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Saito I, Shirai T, Sato H, Ishii T, Fujii H. Enthesitis as an initial presentation of vascular Behçet's syndrome: a case-based review. Rheumatol Int 2024:10.1007/s00296-024-05607-3. [PMID: 38713409 DOI: 10.1007/s00296-024-05607-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024]
Abstract
Enthesitis is a characteristic manifestation of spondyloarthropathy (SpA). Historically, Behçet's syndrome (BS) was classified within SpA. Although they are now classified separately, the association between BS and SpA remains controversial. The concept of MHC-I (major histocompatibility complex class I)-opathy has been proposed based on the overlap in immunopathological mechanisms among diseases associated with human leukocyte antigen (HLA) class I. Enthesitis is a frequent complication in patients with BS who also have acne and arthritis. However, information regarding enthesitis in patients with BS without arthritis (BS-WA) is limited. Herein, we report a case of vascular BS complicated by enthesitis. In this case, heel pain was the dominant symptom at presentation. Laboratory tests revealed chlamydia antibody positivity, leading to a tentative diagnosis of reactive arthritis. Despite treatment, C-reactive protein (CRP) levels remained elevated. Imaging revealed numerous aneurysmal lesions in the large vessels. Based on these findings and other symptoms, patient was diagnosed with vascular BS. He tested positive for HLA-B15 and HLA-B46, which are associated with peripheral SpA. Subsequent remission induction therapy for BS was effective and the patient was discharged without complications. Our case and a literature review suggest that there exists a subgroup of BS-WA with a complication of enthesitis, possibly belonging to the spectrum of MHC-I-opathies. It is important to consider BS as a differential diagnosis in patients presenting with enthesitis and to conduct a precise medical history review regarding the symptoms of BS.
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Affiliation(s)
- Isso Saito
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Miyagi, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Miyagi, Japan.
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Miyagi, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Miyagi, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Miyagi, Japan
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2
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Okazaki S, Shirai T, Sato H, Ishii T, Fujii H. Development of anti-MDA5 autoantibody-positive dermatomyositis following the use of etanercept biosimilar in rheumatoid arthritis. Mod Rheumatol Case Rep 2024:rxae013. [PMID: 38597870 DOI: 10.1093/mrcr/rxae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/01/2023] [Accepted: 04/09/2024] [Indexed: 04/11/2024]
Abstract
The induction of autoimmune diseases during tumor necrosis factor-alpha inhibitor (TNFi) usage has been described. Herein, we report a rare case of a 49-year-old woman with anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-positive dermatomyositis (DM), which developed five weeks after the introduction of an etanercept biosimilar to rheumatoid arthritis (RA). Four of the five known cases, including ours, of anti-MDA5Ab positive DM complicated with RA revealed anti-MDA5Ab positive DM following TNFi usage. When patients with RA are diagnosed with interstitial lung disease during TNFi usage, anti-MDA5 Ab-positive DM could be a differential diagnosis.
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Affiliation(s)
- Soshi Okazaki
- Department of Rheumatology, Tohoku University Hospital Sendai, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital Sendai, Japan
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital Sendai, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital Sendai, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital Sendai, Japan
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3
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Shimada S, Yamaguchi T, Mikoshiba S, Sato K, Mitsumura T, Komori K, Yamana T, Iijima Y, Sakakibara R, Shibata S, Honda T, Shirai T, Okamoto T, Furusawa H, Tateishi T, Miyazaki Y. Relapsing bronchopneumonia due to community-associated methicillin-resistant Staphylococcus aureus: a case report. BMC Infect Dis 2024; 24:374. [PMID: 38575909 PMCID: PMC10993438 DOI: 10.1186/s12879-024-09268-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased the incidence of community-onset MRSA infection. Respiratory tract infections caused by MRSA has been noted for their severity; however, repeated relapses that require extended antibiotic therapy are rare. CASE PRESENTATION We report a case of relapsing bronchopneumonia caused by CA-MRSA in a 56-year-old man. The patient responded to antibiotics, but repeatedly relapsed after stopping treatment. MRSA was consistently isolated from airway specimens during each relapse. Extended oral antibiotic treatment with trimethoprim/sulfamethoxazole (TMP/SMX) for 6 months achieved infection control. Whole-genome sequencing of the isolated strain revealed that the causative agent was sequence type (ST)1/staphylococcal cassette chromosome mec (SCCmec) type IVa, a clone that is rapidly increasing in Japan. DISCUSSION AND CONCLUSIONS This patient had an unusual course of MRSA bronchopneumonia with repeated relapses. Although the choice of antibiotics for long-term use in MRSA respiratory tract infections has not been well established, TMP/SMX was effective and well tolerated for long-term therapy in this case. The clinical course of infections related to the rapid emerging clone, ST1/SCCmec type IVa warrants further attention.
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Affiliation(s)
- Sho Shimada
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
| | - Tetsuo Yamaguchi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omorinishi, Ota-Ku, Tokyo, 143-8540, Japan
| | - Satsuki Mikoshiba
- Department of Respiratory Medicine, National Hospital Organization Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan
| | - Kazuaki Sato
- Department of Respiratory Medicine, Soka Municipal Hospital, 2-21-1 Soka, Soka-Shi, Saitama, 340-8560, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Kohji Komori
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omorinishi, Ota-Ku, Tokyo, 143-8540, Japan
| | - Takashi Yamana
- Department of Respiratory Medicine, National Hospital Organization Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan
| | - Yuki Iijima
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
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4
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Shirota S, Shirai T, Mori K, Inoue J, Sato H, Ishii T, Fujii H. Comment on: A case of vanishing bile duct syndrome during treatment of microscopic polyangiitis with avacopan. Rheumatology (Oxford) 2024; 63:e149-e150. [PMID: 37878792 DOI: 10.1093/rheumatology/kead561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Sae Shirota
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Kentaro Mori
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Jun Inoue
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
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5
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Takeishi A, Shaban AK, Kakihana T, Takihara H, Okuda S, Osada H, Suameitria Dewi DNS, Ozeki Y, Yoshida Y, Nishiyama A, Tateishi Y, Aizu Y, Chuma Y, Onishi K, Hayashi D, Yamamoto S, Mukai T, Ato M, Thai DH, Nhi HTT, Shirai T, Shibata S, Obata F, Fujii J, Yamayoshi S, Kiso M, Matsumoto S. Genetic engineering employing MPB70 and its promoter enables efficient secretion and expression of foreign antigen in bacillus Calmette Guérin (BCG) Tokyo. Microbiol Immunol 2024; 68:130-147. [PMID: 38294180 DOI: 10.1111/1348-0421.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/12/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024]
Abstract
Vaccination is an important factor in public health. The recombinant bacillus Calmette Guérin (rBCG) vaccine, which expresses foreign antigens, is expected to be a superior vaccine against infectious diseases. Here, we report a new recombination platform in which the BCG Tokyo strain is transformed with nucleotide sequences encoding foreign protein fused with the MPB70 immunogenic protein precursor. By RNA-sequencing, mpb70 was found to be the most transcribed among all known genes of BCG Tokyo. Small oligopeptide, namely, polyhistidine tag, was able to be expressed in and secreted from rBCG through a process in which polyhistidine tag fused with intact MPB70 were transcribed by an mpb70 promoter. This methodology was applied to develop an rBCG expressing the receptor binding domain (RBD) of severe acute respiratory syndrome coronavirus 2. Immunoblotting images and mass spectrometry data showed that RBD was also secreted from rBCG. Sera from mice vaccinated with the rBCG showed a tendency of weak neutralizing capacity. The secretion was retained even after a freeze-drying process. The freeze-dried rBCG was administered to and recovered from mice. Recovered rBCG kept secreting RBD. Collectively, our recombination platform offers stable secretion of foreign antigens and can be applied to the development of practical rBCGs.
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Affiliation(s)
- Atsuki Takeishi
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
| | - Amina K Shaban
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
| | - Taichi Kakihana
- Department of Virology, School of Medicine, Niigata University, Niigata, Japan
| | - Hayato Takihara
- Medical AI Center, School of Medicine, Niigata University, Niigata, Japan
| | - Shujiro Okuda
- Medical AI Center, School of Medicine, Niigata University, Niigata, Japan
| | - Hidekazu Osada
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
- NIPPON ZENYAKU KOGYO CO., LTD, Fukushima, Japan
| | - Desak Nyoman Surya Suameitria Dewi
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
- Microbiology, Universitas Ciputra, Surabaya, Indonesia
| | - Yuriko Ozeki
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
| | - Yutaka Yoshida
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
| | - Akihito Nishiyama
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
| | - Yoshitaka Tateishi
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
| | - Yuki Aizu
- Division of Research and Development, Japan BCG Laboratory, Tokyo, Japan
| | - Yasushi Chuma
- Division of Research and Development, Japan BCG Laboratory, Tokyo, Japan
| | - Kazuyo Onishi
- Division of Research and Development, Japan BCG Laboratory, Tokyo, Japan
| | - Daisuke Hayashi
- Division of Research and Development, Japan BCG Laboratory, Tokyo, Japan
| | - Saburo Yamamoto
- Division of Research and Development, Japan BCG Laboratory, Tokyo, Japan
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tetsu Mukai
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Manabu Ato
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Duong Huu Thai
- Institute of Vaccines and Medical Biologicals, Nha Trang, Vietnam
| | - Huynh Thi Thao Nhi
- Department of BCG production, Institute of Vaccines and Medical Biologicals, Nha Trang, Vietnam
| | - Tsuyoshi Shirai
- Department of Bioscience, Nagahama Institute of Bio-Science and Technology, Shiga, Japan
| | - Satoshi Shibata
- Department of Microbiology and Immunology, Division of Bacteriology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Fumiko Obata
- Department of Microbiology and Immunology, Division of Bacteriology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Jun Fujii
- Department of Microbiology and Immunology, Division of Bacteriology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Seiya Yamayoshi
- Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Maki Kiso
- Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Sohkichi Matsumoto
- Department of Bacteriology, School of Medicine, Niigata University, Niigata, Japan
- Department of Medical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Division of Research Aids, Hokkaido University Institute for Vaccine Research & Development, Sapporo, Hokkaido, Japan
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6
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Maruyama S, Furusawa H, Endo S, Kumagai T, Mitsumura T, Shimada S, Yamana T, Sakakibara R, Iijima Y, Shibata S, Honda T, Shirai T, Okamoto T, Tateishi T, Tamaoka M, Kinowaki Y, Ishibashi H, Okubo K, Miyazaki Y. Pulmonary Artery Aneurysm in a Patient with Nontuberculous Mycobacteria Infection. Intern Med 2024; 63:989-992. [PMID: 37558481 PMCID: PMC11045386 DOI: 10.2169/internalmedicine.2199-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/05/2023] [Indexed: 08/11/2023] Open
Abstract
Nontuberculous mycobacterial (NTM) infection sometimes leads to the development of pulmonary artery aneurysm (PAA), a rare but life-threatening complication. We herein report a 64-year-old woman with a history of NTM infection who presented with severe hemoptysis. Computed tomography revealed a ruptured PAA, which was treated successfully with pulmonary artery embolization. Subsequent right total pneumonectomy was performed to control infection. This case emphasizes the need to consider PAA in patients with NTM infection who present with hemoptysis. Early detection and appropriate management are critical for preventing this fatal complication.
