung
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | | | - Hidemasa Goto
- Division of Biochemistry, Aichi Cancer Center Research Institute, Nagoya, Aichi 464-8681, Japan
| | - Masaki Inagaki
- Division of Biochemistry, Aichi Cancer Center Research Institute, Nagoya, Aichi 464-8681, Japan
| | - Sang Hyun Lee
- Program in Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore.
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Aoyagi T, Kaito C, Sekimizu K, Omae Y, Saito Y, Mao H, Inomata S, Hatta M, Endo S, Kanamori H, Gu Y, Tokuda K, Yano H, Kitagawa M, Kaku M. Impact of psm-mec in the mobile genetic element on the clinical characteristics and outcome of SCCmec-II methicillin-resistant Staphylococcus aureus bacteraemia in Japan. Clin Microbiol Infect 2014; 20:912-9. [PMID: 24476401 DOI: 10.1111/1469-0691.12575] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/20/2014] [Accepted: 01/27/2014] [Indexed: 11/28/2022]
Abstract
Over-expression of alpha-phenol-soluble modulins (PSMs) results in high virulence of community-associated methicillin-resistant Staphylococcus aureus (MRSA). The psm-mec gene, located in the mobile genetic element SCCmec-II, suppresses PSMαs production. Fifty-two patients with MRSA bacteraemia were enrolled. MRSA isolates were evaluated with regard to the psm-mec gene sequence, bacterial virulence, and the minimum inhibitory concentration (MIC) of vancomycin and teicoplanin. Fifty-one MRSA isolates were classified as SCCmec-II, and 10 had one point mutation in the psm-mec promoter. We compared clinical characteristics and outcomes between mutant MRSA and wild-type MRSA. Production of PSMα3 in mutant MRSA was significantly increased, but biofilm formation was suppressed. Wild-type MRSA caused more catheter-related bloodstream infections (30/41 vs. 3/10, p 0.0028), whereas mutant MRSA formed more deep abscesses (4/10 vs. 3/41, p 0.035). Bacteraemia caused by mutant MRSA was associated with reduced 30-day mortality (1/10 vs. 13/41, p 0.25), although this difference was not significant. The MIC90 of teicoplanin was higher for wild-type MRSA (1.5 mg/L vs. 1 mg/L), but the MIC of vancomycin was not different between the two groups. The 30-day mortality of MRSA with a high MIC of teicoplanin (≥1.5 mg/L) was higher than that of strains with a lower MIC (≤0.75 mg/L) (6/10 vs. 6/33, p 0.017). Mutation of the psm-mec promoter contributes to virulence of SCCmec-II MRSA, and the product of psm-mec may determine the clinical characteristics of bacteraemia caused by SCCmec-II MRSA, but it does not affect mortality.
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Affiliation(s)
- T Aoyagi
- Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Katsurada M, Izumo T, Nagai Y, Chavez C, Kitagawa M, Torii J, Iwase T, Aso T, Tsuchida T, Sasada S. The Dose and Risk Factors for Radiation Exposure to Medical Staff during Endobronchial Ultrasonography with a Guide Sheath for Peripheral Pulmonary Lesions under X-ray Fluoroscopy. Jpn J Clin Oncol 2014; 44:257-62. [DOI: 10.1093/jjco/hyt224] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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