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Affiliation(s)
- Soichi Maruyama
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
- Department of Respiratory Medicine, Nerima Hikarigaoka Hospital, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Satoshi Endo
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takashi Kumagai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shimada
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takashi Yamana
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Yuki Iijima
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Meiyo Tamaoka
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Yuko Kinowaki
- Department of Comprehensive Pathology, Tokyo Medical and Dental University, Japan
| | - Hironori Ishibashi
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Kenichi Okubo
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
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7
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Sugihara T, Yoshifuji H, Uchida HA, Maejima Y, Watanabe Y, Tanemoto K, Umezawa N, Manabe Y, Ishizaki J, Shirai T, Nagafuchi H, Hasegawa H, Niiro H, Ishii T, Nakaoka Y, Harigai M. Establishing clinical remission criteria for giant cell arteritis: Results of a Delphi exercise carried out by an expert panel of the Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis. Mod Rheumatol 2024; 34:568-575. [PMID: 37225423 DOI: 10.1093/mr/road046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/06/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop a proposal for giant cell arteritis remission criteria in order to implement a treat-to-target algorithm. METHODS A task force consisting of 10 rheumatologists, 3 cardiologists, 1 nephrologist, and 1 cardiac surgeon was established in the Large-vessel Vasculitis Group of the Japanese Research Committee of the Ministry of Health, Labour and Welfare for Intractable Vasculitis to conduct a Delphi survey of remission criteria for giant cell arteritis. The survey was circulated among the members over four reiterations with four face-to-face meetings. Items with a mean score of ≥4 were extracted as items for defining remission criteria. RESULTS An initial literature review yielded a total of 117 candidate items for disease activity domains and treatment/comorbidity domains of remission criteria, of which 35 were extracted as disease activity domains (systematic symptoms, signs and symptoms of cranial and large-vessel area, inflammatory markers, and imaging findings). For the treatment/comorbidity domain, ≤5 mg/day of prednisolone 1 year after starting glucocorticoids was extracted. The definition of achievement of remission was the disappearance of active disease in the disease activity domain, normalization of inflammatory markers, and ≤5 mg/day of prednisolone. CONCLUSION We developed proposals for remission criteria to guide the implementation of a treat-to-target algorithm for giant cell arteritis.
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Affiliation(s)
- Takahiko Sugihara
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Haruhito A Uchida
- Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiko Watanabe
- First Department of Physiology, Kawasaki Medical School, Kurashiki, Japan
| | - Kazuo Tanemoto
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Natsuka Umezawa
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Manabe
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Jun Ishizaki
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tsuyoshi Shirai
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroko Nagafuchi
- Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hitoshi Hasegawa
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hiroaki Niiro
- Department of Medical Education, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomonori Ishii
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | - Yoshikazu Nakaoka
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masayoshi Harigai
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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8
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Shiraishi T, Katayama Y, Nishiyama M, Shoji H, Miyakawa T, Mizoo T, Matsumoto A, Hijikata A, Shirai T, Mayanagi K, Nakayama KI. The complex etiology of autism spectrum disorder due to missense mutations of CHD8. Mol Psychiatry 2024:10.1038/s41380-024-02491-y. [PMID: 38438524 DOI: 10.1038/s41380-024-02491-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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
CHD8 is an ATP-dependent chromatin-remodeling factor encoded by the most frequently mutated gene in individuals with autism spectrum disorder (ASD). Although many studies have examined the consequences of CHD8 haploinsufficiency in cells and mice, few have focused on missense mutations, the most common type of CHD8 alteration in ASD patients. We here characterized CHD8 missense mutations in ASD patients according to six prediction scores and experimentally examined the effects of such mutations on the biochemical activities of CHD8, neural differentiation of embryonic stem cells, and mouse behavior. Only mutations with high prediction scores gave rise to ASD-like phenotypes in mice, suggesting that not all CHD8 missense mutations detected in ASD patients are directly responsible for the development of ASD. Furthermore, we found that mutations with high scores cause ASD by mechanisms either dependent on or independent of loss of chromatin-remodeling function. Our results thus provide insight into the molecular underpinnings of ASD pathogenesis caused by missense mutations of CHD8.
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Affiliation(s)
- Taichi Shiraishi
- Division of Cell Biology, Medical Institute of Bioregulation, Kyushu University, 3-1-1 Maidashi, Fukuoka, Fukuoka, 812-8582, Japan
| | - Yuta Katayama
- Division of Cell Biology, Medical Institute of Bioregulation, Kyushu University, 3-1-1 Maidashi, Fukuoka, Fukuoka, 812-8582, Japan
| | - Masaaki Nishiyama
- Department of Histology and Cell Biology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Hirotaka Shoji
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Aichi, 470-1192, Japan
| | - Tsuyoshi Miyakawa
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Aichi, 470-1192, Japan
| | - Taisuke Mizoo
- Division of Cell Biology, Medical Institute of Bioregulation, Kyushu University, 3-1-1 Maidashi, Fukuoka, Fukuoka, 812-8582, Japan
| | - Akinobu Matsumoto
- Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, 464-8602, Japan
| | - Atsushi Hijikata
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Tsuyoshi Shirai
- Department of Computer Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura-Cho, Nagahama, Shiga, 526-0829, Japan
| | - Kouta Mayanagi
- Department of Drug Discovery Structural Biology, Graduate School of Pharmaceutical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, Fukuoka, 812-8582, Japan
| | - Keiichi I Nakayama
- Division of Cell Biology, Medical Institute of Bioregulation, Kyushu University, 3-1-1 Maidashi, Fukuoka, Fukuoka, 812-8582, Japan.
- Anticancer Strategies Laboratory, TMDU Advanced Research Institute, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
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Yamato M, Shirai T, Ishii Y, Sato H, Ishii T, Fujii H. Impact of subcutaneous belimumab on disease activity, patient satisfaction, and metabolic profile in long-lasting systemic lupus erythematosus. Clin Rheumatol 2024; 43:1023-1035. [PMID: 38334937 DOI: 10.1007/s10067-024-06904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/14/2024] [Accepted: 02/03/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Atherosclerosis is a major complication of systemic lupus erythematosus (SLE) and is exacerbated by the disease itself, drug toxicity, and metabolic syndrome. Although belimumab (BEL) can ameliorate disease activity and reduce prednisolone (PSL) dose in SLE, its effect on metabolic profiles is obscure. We aimed to assess the effects of subcutaneous BEL on disease activity and metabolic profiles. METHODS A total of 106 patients with SLE who received subcutaneous BEL were included, and 76 patients who started BEL treatment at least 1 year prior were evaluated. Clinical information, including retention rate, disease activity, renal outcome, patient satisfaction, and metabolic profiles, were retrospectively analysed. RESULTS The retention rate of BEL was > 80% after 2 years, and ineffectiveness and pain were the major reasons for discontinuation of BEL treatment. Satisfaction with side effects was higher in the BEL group than that in the PSL group. Belimumab significantly improved disease activity, lupus nephritis, and PSL dosage, with a median reduction of 4 mg/day. These effects were observed in active disease and positive C1q-binding immune complex, and PSL reduction ≥ 5 mg was achievable in such cases. Patients with PSL reduction of ≥ 5 mg showed significantly lower blood low-density lipoprotein and triglyceride by 13 and 17 mg/dL, respectively, while those with PSL reduction of < 5 mg remained unaltered. CONCLUSION Subcutaneous BEL was effective in improving disease activity and proteinuria in patients with chronic disease while reducing PSL. Reduction in PSL by BEL also improved lipid status, which could synergistically reduce cardiovascular risk in SLE. Key Points • Significant reduction of disease activity, proteinuria, and prednisolone was observed in patients using subcutaneous belimumab. • Patient satisfaction was higher in terms of side effects in subcutaneous belimumab compared with prednisolone. • Reduction in prednisolone by belimumab contributed to the improvement of lipid status and would reduce the cardiovascular risk.
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Affiliation(s)
- Maya Yamato
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.
| | - Yusho Ishii
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
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Iijima Y, Ejima M, Yamana T, Sonoda S, Shibata S, Shirai T, Okamoto T, Furusawa H, Tateishi T, Adachi T, Mori M, Kirimura S, Anzai T, Takahashi K, Miyazaki Y. Assessment of clinical relevance of antigen improves diagnostic accuracy of hypersensitivity pneumonitis. BMC Pulm Med 2024; 24:84. [PMID: 38355540 PMCID: PMC10865633 DOI: 10.1186/s12890-024-02849-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Exposure assessment is integral to the diagnosis of hypersensitivity pneumonitis (HP). Although the clinical relevance of exposed antigens is essential for the assessment, many of the previous guidelines or reports have only evaluated simple exposure histories or immunological tests. To overcome this problem, the Exposure Assessment Form (EAF) was developed as an assessment tool for classifying the exposure grade from G0 to G4. The EAF was modified from the description in the Japanese clinical practice guide 2022 for HP published by the Japanese Respiratory Society. METHODS One hundred and seventy-two consecutive patients with interstitial lung disease who underwent multidisciplinary discussion (MDD) at our hospital were retrospectively examined. We assessed whether the use of the EAF improved the diagnostic performance of the international guideline of HP. We also evaluated whether the exposure grade affected the prognosis of HP. RESULTS Even when a HP diagnosis was made with a confidence of 70% or higher according to the international guideline, less than half of these cases resulted in a final diagnosis of HP when the exposure grades were lower than G3. When the result of the EAF was integrated into the exposure definition of the international guideline, the specificity of the diagnostic performance improved, while sensitivity was maintained. Furthermore, HP patients with an exposure grade of G3 or higher showed a tendency to take a longer time to initiate medication. CONCLUSIONS This is the first study to evaluate the clinical relevance of possible antigens using the EAF. Assessing the exposure grade prevents overdiagnosis and improves the diagnostic performance of the international guideline.
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Affiliation(s)
- Yuki Iijima
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Masaru Ejima
- Department of Respiratory Medicine, Japanese Red Cross Musashino Hospital, 1-26-1, Minamimachi, Musasshino-City, Tokyo, 180-8610, Japan
| | - Takashi Yamana
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Shiro Sonoda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
- Department of Pulmonary Immunotherapeutics, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Takuya Adachi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Mio Mori
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Susumu Kirimura
- Department of Pathology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Tatsuhiko Anzai
- Department of Biostatistics, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
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Yamato M, Shirai T, Sato H, Ishii T, Fujii H. First reported case of pulmonary arteritis in patients with relapsing polychondritis. Rheumatology (Oxford) 2024; 63:e9-e11. [PMID: 37326857 DOI: 10.1093/rheumatology/kead300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 06/17/2023] Open
Affiliation(s)
- Maya Yamato
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
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Aoki H, Miyazaki Y, Anzai T, Yokoyama K, Tsuchiya J, Shirai T, Shibata S, Sakakibara R, Mitsumura T, Honda T, Furusawa H, Okamoto T, Tateishi T, Tamaoka M, Yamamoto M, Takahashi K, Tateishi U, Yamaguchi T. Deep convolutional neural network for differentiating between sarcoidosis and lymphoma based on [ 18F]FDG maximum-intensity projection images. Eur Radiol 2024; 34:374-383. [PMID: 37535157 DOI: 10.1007/s00330-023-09937-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/10/2023] [Accepted: 01/29/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES To compare the [18F]FDG PET/CT findings of untreated sarcoidosis and malignant lymphoma (ML) and develop convolutional neural network (CNN) models to differentiate between these diseases using maximum intensity projection (MIP) [18F]FDG PET images. METHODS We retrospectively collected data on consecutive patients newly diagnosed with sarcoidosis and ML who underwent [18F]FDG PET/CT before treatment. Two nuclear radiologists reviewed the images. CNN models were created using MIP PET images and evaluated with k-fold cross-validation. The points of interest were visualized using gradient-weighted class activation mapping (Grad-CAM). RESULTS A total of 56 patients with sarcoidosis and 62 patients with ML were included. Patients with sarcoidosis had more prominent FDG accumulation in the mediastinal lymph nodes and lung lesions, while those with ML had more prominent accumulation in the cervical lymph nodes (all p < 0.001). For the mediastinal lymph nodes, sarcoidosis patients had significant FDG accumulation in the level 2, 4, 7, and 10 lymph nodes (all p < 0.01). Otherwise, the accumulation in ML patients tended to be in the level 1 lymph nodes (p = 0.08). The CNN model using frontal and lateral MIP images achieved an average accuracy of 0.890 (95% CI: 0.804-0.977), a sensitivity of 0.898 (95% CI: 0.782-1.000), a specificity of 0.907 (95% CI: 0.799-1.000), and an area under the curve of 0.963 (95% CI: 0.899-1.000). Grad-CAM showed that the model focused on the sites of abnormal FDG accumulation. CONCLUSIONS CNN models based on differences in FDG accumulation sites archive high performance in differentiating between sarcoidosis and ML. CLINICAL RELEVANCE STATEMENT We developed a CNN model using MIP images of [18F]FDG PET/CT to distinguish between sarcoidosis and malignant lymphoma. It achieved high performance and could be useful in diagnosing diseases with involvement across organs and lymph nodes. KEY POINTS • There are differences in FDG distribution when comparing whole-body [18F]FDG PET/CT findings in patients with sarcoidosis and malignant lymphoma before treatment. • Convolutional neural networks, a type of deep learning technique, trained with maximum-intensity projection PET images from two angles showed high performance. • A deep learning model that utilizes differences in FDG distribution may be helpful in differentiating between diseases with lesions that are characteristically widespread among organs and lymph nodes.
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Affiliation(s)
- Hikaru Aoki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan.
| | - Tatsuhiko Anzai
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kota Yokoyama
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichi Tsuchiya
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Meiyo Tamaoka
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Tokyo, Bunkyo-ku, 113-8510, Japan
| | - Masahide Yamamoto
- Department of Hematological Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuo Yamaguchi
- Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan
- Shinjuku Tsurukame Clinic, Tokyo, Japan
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Yamada K, Shioya R, Nishino K, Furihata H, Hijikata A, Kaneko MK, Kato Y, Shirai T, Kosako H, Sawasaki T. Proximity extracellular protein-protein interaction analysis of EGFR using AirID-conjugated fragment of antigen binding. Nat Commun 2023; 14:8301. [PMID: 38097606 PMCID: PMC10721602 DOI: 10.1038/s41467-023-43931-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023] Open
Abstract
Receptor proteins, such as epidermal growth factor receptor (EGFR), interact with other proteins in the extracellular region of the cell membrane to drive intracellular signalling. Therefore, analysis of extracellular protein-protein interactions (exPPIs) is important for understanding the biological function of receptor proteins. Here, we present an approach using a proximity biotinylation enzyme (AirID) fusion fragment of antigen binding (FabID) to analyse the proximity exPPIs of EGFR. AirID was C-terminally fused to the Fab fragment against EGFR (EGFR-FabID), which could then biotinylate the extracellular region of EGFR in several cell lines. Liquid Chromatography-Mass Spectrometry (LC-MS/MS) analysis indicated that many known EGFR interactors were identified as proximity exPPIs, along with many unknown candidate interactors, using EGFR-FabID. Interestingly, these proximity exPPIs were influenced by treatment with EGF ligand and its specific kinase inhibitor, gefitinib. These results indicate that FabID provides accurate proximity exPPI analysis of target receptor proteins on cell membranes with ligand and drug responses.
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Affiliation(s)
- Kohdai Yamada
- Division of Cell-Free Life Science, Proteo-Science Center, Ehime University, 3 Bunkyo-cho, Matsuyama, Ehime, 790-8577, Japan
| | - Ryouhei Shioya
- Division of Cell-Free Life Science, Proteo-Science Center, Ehime University, 3 Bunkyo-cho, Matsuyama, Ehime, 790-8577, Japan
| | - Kohei Nishino
- Division of Cell Signaling, Fujii Memorial Institute of Medical Sciences, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, 770-8503, Japan
| | - Hirotake Furihata
- Division of Cell-Free Life Science, Proteo-Science Center, Ehime University, 3 Bunkyo-cho, Matsuyama, Ehime, 790-8577, Japan
| | - Atsushi Hijikata
- Laboratory of Computational Genomics, School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, 192-0392, Japan
| | - Mika K Kaneko
- Department of Antibody Drug Development, Tohoku University Graduate School of Medicine, Sendai, 980-8575, Japan
- Department of Molecular Pharmacology, Tohoku University Graduate School of Medicine, Sendai, 980-8575, Japan
| | - Yukinari Kato
- Department of Antibody Drug Development, Tohoku University Graduate School of Medicine, Sendai, 980-8575, Japan
- Department of Molecular Pharmacology, Tohoku University Graduate School of Medicine, Sendai, 980-8575, Japan
| | - Tsuyoshi Shirai
- Department of Bioscience, Nagahama Institute of BioScience and Technology, 1266 Tamura, Nagahama, 526-0829, Japan
| | - Hidetaka Kosako
- Division of Cell Signaling, Fujii Memorial Institute of Medical Sciences, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, 770-8503, Japan.
| | - Tatsuya Sawasaki
- Division of Cell-Free Life Science, Proteo-Science Center, Ehime University, 3 Bunkyo-cho, Matsuyama, Ehime, 790-8577, Japan.
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Yasaka K, Yamazaki T, Sato H, Shirai T, Cho M, Ishida K, Ito K, Tanaka T, Ogasawara K, Harigae H, Ishii T, Fujii H. Phospholipase D4 as a signature of toll-like receptor 7 or 9 signaling is expressed on blastic T-bet + B cells in systemic lupus erythematosus. Arthritis Res Ther 2023; 25:200. [PMID: 37840148 PMCID: PMC10577954 DOI: 10.1186/s13075-023-03186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/07/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND In systemic lupus erythematosus (SLE), autoreactive B cells are thought to develop by-passing immune checkpoints and contribute to its pathogenesis. Toll-like receptor (TLR) 7 and 9 signaling have been implicated in their development and differentiation. Although some B cell subpopulations such as T-bet + double negative 2 (DN2) cells have been identified as autoreactive in the past few years, because the upregulated surface markers of those cells are not exclusive to them, it is still challenging to specifically target autoreactive B cells in SLE patients. METHODS Our preliminary expression analysis revealed that phospholipase D4 (PLD4) is exclusively expressed in plasmacytoid dendritic cells (pDCs) and B cells in peripheral blood mononuclear cells (PBMCs) samples. Monoclonal antibodies against human PLD4 were generated, and flow cytometry analyses were conducted for PBMCs from 23 healthy donors (HDs) and 40 patients with SLE. In vitro cell culture was also performed to study the conditions that induce PLD4 in B cells from HDs. Finally, recombinant antibodies were synthesized from subpopulations of PLD4 + B cells from a patient with SLE, and their antinuclear activity was measured through enzyme-linked immunosorbent assay. RESULTS pDCs from both groups showed comparable frequency of surface PLD4 expression. PLD4 + B cells accounted for only a few percent of HD B cells, whereas they were significantly expanded in patients with SLE (2.1% ± 0.4% vs. 10.8% ± 1.2%, P < 0.005). A subpopulation within PLD4 + B cells whose cell size was comparable to CD38 + CD43 + plasmablasts was defined as "PLD4 + blasts," and their frequencies were significantly correlated with those of plasmablasts (P < 0.005). PLD4 + blasts phenotypically overlapped with double negative 2 (DN2) cells, and, in line with this, their frequencies were significantly correlated with several clinical markers of SLE. In vitro assay using healthy PBMCs demonstrated that TLR7 or TLR9 stimulation was sufficient to induce PLD4 on the surface of the B cells. Finally, two out of three recombinant antibodies synthesized from PLD4 + blasts showed antinuclear activity. CONCLUSION PLD4 + B cells, especially "blastic" ones, are likely autoreactive B cells undergoing TLR stimulation. Therefore, PLD4 is a promising target marker in SLE treatment.
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Affiliation(s)
- Ken Yasaka
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomohide Yamazaki
- Research and Development Department, Ginkgo Biomedical Research Institute, SBI Biotech Co., Ltd., Tokyo, Japan
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Minkwon Cho
- Research and Development Department, Ginkgo Biomedical Research Institute, SBI Biotech Co., Ltd., Tokyo, Japan
| | - Koji Ishida
- Research and Development Department, Ginkgo Biomedical Research Institute, SBI Biotech Co., Ltd., Tokyo, Japan
| | - Koyu Ito
- Department of Immunobiology, Institute of Development Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Tetsuhiro Tanaka
- Division of Nephrology and Hypertension, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Kouetsu Ogasawara
- Department of Immunobiology, Institute of Development Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Hideo Harigae
- Department of Hematology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.
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Okada K, Sakakibara R, Honda T, Mitsumura T, Shibata S, Shirai T, Okamoto T, Furusawa H, Tateishi T, Miyazaki Y. Tolerability of sotorasib for KRAS positive lung adenocarcinoma patient with pre-existing interstitial pneumonia; A case report. Respir Med Case Rep 2023; 46:101929. [PMID: 37886215 PMCID: PMC10598048 DOI: 10.1016/j.rmcr.2023.101929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/16/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
A 74-year-old man was referred to our hospital with an abnormal chest shadow. Computed tomography (CT) revealed a mass in the left upper lobe and interstitial pneumonia (IP). The patient underwent CT-guided needle biopsy and was diagnosed as lung adenocarcinoma with cT2aN1M1a Stage IVA (PUL). The patient was administered 6 cycles of CBDCA + nab-paclitaxel as first-line, 3 cycles of atezolizumab as second-line, and 8 cycles of S-1 as third-line treatment but finally showed tumor progression. Because comprehensive genome profiling test revealed KRAS G12C mutation, sotorasib was initiated as fourth-line treatment and showed tumor regression without exacerbation of pre-existing IP.
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Affiliation(s)
- Kohei Okada
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Pulmonary Immunotherapeutic, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Pulmonary Immunotherapeutic, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Katakura T, Shirai T, Sato H, Ishii T, Fujii H. Successful management of interstitial lung disease in dermatomyositis complicated by malignancy: a case-based review. Rheumatol Int 2023:10.1007/s00296-023-05442-y. [PMID: 37682289 DOI: 10.1007/s00296-023-05442-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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
Dermatomyositis (DM) is associated with interstitial lung disease (ILD) and malignancy. However, the coexistence of ILD and malignancy (DM-ILD-malignancy) is rare, and limited information exists regarding its management. Herein, we report the case of a 70-year-old man who developed DM with rapidly progressive ILD and advanced gastric cancer and provide a literature review of managing DM-ILD-malignancy. The patient presented with typical DM skin rashes and shortness of breath, which worsened within 1 month, without muscular symptoms. Additionally, the patient tested negative for myositis-specific autoantibodies (MSAs). Computed tomography revealed ILD and advanced gastric cancer, which was confirmed on endoscopic examination to be a poorly differentiated adenocarcinoma. Although the patient's ILD progressed rapidly, surgical treatment of the cancer was prioritized. Prednisolone (PSL) 0.5 mg/kg was initiated 3 days before surgery and increased to 1 mg/kg at 7 days postoperative. Remarkable improvement in the skin rash and ILD was observed, and the PSL dose was tapered without immunosuppressants. A literature review revealed that anti-melanoma differentiation-associated gene 5 and anti-aminoacyl transfer RNA synthetase antibodies are the predominant MSAs in DM-ILD-malignancy, and the optimal treatment should be determined based on several factors, including ILD patterns, and malignancy type and stage. In particular, lung cancer may be a risk factor for the acute exacerbation of ILD, and preceding immunosuppression would be useful. Furthermore, prioritizing surgery for gastric cancer is effective because of its paraneoplastic nature.
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Affiliation(s)
- Tokio Katakura
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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17
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Maeda A, Tsuchida N, Uchiyama Y, Horita N, Kobayashi S, Kishimoto M, Kobayashi D, Matsumoto H, Asano T, Migita K, Kato A, Mori I, Morita H, Matsubara A, Marumo Y, Ito Y, Machiyama T, Shirai T, Ishii T, Kishibe M, Yoshida Y, Hirata S, Akao S, Higuchi A, Rokutanda R, Nagahata K, Takahashi H, Katsuo K, Ohtani T, Fujiwara H, Nagano H, Hosokawa T, Ito T, Haji Y, Yamaguchi H, Hagino N, Shimizu T, Koga T, Kawakami A, Kageyama G, Kobayashi H, Aoki A, Mizokami A, Takeuchi Y, Motohashi R, Hagiyama H, Itagane M, Teruya H, Kato T, Miyoshi Y, Kise T, Yokogawa N, Ishida T, Umeda N, Isogai S, Naniwa T, Yamabe T, Uchino K, Kanasugi J, Takami A, Kondo Y, Furuhashi K, Saito K, Ohno S, Kishimoto D, Yamamoto M, Fujita Y, Fujieda Y, Araki S, Tsushima H, Misawa K, Katagiri A, Kobayashi T, Hashimoto K, Sone T, Hidaka Y, Ida H, Nishikomori R, Doi H, Fujimaki K, Akasaka K, Amano M, Matsushima H, Kashino K, Ohnishi H, Miwa Y, Takahashi N, Takase-Minegishi K, Yoshimi R, Kirino Y, Nakajima H, Matsumoto N. Efficient detection of somatic UBA1 variants and clinical scoring system predicting patients with variants in VEXAS syndrome. Rheumatology (Oxford) 2023:kead425. [PMID: 37606963 DOI: 10.1093/rheumatology/kead425] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVES To efficiently detect somatic UBA1 variants and establish a clinical scoring system predicting patients with pathogenic variants in VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome. METHODS Eighty-nine Japanese patients with clinically suspected VEXAS syndrome were recruited [81 males and 8 females; median onset age (IQR) 69.3 years (62.1-77.6)]. Peptide nucleic acid-clamping PCR (PNA-PCR), regular PCR targeting exon 3 clustering UBA1 variants, and subsequent Sanger sequencing were conducted for variant screening. Partitioning digital PCR (pdPCR) or targeted amplicon deep sequencing (TAS) was also performed to evaluate the variant allele frequency (VAF). We developed our clinical scoring system to predict UBA1 variant-positive and ‑negative patients and assessed the diagnostic value of our system using receiver operating characteristic (ROC) curve analysis. RESULTS Forty patients with reported pathogenic UBA1 variants (40/89, 44.9%) were identified, including a case having a variant with VAF of 1.7%, using a highly sensitive method. Our clinical scoring system considering >50 years of age, cutaneous lesions, lung involvement, chondritis, and macrocytic anaemia efficiently predicted patients with UBA1 variants (the area under the curve for the scoring total was 0.908). CONCLUSIONS Genetic screening with the combination of regular PCR and PNA-PCR detected somatic UBA1 variants with high sensitivity and specificity. Our scoring system could efficiently predict patients with UBA1 variants.
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Affiliation(s)
- Ayaka Maeda
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomi Tsuchida
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Yuri Uchiyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama, Japan
| | - Satoshi Kobayashi
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Daisuke Kobayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruki Matsumoto
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ayaka Kato
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Ichiro Mori
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Hiroyuki Morita
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Akihiro Matsubara
- Department of Dermatology, Chita Kosei Hospital, Mihama, Aichi, Japan
| | - Yoshiaki Marumo
- Department of Hematology and Oncology, Graduated school of medicine, Nagoya City University, Nagoya, Aichi, Japan
| | - Yuji Ito
- Department of General Internal Medicine, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
| | - Tomoaki Machiyama
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Mari Kishibe
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yusuke Yoshida
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shintaro Hirata
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Satoshi Akao
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Akitsu Higuchi
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ryo Rokutanda
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ken Nagahata
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Koske Katsuo
- Department of Dermatology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Toshio Ohtani
- Department of Dermatology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Hiroshi Fujiwara
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Hiromichi Nagano
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Takashi Hosokawa
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Takanori Ito
- Department of Rheumatology, Daido Hospital, Nagoya, Aichi, Japan
| | - Yoichiro Haji
- Department of Rheumatology, Daido Hospital, Nagoya, Aichi, Japan
| | - Hiroyuki Yamaguchi
- Department of Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Noboru Hagino
- Department of Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Toshimasa Shimizu
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Goichi Kageyama
- Department of Rheumatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Hiroshi Kobayashi
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Akinari Mizokami
- Department of Rheumatology, Japan Community Healthcare Organization (JCHO), Isahaya General Hospital, Isahaya, Nagasaki, Japan
| | - Yoichi Takeuchi
- Department of Rheumatology and Nephrology, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Rena Motohashi
- Department of Rheumatology and Nephrology, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Hiroyuki Hagiyama
- Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan
| | - Masaki Itagane
- Department of Rheumatology, Okinawa Chubu Hospital, Uruma, Okinawa, Japan
| | - Hiroyuki Teruya
- Department of Allergy and Rheumatology, Graduation School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomohiro Kato
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Yuji Miyoshi
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Takayasu Kise
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Takako Ishida
- Department of Dermatology, Hiroshima General Hospital, Hatsukaichi, Hiroshima, JA, Japan
| | - Naoki Umeda
- Department of Dermatology, Hiroshima General Hospital, Hatsukaichi, Hiroshima, JA, Japan
| | - Shuntaro Isogai
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Taio Naniwa
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Toru Yamabe
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Jo Kanasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yasushi Kondo
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kazunori Furuhashi
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Koichi Saito
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shigeru Ohno
- Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Daiga Kishimoto
- Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Mari Yamamoto
- Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Yoshiro Fujita
- Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Yuichiro Fujieda
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Sachiko Araki
- Department of Internal Medicine, Niizashiki Central General Hospital, Niiza, Saitama, Japan
| | - Hiroshi Tsushima
- Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Kyohei Misawa
- Department of Hematology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Akira Katagiri
- Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Takehiro Sone
- Division of Hematology, Department of Internal Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Yukiko Hidaka
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroshi Doi
- Department of Immunology, Shiga General Hospital, Moriyama, Shiga, Japan
| | | | - Keiichi Akasaka
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Masako Amano
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Hidekazu Matsushima
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Kaori Kashino
- Department of Dermatology, Onomichi Municipal Hospital, Onomichi, Hiroshima, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Yuki Miwa
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Noriyuki Takahashi
- Department of Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Department of General Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Kaoru Takase-Minegishi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Nishikino T, Hijikata A, Kojima S, Shirai T, Kainosho M, Homma M, Miyanoiri Y. Changes in the hydrophobic network of the FliG MC domain induce rotational switching of the flagellar motor. iScience 2023; 26:107320. [PMID: 37520711 PMCID: PMC10372836 DOI: 10.1016/j.isci.2023.107320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/18/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023] Open
Abstract
The FliG protein plays a pivotal role in switching the rotational direction of the flagellar motor between clockwise and counterclockwise. Although we previously showed that mutations in the Gly-Gly linker of FliG induce a defect in switching rotational direction, the detailed molecular mechanism was not elucidated. Here, we studied the structural changes in the FliG fragment containing the middle and C-terminal regions, named FliGMC, and the switch-defective FliGMC-G215A, using nuclear magnetic resonance (NMR) and molecular dynamics simulations. NMR analysis revealed multiple conformations of FliGMC, and the exchange process between these conformations was suppressed by the G215A residue substitution. Furthermore, changes in the intradomain orientation of FliG were induced by changes in hydrophobic interaction networks throughout FliG. Our finding applies to FliG in a ring complex in the flagellar basal body, and clarifies the switching mechanism of the flagellar motor.
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Affiliation(s)
- Tatsuro Nishikino
- Laboratory for Ultra-High Magnetic Field NMR Spectroscopy, Research Center for Next-Generation Protein Sciences, Institute for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Atsushi Hijikata
- Department of Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura, Nagahama, Shiga 526-0829, Japan
| | - Seiji Kojima
- Division of Biological Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | - Tsuyoshi Shirai
- Department of Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura, Nagahama, Shiga 526-0829, Japan
| | - Masatsune Kainosho
- Graduate School of Pharmaceutical Sciences, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
- Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami-ohsawa, Hachioji, Tokyo 192-0397, Japan
| | - Michio Homma
- Division of Biological Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
- Department of Physics, Graduate School of Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | - Yohei Miyanoiri
- Laboratory for Ultra-High Magnetic Field NMR Spectroscopy, Research Center for Next-Generation Protein Sciences, Institute for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, Osaka 565-0871, Japan
- Graduate School of Pharmaceutical Sciences, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
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19
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Ichimura H, Ichikawa S, Ono K, Inokura K, Hoshi Y, Shirai T, Fukuhara N, Yokoyama H, Fujii H, Harigae H. Severe Bone Marrow Aplasia Following Macrophage Activation Syndrome in Systemic Lupus Erythematosus. TOHOKU J EXP MED 2023; 260:301-304. [PMID: 37164698 DOI: 10.1620/tjem.2023.j037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Macrophage activation syndrome (MAS) is a potentially fatal complication of rheumatic diseases, characterized by activated macrophages with hemophagocytosis and multiple organ damage. We report a case of MAS associated with systemic lupus erythematosus that initially presented with severe liver dysfunction. Although it was improved with steroids and plasmapheresis, severe pancytopenia was subsequently experienced, and the bone marrow showed severe aplasia similar to aplastic anemia. Nevertheless, the administration of immunosuppressants resulted in the recovery of blood counts within two weeks. When severe MAS results in cytokine overproduction, bone marrow aplasia may occur, for which immunosuppressive therapy may be highly effective.
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Affiliation(s)
| | | | - Koya Ono
- Department of Hematology, Tohoku University Hospital
| | - Kyoko Inokura
- Department of Hematology, Tohoku University Hospital
| | - Yosuke Hoshi
- Department of Rheumatology, Tohoku University Hospital
| | | | | | | | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital
| | - Hideo Harigae
- Department of Hematology, Tohoku University Hospital
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Akagi JI, Yokoi M, Miyake Y, Shirai T, Baba T, Cho YM, Hanaoka F, Sugasawa K, Iwai S, Ogawa K. A formamidopyrimidine derivative from the deoxyguanosine adduct produced by food contaminant acrylamide induces DNA replication block and mutagenesis. J Biol Chem 2023; 299:105002. [PMID: 37394003 PMCID: PMC10406624 DOI: 10.1016/j.jbc.2023.105002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/04/2023] Open
Abstract
Acrylamide, a common food contaminant, is metabolically activated to glycidamide, which reacts with DNA at the N7 position of dG, forming N7-(2-carbamoyl-2-hydroxyethyl)-dG (GA7dG). Owing to its chemical lability, the mutagenic potency of GA7dG has not yet been clarified. We found that GA7dG undergoes ring-opening hydrolysis to form N6-(2-deoxy-d-erythro-pentofuranosyl)-2,6-diamino-3,4-dihydro-4-oxo-5-[N-(2-carbamoyl-2-hydroxyethyl)formamido]pyrimidine (GA-FAPy-dG), even at neutral pH. Therefore, we aimed to examine the effects of GA-FAPy-dG on the efficiency and fidelity of DNA replication using an oligonucleotide carrying GA-FAPy-9-(2-deoxy-2-fluoro-β-d-arabinofuranosyl)guanine (dfG), a 2'-fluorine substituted analog of GA-FAPy-dG. GA-FAPy-dfG inhibited primer extension by both human replicative DNA polymerase ε and the translesion DNA synthesis polymerases (Polη, Polι, Polκ, and Polζ) and reduced the replication efficiency by less than half in human cells, with single base substitution at the site of GA-FAPy-dfG. Unlike other formamidopyrimidine derivatives, the most abundant mutation was G:C > A:T transition, which was decreased in Polκ- or REV1-KO cells. Molecular modeling suggested that a 2-carbamoyl-2-hydroxyethyl group at the N5 position of GA-FAPy-dfG can form an additional H-bond with thymidine, thereby contributing to the mutation. Collectively, our results provide further insight into the mechanisms underlying the mutagenic effects of acrylamide.
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Affiliation(s)
- Jun-Ichi Akagi
- Division of Pathology, National Institute of Health Sciences, Kawasaki, Kanagawa, Japan.
| | - Masayuki Yokoi
- Biosignal Research Center, Kobe University, Kobe, Hyogo, Japan
| | - Yumi Miyake
- Forefront Research Center, Graduate School of Science, Osaka University, Toyonaka, Osaka, Japan
| | - Tsuyoshi Shirai
- Department of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Tomohiro Baba
- Graduate School of Engineering Science, Osaka University, Toyonaka, Osaka, Japan
| | - Young-Man Cho
- Division of Pathology, National Institute of Health Sciences, Kawasaki, Kanagawa, Japan
| | - Fumio Hanaoka
- Biosignal Research Center, Kobe University, Kobe, Hyogo, Japan; National Institute of Genetics, Mishima, Shizuoka, Japan
| | - Kaoru Sugasawa
- Biosignal Research Center, Kobe University, Kobe, Hyogo, Japan
| | - Shigenori Iwai
- Graduate School of Engineering Science, Osaka University, Toyonaka, Osaka, Japan
| | - Kumiko Ogawa
- Division of Pathology, National Institute of Health Sciences, Kawasaki, Kanagawa, Japan
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Shirai T. Common Autoantibody among Takayasu Arteritis and Ulcerative Colitis: A Possible Pathophysiology That Includes Gut-Vessel Connection in Vascular Inflammation. JMA J 2023; 6:265-273. [PMID: 37560375 PMCID: PMC10407456 DOI: 10.31662/jmaj.2023-0038] [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: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 08/11/2023] Open
Abstract
Takayasu arteritis (TAK) is a type of large-vessel vasculitis that predominantly affects young females. The precise pathomechanism of TAK is still under investigation. In TAK, the vasa vasorum is considered to be the initial inflammatory site. Disruption of the vasa vasorum induces the entry of inflammatory cells into the vascular wall of large vessels between the media and adventitia, and infiltrated cells damage the vascular components, eventually leading to stenosis or dilatation of the affected arteries. In addition, T cells are considered key players in TAK, and myeloid cells function as effector cells. Although the roles of B cells in TAK are poorly understood, recent evidence supports their contribution to the pathogenicity of TAK. Particularly, two autoantibodies have been identified in TAK through investigation of anti-endothelial cell antibodies, and they could be involved in the maintenance of vascular inflammation. Furthermore, one of the autoantibodies, anti-endothelial protein C receptor, was shown to be present in ulcerative colitis (UC), which is genetically and clinically associated with TAK. Similar autoantibodies in inflammatory diseases with different target organs indicate a common underlying pathophysiology of these diseases, which could be characterized by the aberrant activation of B cells. This review discusses recent understanding of the pathomechanisms of TAK and UC, with a focus on the involvement of B cells and autoantibodies. The close association of UC with TAK further suggests a common etiology, and the importance of the intestinal microbiota, including dysbiosis, is also becoming known in TAK. Investigation of such common factors among TAK and UC would improve understanding of the interplay between gut and vascular inflammation, which is a new concept for developing vascular inflammation through the gut-vessel connection.
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Affiliation(s)
- Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
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22
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Shirai T, Watanabe S, Shinozaki NO, Baba K, Yamasaki H, Ishii T, Fujii H. Common dysbiosis features between patients of different social environments in Takayasu arteritis: comment on the article by Fan et al. Arthritis Rheumatol 2023; 75:1291-1292. [PMID: 36622341 DOI: 10.1002/art.42438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Affiliation(s)
| | | | | | | | | | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, Tokyo, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, Tokyo, Japan
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23
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Shirai T, Tanino Y, Nikaido T, Takaku Y, Hashimoto S, Taguchi Y, Baba T, Ogura T, Kataoka K, Nakayama M, Yamada Y, Matsushima S, Minami K, Miyazaki Y. Utility of budgerigar/pigeon/parrot-specific IgG antibody with ImmunoCAP® in bird-related hypersensitivity pneumonitis caused by other bird species and duvet. Respir Investig 2023; 61:520-526. [PMID: 37295290 DOI: 10.1016/j.resinv.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/11/2023] [Accepted: 05/01/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Bird-related hypersensitivity pneumonitis (BRHP) is an extrinsic allergic alveolitis caused by inhalation of bird antigens. Although the measurement of serum-specific IgG antibodies against budgerigar, pigeon, and parrot with ImmunoCAP® is available in Japan, the utility of the test for patients with causes by bird breeding other than these three species, including contact with wild birds/poultry/bird manure, and use of a duvet is unknown. METHODS Of the 75 BRHP patients who participated in our previous study, 30 were included. Six cases were caused by bird breeding of species other than pigeon, budgerigar, and parrot, seven were in contact with wild birds/poultry/bird manure, and 17 were using a duvet. Bird-specific IgG antibodies were compared among the patients, 64 controls, and 147 healthy participants. RESULTS In patients with BRHP caused by bird breeding, budgerigar and parrot-specific IgG levels were significantly higher than in disease controls. Only parrot-specific IgG was significantly higher than in disease controls in patients caused by duvet use. However, among patients with acute episodes (acute and recurrent type of chronic BRHP), IgG antibodies against all three species were significantly higher than those of disease controls caused by bird breeding and the use of a duvet. CONCLUSIONS Bird-specific IgG antibody with ImmunoCAP® was useful for screening and diagnosing BRHP caused by other bird species and duvets.
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Affiliation(s)
- Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yotaro Takaku
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
| | | | - Yoshio Taguchi
- Department of Respiratory Medicine, Tenri Hospital, Nara, Japan
| | - Tomohisa Baba
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Kensuke Kataoka
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan
| | - Masayuki Nakayama
- Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Yoshihito Yamada
- Department of Respiratory Medicine, JR Tokyo General Hospital, Tokyo, Japan
| | - Sayomi Matsushima
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Keiichiro Minami
- Immuno Diagnostic Division, Thermo Fisher Scientific, Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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24
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Hori S, Tateyama M, Shirai T, Kubo Y, Saitoh O. Two single-point mutations in Ankyrin Repeat one drastically change the threshold temperature of TRPV1. Nat Commun 2023; 14:2415. [PMID: 37169739 PMCID: PMC10175561 DOI: 10.1038/s41467-023-38051-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/13/2023] [Indexed: 05/13/2023] Open
Abstract
TRPV1 plays an important role in the thermosensory system; however, the mechanism controlling its heat activation property is not well understood. Here, we determine the heat activation properties of TRPV1 cloned from tailed amphibians, which prefer cooler environments, finding the threshold temperatures were approximately 10 °C lower compared with rat TRPV1 (rTRPV1). We find that two amino acid residues (Gln, Leu/Val) in the Ankyrin Repeat 1 (ANK1) region of the N-terminal domain are conserved among tailed amphibians and different from those (Arg, Lys) in rTRPV1. We observe the activation by heat in all urodelan TRPV1s is markedly elevated by substitution of these two amino acids. Conversely, reciprocal substitutions of rTRPV1 apparently lowers the high threshold temperature. Our studies demonstrate that tailed amphibians express TRPV1 with a reduced heat-activation threshold by substitution of two amino acid residues in the ANK1 region that likely contribute to cool-habitat selection.
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Affiliation(s)
- Shogo Hori
- Graduate School of Biosciences, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Michihiro Tateyama
- Division of Biophysics and Neurobiology, National Institute for Physiological Sciences, Okazaki, Aichi, 444-8585, Japan
| | - Tsuyoshi Shirai
- Graduate School of Biosciences, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Yoshihiro Kubo
- Division of Biophysics and Neurobiology, National Institute for Physiological Sciences, Okazaki, Aichi, 444-8585, Japan
| | - Osamu Saitoh
- Graduate School of Biosciences, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan.
- Genome Editing Research Institute, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan.
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25
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Hayashi T, Yano N, Kora K, Yokoyama A, Maizuru K, Kayaki T, Nishikawa K, Osawa M, Niwa A, Takenouchi T, Hijikata A, Shirai T, Suzuki H, Kosaki K, Saito MK, Takita J, Yoshida T. Involvement of mTOR pathway in neurodegeneration in NSF-related developmental and epileptic encephalopathy. Hum Mol Genet 2023; 32:1683-1697. [PMID: 36645181 PMCID: PMC10162430 DOI: 10.1093/hmg/ddad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
Membrane fusion is mediated by soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins. During neurotransmitter exocytosis, SNARE proteins on a synaptic vesicle and the target membrane form a complex, resulting in neurotransmitter release. N-ethylmaleimide-sensitive factor (NSF), a homohexameric ATPase, disassembles the complex, allowing individual SNARE proteins to be recycled. Recently, the association between pathogenic NSF variants and developmental and epileptic encephalopathy (DEE) was reported; however, the molecular pathomechanism of NSF-related DEE remains unclear. Here, three patients with de novo heterozygous NSF variants were presented, of which two were associated with DEE and one with a very mild phenotype. One of the DEE patients also had hypocalcemia from parathyroid hormone deficiency and neuromuscular junction impairment. Using PC12 cells, a neurosecretion model, we show that NSF with DEE-associated variants impaired the recycling of vesicular membrane proteins and vesicle enlargement in response to exocytotic stimulation. In addition, DEE-associated variants caused neurodegenerative change and defective autophagy through overactivation of the mammalian/mechanistic target of rapamycin (mTOR) pathway. Treatment with rapamycin, an mTOR inhibitor or overexpression of wild-type NSF ameliorated these phenotypes. Furthermore, neurons differentiated from patient-derived induced pluripotent stem cells showed neurite degeneration, which was also alleviated by rapamycin treatment or gene correction using genome editing. Protein structure analysis of NSF revealed that DEE-associated variants might disrupt the transmission of the conformational change of NSF monomers and consequently halt the rotation of ATP hydrolysis, indicating a dominant negative mechanism. In conclusion, this study elucidates the pathomechanism underlying NSF-related DEE and identifies a potential therapeutic approach.
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Affiliation(s)
- Takahiro Hayashi
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Naoko Yano
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Kengo Kora
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Atsushi Yokoyama
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Kanako Maizuru
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Taisei Kayaki
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Kinuko Nishikawa
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Mitsujiro Osawa
- Thyas Co. Ltd, Kyoto 606-8501, Japan
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA) Kyoto University, Kyoto 606-8507, Japan
| | - Akira Niwa
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA) Kyoto University, Kyoto 606-8507, Japan
| | - Toshiki Takenouchi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
| | - Atsushi Hijikata
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga 526-0829, Japan
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo 192-0392, Japan
| | - Tsuyoshi Shirai
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga 526-0829, Japan
| | - Hisato Suzuki
- Center for Medical Genetics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
| | - Megumu K Saito
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA) Kyoto University, Kyoto 606-8507, Japan
| | - Junko Takita
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Takeshi Yoshida
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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26
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Shirai T, Machiyama T, Sato H, Ishii T, Fujii H. Intensive induction therapy combining tofacitinib, rituximab and plasma exchange in severe anti-melanoma differentiation-associatedprotein-5 antibody-positive dermatomyositis. Clin Exp Rheumatol 2023; 41:291-300. [PMID: 36700661 DOI: 10.55563/clinexprheumatol/8kulbf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Anti-melanoma differentiation-associated protein-5 (MDA5) autoantibodies (Abs) are associated with rapidly progressive interstitial lung disease (RP-ILD) in dermatomyositis (DM). Because the addition of plasma exchange (PE) and rituximab (RTX) to triple therapy is inadequate in severe cases, we treat such cases with intensive induction therapy (IIT) combining all these options with tofacitinib (TOF). In this study, we investigated the poor prognostic factors and the efficacy and safety of IIT. METHODS Thirty-three patients diagnosed with anti-MDA5 Ab-positive DM in our institution between 2014 and 2021 were included. The clinical characteristics of poor prognosis were retrospectively analysed using principal component analysis (PCA), and the outcomes of IIT were analysed in terms of survival, assessed using the Kaplan-Meier test, and adverse events. RESULTS Although triple therapy with RTX, PE, or intravenous immunoglobulin was administered before the introduction of IIT, eight of 12 RP-ILD cases with a ferritin level >400 ng/mL (mean, 2,342) died within a median of 2.5 months. PCA revealed distinct clusters for prognosis, and age and serum ferritin were leading predictors of the prognosis. IIT, consisting of combinations of triple therapy with higher doses of methylprednisolone, PE, RTX, and TOF, was applied to eight patients (mean ferritin, 3,558). Although two patients died even with these regimens, a significant improvement in survival was documented. Several IIT-related adverse events were observed, including viral and fungal infections and cytopenia. CONCLUSIONS IIT significantly improved the survival of patients with severe anti-MDA5 Ab-positive RP-ILD. Although infections are noted, their benefits outweigh the risks in younger patients with high serum ferritin levels.
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Affiliation(s)
- Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan.
| | - Tomoaki Machiyama
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
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27
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Shirai T, Sato H, Ishii T, Fujii H. Dysbiosis in Takayasu arteritis complicated with infectious endocarditis following tocilizumab administration. Scand J Rheumatol 2023; 52:224-226. [PMID: 36255303 DOI: 10.1080/03009742.2022.2124620] [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: 10/24/2022]
Affiliation(s)
- T Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - H Sato
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - T Ishii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - H Fujii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
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28
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Kakuta Y, Shirai T, McGovern DPB, Braun J, Fujii H, Masamune A. Novel Diagnostic Autoantibodies Against Endothelial Protein C Receptor in Patients With Ulcerative Colitis. Clin Gastroenterol Hepatol 2023; 21:844-846. [PMID: 34971808 DOI: 10.1016/j.cgh.2021.12.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Received: 11/15/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 02/07/2023]
Abstract
There have been many reports on serologic autoantibodies in inflammatory bowel diseases (IBD),1 consisting of ulcerative colitis (UC) and Crohn's disease (CD), and recently Kuwada et al2 reported a new autoantibody against integrin αvβ6 with high sensitivity and specificity for UC. Concurrently, we had discovered autoantibodies against endothelial protein C receptor (EPCR) in Takayasu arteritis (TAK), which is sometimes complicated by UC.3 Interestingly, this autoantibody was found in most patients with TAK associated with UC, and we found that the positivity rate in patients with UC without TAK was also high, suggesting that anti-EPCR antibody is a candidate autoantibody useful for the diagnosis of UC.4 To clarify the diagnostic usefulness of anti-EPCR antibodies in patients with IBD and their relationship to several disease subphenotypes and their disease activities, we analyzed the serum samples from patients with IBD and non-IBD control subjects in Japan and the United States.
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Affiliation(s)
- Yoichi Kakuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Dermot P B McGovern
- F. Widjaja Family Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jonathan Braun
- F. Widjaja Family Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
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29
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Tateishi T, Shimada S, Yamana T, Iijima Y, Sakakibara R, Mitsumura T, Shibata S, Honda T, Shirai T, Okamoto T, Tamaoka M, Sasai T, Miyazaki Y. COVID-19 Pneumonia Followed by Anti-signal Recognition Particle Antibody-positive Fibrosing Interstitial Lung Disease: A Case Report. Intern Med 2023; 62:1323-1328. [PMID: 36754401 DOI: 10.2169/internalmedicine.8877-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) pneumonia is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently accompanied by various sequelae. Interstitial lung diseases (ILDs) are observed in COVID-19 pneumonia patients after recovery, probably due to persistent inflammation in the lungs. We herein report a case of ILD with anti-signal recognition particle antibodies following severe COVID-19 pneumonia. The patient was diagnosed with ILD three months after COVID-19 pneumonia. Although the exact mechanism is unknown, the autoantibody-induced immune response might have been the pulmonary fibrosis trigger in this patient.
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Affiliation(s)
- Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
- Department of Respiratory Physiology and Sleep Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shimada
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takashi Yamana
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Yuki Iijima
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
- Department of Pulmonary Immunotherapeutics, Tokyo Medical and Dental University, Japan
| | - Meiyo Tamaoka
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
- Department of Respiratory Physiology and Sleep Medicine, Tokyo Medical and Dental University, Japan
| | - Tsuneo Sasai
- Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
- Department of Respiratory Physiology and Sleep Medicine, Tokyo Medical and Dental University, Japan
- Department of Pulmonary Immunotherapeutics, Tokyo Medical and Dental University, Japan
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30
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Ito N, Shirai T, Toyohara T, Hashimoto H, Sato H, Fujii H, Ishii T, Harigae H. "Coexistence of IgA nephropathy and renal artery stenosis in Takayasu arteritis: case report and literature review". Rheumatol Int 2023; 43:391-398. [PMID: 35013840 DOI: 10.1007/s00296-021-05066-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
Although Takayasu arteritis (TAK) is a form of large vessel vasculitis, complications of glomerulonephritis have occasionally been observed, with mesangial proliferative glomerulonephritis as the most common. The aim of this work was to present a case-based review regarding the association of glomerulonephritis and IgA nephropathy (IgAN) with TAK. A literature search was carried out using the PubMed and Scopus databases for articles published in English, and the Ichu-shi Web for Japanese. A 34-year-old Japanese man was evaluated for proteinuria, and IgAN was diagnosed by renal biopsy. Simultaneously, aortic wall thickening and right renal artery stenosis confirmed a coexisting TAK. Prednisolone and methotrexate improved both diseases, and percutaneous transluminal renal angioplasty resulted in right renal artery reopening. Our case and literature review revealed that membranous proliferative glomerulonephritis and IgAN are common in eastern Asia, while focal segmental glomerulosclerosis and mesangial proliferative glomerulonephritis are common in other regions. The incidence of IgAN is higher in TAK cases and is mostly reported in Asia. Abdominal aortic involvement and renal artery stenosis are common in cases with preceding TAK. IgAN could be related to the cytokine network involving interleukin-6, suggesting the usefulness of tocilizumab in patients with TAK accompanied by IgAN. The type of glomerulonephritis complicated with TAK differs among regions, and patients with TAK are more likely to experience IgAN than the healthy population.
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Affiliation(s)
- Nono Ito
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tsuyoshi Shirai
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Takafumi Toyohara
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideaki Hashimoto
- Division of Nephrology and Endocrinology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hiroko Sato
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroshi Fujii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomonori Ishii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hideo Harigae
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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31
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Ida C, Yamashita S, Eguchi T, Kuroda Y, Nakae S, Nishi Y, Kamemura K, Shirai T, Mizukami T, Tanaka M, Moss J, Miwa M. An Enzyme-Linked Immunosorbent Assay to Quantify Poly (ADP-Ribose) Level In Vivo. Methods Mol Biol 2022; 2609:91-100. [PMID: 36515831 DOI: 10.1007/978-1-0716-2891-1_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PolyADP-ribosylation is a posttranslational modification of proteins that results from enzymatic synthesis of poly(ADP-ribose) with NAD+ as the substrate. A unique characteristic of polyADP-ribosylation is that the poly(ADP-ribose) chain can have 200 or more ADP-ribose residues in branched patterns, and the presence and variety of these chains can have substantive effects on protein function. To understand how polyADP-ribosylation affects biological processes, it is important to know the physiological level of poly(ADP-ribose) in cells. Under normal cell physiological conditions and in the absence of any exogenous DNA damaging agents, we found that the concentration of poly(ADP-ribose) in HeLa cells is approximately 0.04 pmol (25 pg)/106 cells, as measured with a double-antibody sandwich, enzyme-linked immunosorbent assay protocol that avoids artificial activation of PARP1 during cell lysis. Notably, this system demonstrated that the poly(ADP-ribose) level peaks in S phase and that the average cellular turnover of a single poly(ADP-ribose) is less than 40 s.
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Affiliation(s)
- Chieri Ida
- Department of Applied Life Studies, College of Nagoya Women's University, Nagoya-shi, Aichi, Japan
| | - Sachiko Yamashita
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Takayuki Eguchi
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Yasuhito Kuroda
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Setsu Nakae
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Yoshisuke Nishi
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Kazuo Kamemura
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Tsuyoshi Shirai
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Tamio Mizukami
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Masakazu Tanaka
- Division of Neuroimmunology, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Masanao Miwa
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan.
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32
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Kamogawa Y, Akita K, Sato H, Shirai T, Ishii T, Harigae H, Fujii H. Sjögren's Syndrome Presenting with Temporary Hemiplegia Mimicking Transient Ischemic Attack. TOHOKU J EXP MED 2022; 258:207-211. [PMID: 36155592 DOI: 10.1620/tjem.2022.j079] [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: 11/18/2022]
Affiliation(s)
| | - Kanae Akita
- Department of Rheumatology, Tohoku University Hospital
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital
| | | | - Tomonori Ishii
- Department of Clinical Research, Innovation and Education Center, Tohoku University Hospital
| | - Hideo Harigae
- Department of Hematology, Tohoku University Graduate School of Medicine
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital
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33
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Yamashita S, Tanaka M, Ida C, Kouyama K, Nakae S, Matsuki T, Tsuda M, Shirai T, Kamemura K, Nishi Y, Moss J, Miwa M. Physiological levels of poly(ADP-ribose) during the cell cycle regulate HeLa cell proliferation. Exp Cell Res 2022; 417:113163. [PMID: 35447104 PMCID: PMC10009817 DOI: 10.1016/j.yexcr.2022.113163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/18/2022] [Accepted: 04/17/2022] [Indexed: 11/19/2022]
Abstract
Protein targets of polyADP-ribosylation undergo covalent modification with high-molecular-weight, branched poly(ADP-ribose) (PAR) of lengths up to 200 or more ADP-ribose residues derived from NAD+. PAR polymerase 1 (PARP1) is the most abundant and well-characterized enzyme involved in PAR biosynthesis. Extensive studies have been carried out to determine how polyADP-ribosylation (PARylation) regulates cell proliferation during cell cycle, with conflicting conclusions. Since significant activation of PARP1 occurs during cell lysis in vitro, we changed the standard method for cell lysis, and using our sensitive ELISA system, quantified without addition of a PAR glycohydrolase inhibitor and clarified that the PAR level is significantly higher in S phase than that in G1. Under normal condition in the absence of exogenous DNA-damaging agent, PAR turns over with a half-life of <40 s; consistent with significant decrease of NAD+ levels in S phase, which is rescued by PARP inhibitors, in line with the observed rapid turnover of PAR. PARP inhibitors delayed cell cycle in S phase and decreased cell proliferation. Our results underscore the importance of a suitable assay system to measure rapid PAR chain dynamics in living cells and aid our understanding of the function of PARylation during the cell cycle.
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Affiliation(s)
- Sachiko Yamashita
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Masakazu Tanaka
- Joint Research Center for Human Retrovirus Infection, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8544, Japan
| | - Chieri Ida
- Department of Applied Life Sciences, College of Nagoya Women's University, Nagoya-shi, Aichi, 467-8610, Japan
| | - Kenichi Kouyama
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Setsu Nakae
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Taisuke Matsuki
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Masataka Tsuda
- Program of Mathematical and Life Sciences, Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, 739-8526, Japan
| | - Tsuyoshi Shirai
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Kazuo Kamemura
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Yoshisuke Nishi
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, 20892-1590, USA
| | - Masanao Miwa
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, 526-0829, Japan.
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Ishikawa T, Suzuki J, Shirai T, Koizumi S, Tsuchiya Y, Hishinuma K, Nakamura Y, Katori Y. Presence of Phlebitis in Aseptic Nasal Septal Abscess Complicated with Ulcerative Colitis; Possible Association with Granulomatosis with Polyangiitis: A Case Report. TOHOKU J EXP MED 2022; 258:29-34. [PMID: 35768225 DOI: 10.1620/tjem.2022.j053] [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: 11/18/2022]
Affiliation(s)
- Tomohiko Ishikawa
- Department of Otorhinolaryngology, Japan Community Health Care Organization (JCHO) Sendai Hospital.,Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
| | - Jun Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
| | | | - Shotaro Koizumi
- Department of Otorhinolaryngology, Japan Community Health Care Organization (JCHO) Sendai Hospital.,Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
| | - Yoshinori Tsuchiya
- Department of Nephrology, Japan Community Health Care Organization (JCHO) Sendai Hospital
| | - Kasumi Hishinuma
- Department of Gastroenterology, Japan Community Health Care Organization (JCHO) Sendai Hospital
| | - Yasuhiro Nakamura
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Yukio Katori
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
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Isogai Y, Imamura H, Sumi T, Shirai T. Improvement of Protein Solubility in Macromolecular Crowding during Myoglobin Evolution. Biochemistry 2022; 61:1543-1547. [PMID: 35674519 DOI: 10.1021/acs.biochem.2c00166] [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: 11/30/2022]
Abstract
The inside of living cells is crowded by extremely high concentrations of biomolecules, and thus globular proteins should have been developed to increase their solubility under such crowding conditions during organic evolution. The O2-storage protein myoglobin (Mb) is known to be expressed in myocytes of diving mammals in much larger quantities than those of land mammals. We have previously resurrected ancient whale and pinniped Mbs and experimentally demonstrated that the diving animal Mbs have evolved to maintain high solubility under the crowding conditions or to increase their tolerance against macromolecular precipitants, rather than solubility in a dilute buffer solution. However, the detail of chemical mechanisms of the precipitant tolerance remains unclear. Here, we investigated pH dependence of the precipitant tolerance (β, slope of the solubility against precipitant concentration) of extant Mbs and plotted the β values, as well as those of ancestral Mbs, against their surface net charges (ZMb). The results demonstrated that the precipitant tolerance was approximated by the square of ZMb, that is, β = aZMb2 + b, in which a and b are constants. This effect of ZMb against the precipitation is not predicted by a classical excluded volume theory that gives constant β for Mbs but can be explained by electrostatic repulsion between Mb molecules. The present study elucidates how Mb molecules have evolved to increase their in vivo solubility and shows the physiological significance of either neutral or basic isoelectric points (pI) of the natural Mbs, rather than acidic pI.
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Affiliation(s)
- Yasuhiro Isogai
- Department of Pharmaceutical Engineering, Toyama Prefectural University, Imizu, Toyama 939-0398, Japan
| | - Hiroshi Imamura
- Department of Applied Chemistry, College of Life Sciences, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Tomonari Sumi
- Research Institute for Interdisciplinary Science, Okayama University, 3-1-1 Tsushima-Naka, Kita-ku, Okayama 700-8530, Japan
| | - Tsuyoshi Shirai
- Department of Computer Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura-Cho, Nagahama, Shiga 526-0829, Japan
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Shirai T, Sato H, Fujii H, Ishii T. POS0841 HIGH-INTENSITY INDUCTION THERAPY COMBINING TOFACITINIB, RITUXIMAB, AND PLASMAPHERESIS IN RAPIDLY PROGRESSIVE INTERSTITIAL LUNG DISEASE ASSOCIATED WITH ANTI-MDA5 ANTIBODY POSITIVE DERMATOMYOSITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRapidly progressive interstitial lung disease (RP-ILD) associated with anti-melanoma differentiation-associated protein 5 (MDA5) autoantibody (Ab) -positive dermatomyositis (DM) is one of the most life-threatening autoimmune conditions. The clinical course is very rapid, leading to death within three months after the onset of symptoms. Although triple therapy which consists of corticosteroids, cyclophosphamide, and tacrolimus has been considered as standard therapy and additional treatments including plasma exchange (PE) and rituximab (RTX) have been reported, the survival rate of patients with poor prognostic factors is still poor even if all of these treatments were applied. Recently, there exist increasing evidences regarding the efficacy of tofacitinib (TOF) in refractory DM. We have treated anti-MDA5Ab-positive RP-ILD with multiple poor prognostic factors with high-intensity induction therapy which combined triple therapy, PE, RTX, and TOF.ObjectivesThis study aimed to investigate the therapeutic efficacy of high-intensity induction therapy for patients with anti-MDA5Ab-positive RP-ILD with multiple poor prognostic factors.Methods31 patients who were diagnosed with anti-MDA5Ab-positive DM during 2014 to 2021 in our institution were included in this study. The clinical characteristics for poor prognosis were retrospectively analyzed, and the outcomes of high-intensity induction therapy were analyzed for the survival and adverse events.Results17 cases were treated before the introduction of TOF. Although triple therapy with RTX, PE, or intravenous immunoglobulin (IVIG) were used, eight out of 10 RP-ILD cases with a ferritin level >400 ng/mL (range, 402.5-5,831; mean, 2,342 ± 2,069) died in median 2.5 months. Poor prognosis was predicted by followings; elevated levels of serum ferritin, lactate dehydrogenase, transaminases, creatinine phosphokinase, and C-reactive protein; decrease in platelets, serum albumin, and oxygen saturation; use of oxygen; higher age; shorter disease duration to admission. The addition of RTX and PE was not enough to control RP-ILD in anti-MDA5Ab positive DM, and prevention of the initial exacerbation of ILD following induction therapy was considered to be important. Based on these observations, high-intensity induction therapy was consisted as follows; triple therapy with decreasing the dose of methylprednisolone by half from 1g to 1 mg/kg, liposteroid to suppress macrophage activity, TOF, PE, and RTX. High-intensity induction therapy was applied in eight patients (ferritin levels; range, 412.2-7,095 ng/mL; mean, 3,558±3,152 ng/mL) with multiple poor prognostic factors described above. Although deaths at two months and eight months due to ILD were observed, significant improvement of survival was documented (Figure 1). Two patients in whom RTX was not initially administered, exacerbation of ILD was observed one month later, which prompted the use of RTX. Several adverse events were observed in high-intensity induction therapy. The most common events were reactivation of cytomegalovirus, meanwhile herpes zoster was not documented. Sustained leukocytopenia and thrombocytopenia were observed in three patients, and two patients developed thrombotic microangiopathy which led to the discontinuation of tacrolimus. Fungal infections in lung were also documented. These adverse events were controllable.Figure 1.ConclusionSignificant improvement of survival was observed in patients treated with high-intensity induction therapy. Meanwhile, stratification of patients for poor prognosis would be important.ReferencesNoneDisclosure of InterestsNone declared
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Mitsumura T, Okamoto T, Tosaka M, Yamana T, Shimada S, Iijima Y, Sakakibara R, Shibata S, Honda T, Shirai T, Ishizuka M, Aiboshi J, Furusawa H, Tateishi T, Tamaoka M, Shigemitsu H, Arai H, Otomo Y, Tohda S, Anzai T, Takahashi K, Yasuda S, Miyazaki Y. SARS-CoV-2 RNA copy number is a factor associated with the mortality of COVID-19 and improves the predictive performance of mortality in severe cases. Jpn J Infect Dis 2022; 75:504-510. [PMID: 35650037 DOI: 10.7883/yoken.jjid.2022.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Factors associated with mortality are important for the treatment of coronavirus disease 2019 (COVID-19). The polymerase chain reaction (PCR) test is the gold standard for diagnosing COVID-19 and reflects the viral load in the upper respiratory tract. This study enrolled 523 patients. Four hundred forty-one and 75 patients were performed PCR testing in nasopharyngeal swabs and sputum specimens, respectively, within 20 days from the onset. We investigated the association between RNA copy number and the severity and mortality of COVID-19, and its effect on the predictive performance for the severity and mortality. RNA copy numbers in nasopharyngeal swabs were higher in the non-survivor group than in the survivor group. Multivariate logistic regression analysis identified that the high RNA copy number (≥ 9 log10 /swab) in nasopharyngeal swabs was a factor associated with mortality (odds ratio, 4.50; 95% confidence interval, 1.510 - 13.100; p = 0.008). Furthermore, in severe cases, adding RNA copy number (≥ 9 log10 /swab), which was adjusted by duration from onset to PCR, improved mortality predictive performance based on known factors. The RNA copy number is a factor associated with the mortality of COVID-19 and can improve the predictive performance of mortality in severe cases.
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Affiliation(s)
- Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan.,Department of Pulmonary Immunotherapeutics, Tokyo Medical and Dental University, Japan
| | - Mizuho Tosaka
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takashi Yamana
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shimada
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Yuki Iijima
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Masahiro Ishizuka
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Junichi Aiboshi
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Meiyo Tamaoka
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Hidenobu Shigemitsu
- Department of Intensive Care Medicine, Tokyo Medical and Dental University, Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University, Japan
| | - Shuji Tohda
- Department of Laboratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tatsuhiko Anzai
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Japan
| | - Shinsuke Yasuda
- Department of Rheumatology, Tokyo Medical and Dental University, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
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Kiyohara M, Shirai T, Nishiyama S, Sato H, Fujii H, Ishii T, Harigae H. Hypertrophic Pachymeningitis Development in Eosinophilic Granulomatosis with Polyangiitis at Relapse of Disease: A Case-Based Review. TOHOKU J EXP MED 2022; 256:241-247. [PMID: 35321968 DOI: 10.1620/tjem.256.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hypertrophic pachymeningitis (HP) presents with thickening of the dura mater in the cerebrum and spine, and its symptoms vary depending on the affected location. The association of HP with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been recognized, and most cases are complicated by granulomatosis with polyangiitis. We report the case of a 47-year-old man who presented with HP upon relapse of eosinophilic granulomatosis with polyangiitis (EGPA), with literature review. He presented with disturbance of consciousness, and magnetic resonance imaging (MRI) revealed thickening of the dura mater around the left parietal lobe. Although myeloperoxidase (MPO)-ANCA was positive on EGPA diagnosis, the elevation of MPO-ANCA was not documented at the onset of HP. Brain perfusion scintigraphy showed an increase in blood flow in the left parietal lobe and temporal lobe, and electroencephalogram (EEG) revealed slow waves in the left parietal lobe. He was treated with a high dose of corticosteroid and rituximab, and the slow waves on EEG and brain perfusion were normalized. Although the most frequent symptom of HP is headache, disturbance of consciousness can be the manifestation of HP, and inflammation of HP could affect the cerebral parenchyma, which can be documented as abnormal EEG and perfusion scintigraphy. Literature review revealed that most of the HP in EGPA developed when EGPA relapsed, and was observed in patients with MPO-ANCA positivity. HP develops without evidence of other clinical features of EGPA; therefore, adequate imaging, including contrast-enhanced MRI, is necessary. Rituximab may be effective for treating HP complicated with EGPA.
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Affiliation(s)
- Machi Kiyohara
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
| | - Tsuyoshi Shirai
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
| | - Shuhei Nishiyama
- Department of Neurology, Tohoku University Graduate School of Medicine
| | - Hiroko Sato
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
| | - Hiroshi Fujii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
| | - Tomonori Ishii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
| | - Hideo Harigae
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine
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Sakashita H, Uchibori K, Jin Y, Tsutsui T, Honda T, Sakakibara R, Mitsumura T, Nukui Y, Shirai T, Masuo M, Suhara K, Furusawa H, Yamashita T, Ohba T, Saito K, Takagiwa J, Miyashita Y, Inase N, Miyazaki Y. A phase II feasibility study of carboplatin and nab-paclitaxel for advanced non-small cell lung cancer patients with interstitial lung disease (YLOG0114). Thorac Cancer 2022; 13:1267-1275. [PMID: 35322551 PMCID: PMC9058300 DOI: 10.1111/1759-7714.14376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/19/2022] [Accepted: 02/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background A standard treatment regimen for advanced non‐small cell lung cancer (NSCLC) patients with interstitial lung disease (ILD) has not been established since most clinical trials exclude such patients because of the high risk of acute exacerbation of ILD. This study aimed to prospectively investigate the efficacy and safety of carboplatin and nab‐paclitaxel as a first‐line regimen for NSCLC patients with ILD. Methods The enrolled patients had treatment‐naïve advanced NSCLC with ILD. The patients received 4–6 cycles of carboplatin (area under the curve = 5) on day 1 and nab‐paclitaxel 100 mg/m2 on days 1, 8, and 15 every 4 weeks. The primary endpoint was the completion rate of four or more cycles. Secondary endpoints included toxicity, overall response rate (ORR), disease control rate (DCR), progression‐free survival (PFS), and overall survival (OS). Results Twenty‐five patients were enrolled in this study. Nine patients had adenocarcinoma, 11 had squamous cell carcinoma, one had large cell carcinoma, and four had NSCLC, not otherwise specified. The completion rate of ≥4 cycles was 76% (95% confidence interval: 56.2%–88.8%), which met the primary endpoint. The ORR and DCR were 44% and 88%, respectively. The median PFS and OS were 5.8 months and 15.8 months, respectively. Three patients experienced grade ≥2 pneumonitis, and one patient met the acute exacerbation criteria. Conclusion The 4‐week modified regimen of carboplatin and nab‐paclitaxel showed tolerable toxicity with favorable efficacy in NSCLC patients with ILD. This regimen may be an effective treatment option for patients in real clinical settings.
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Affiliation(s)
- Hiroyuki Sakashita
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ken Uchibori
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuto Jin
- Department of Respiratory Medicine, Hiratsuka Kyosai Hospital, Kanagawa, Japan
| | - Toshiharu Tsutsui
- Department of Respiratory Medicine, Yamanashi Prefectural Central Hospital, Yamanashi, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihisa Nukui
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Masuo
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kozo Suhara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takaaki Yamashita
- Department of Respiratory Medicine, JA Toride General Medical Center, Ibaraki, Japan
| | - Takehiko Ohba
- Department of Pulmonology, Ome Municipal General Hospital, Tokyo, Japan
| | - Kazuhito Saito
- Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Jun Takagiwa
- Department of Pulmonology, Tokyo Kyosai Hospital, Tokyo, Japan
| | - Yoshihiro Miyashita
- Department of Respiratory Medicine, Yamanashi Prefectural Central Hospital, Yamanashi, Japan
| | - Naohiko Inase
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Mori S, Nomura K, Fujikawa K, Osawa T, Shionyu M, Yoda T, Shirai T, Tsuda S, Yoshizawa-Kumagaye K, Masuda S, Nishio H, Yoshiya T, Suzuki S, Muramoto M, Nishiyama KI, Shimamoto K. Intermolecular Interactions between a Membrane Protein and a Glycolipid Essential for Membrane Protein Integration. ACS Chem Biol 2022; 17:609-618. [PMID: 35239308 DOI: 10.1021/acschembio.1c00882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Inducing newly synthesized proteins to appropriate locations is an indispensable biological function in every organism. Integration of proteins into biomembranes in Escherichia coli is mediated by proteinaceous factors, such as Sec translocons and an insertase YidC. Additionally, a glycolipid named MPIase (membrane protein integrase), composed of a long sugar chain and pyrophospholipid, was proven essential for membrane protein integration. We reported that a synthesized minimal unit of MPIase possessing only one trisaccharide, mini-MPIase-3, involves an essential structure for the integration activity. Here, to elucidate integration mechanisms using MPIase, we analyzed intermolecular interactions of MPIase or its synthetic analogs with a model substrate, the Pf3 coat protein, using physicochemical methods. Surface plasmon resonance (SPR) analyses revealed the importance of a pyrophosphate for affinity to the Pf3 coat protein. Compared with mini-MPIase-3, natural MPIase showed faster association and dissociation due to its long sugar chain despite the slight difference in affinity. To focus on more detailed MPIase substructures, we performed docking simulations and saturation transfer difference-nuclear magnetic resonance. These experiments yielded that the 6-O-acetyl group on glucosamine and the phosphate of MPIase play important roles leading to interactions with the Pf3 coat protein. The high affinity of MPIase to the hydrophobic region and the basic amino acid residues of the protein was suggested by docking simulations and proven experimentally by SPR using protein mutants devoid of target regions. These results demonstrated the direct interactions of MPIase with a substrate protein and revealed detailed mechanisms of membrane protein integration.
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Affiliation(s)
- Shoko Mori
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
- Department of Chemistry, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - Kaoru Nomura
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Kohki Fujikawa
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Tsukiho Osawa
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Masafumi Shionyu
- Department of Frontier Bioscience, Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura-cho, Nagahama, Shiga 526-0829, Japan
| | - Takao Yoda
- Department of Frontier Bioscience, Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura-cho, Nagahama, Shiga 526-0829, Japan
| | - Tsuyoshi Shirai
- Department of Frontier Bioscience, Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura-cho, Nagahama, Shiga 526-0829, Japan
| | - Shugo Tsuda
- Peptide Institute, Inc., 7-2-9 Saito-Asagi, Ibaraki, Osaka 567-0085, Japan
| | - Kumiko Yoshizawa-Kumagaye
- Department of Chemistry, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
- Peptide Institute, Inc., 7-2-9 Saito-Asagi, Ibaraki, Osaka 567-0085, Japan
| | - Shun Masuda
- Peptide Institute, Inc., 7-2-9 Saito-Asagi, Ibaraki, Osaka 567-0085, Japan
| | - Hideki Nishio
- Department of Chemistry, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
- Peptide Institute, Inc., 7-2-9 Saito-Asagi, Ibaraki, Osaka 567-0085, Japan
| | - Taku Yoshiya
- Peptide Institute, Inc., 7-2-9 Saito-Asagi, Ibaraki, Osaka 567-0085, Japan
| | - Sonomi Suzuki
- Department of Biological Chemistry and Food Sciences, Faculty of Agriculture, Iwate University, 3-18-8 Ueda, Morioka, Iwate 020-8550, Japan
| | - Maki Muramoto
- Department of Biological Chemistry and Food Sciences, Faculty of Agriculture, Iwate University, 3-18-8 Ueda, Morioka, Iwate 020-8550, Japan
| | - Ken-ichi Nishiyama
- Department of Biological Chemistry and Food Sciences, Faculty of Agriculture, Iwate University, 3-18-8 Ueda, Morioka, Iwate 020-8550, Japan
| | - Keiko Shimamoto
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
- Department of Chemistry, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
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Shirai T, Suzuki J, Kuniyoshi S, Tanno Y, Fujii H. Granulomatosis with polyangiitis following Pfizer-BioNTech COVID-19 vaccination. Mod Rheumatol Case Rep 2022; 7:127-129. [PMID: 35246689 PMCID: PMC8903471 DOI: 10.1093/mrcr/rxac016] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/22/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
We report the first case of proteinase 3-antineutrophil cytoplasmic antibody-positive granulomatosis with polyangiitis (GPA) with predominant ears, nose, and throat manifestations following coronavirus disease 2019 (COVID-19) vaccination. A 63-year-old woman presented with aural fullness 3 days after vaccination. She presented with progressive rhinosinusitis and otitis media leading to profound hearing loss within 3 weeks. Clinical imaging revealed soft-tissue shadows in the paranasal sinuses with multiple pulmonary nodules, and histopathology was consistent with a diagnosis of GPA. It is crucial to be wary of the possibility of GPA in patients who received COVID-19 vaccines due to its rapid disease progression.
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Affiliation(s)
- Tsuyoshi Shirai
- Corresponding author: Tsuyoshi Shirai, Department of Rheumatology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. Tel: 81-22-717-7165, Fax: 81-22-717-7497, E-mail:
| | - Jun Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Shimpei Kuniyoshi
- Department of Pathology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Yuito Tanno
- Department of Rheumatology, Tohoku University Hospital, Miyagi, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, Miyagi, Japan
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Murakami T, Iijima Y, Ando T, Ejima M, Shirai T, Furusawa H, Okamoto T, Tateishi T, Tamaoka M, Miyazaki Y. Successful diagnosis of humidifier lung by individual provocation test to a responsible environment, a case report. Respir Med Case Rep 2022; 37:101639. [PMID: 35360360 PMCID: PMC8960957 DOI: 10.1016/j.rmcr.2022.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/01/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
A 52-year-old woman presented with repeating episodes of pneumonia which spontaneously resolved after hospitalization. Hypersensitivity pneumonitis was suspected, but the causative antigen was not determined whether the parakeets she kept or the humidifier she owned was causative exposure. To identify which exposure is culprit, individual provocation test to a responsible environment was sequentially conducted. First, a home-returning provocation test to the parakeet was negative. Contrarily, the humidifier provocation test to her own humidifier was positive for symptoms, radiological changes, and inflammatory responses in blood test. Finally, she was diagnosed as having humidifier lung. When several antigens are suspected to be the causative agents for hypersensitivity pneumonitis, a step-by-step provocation tests is useful.
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Ishii K, Shirai T, Kakuta Y, Machiyama T, Sato H, Ishii T, Harigae H, Fujii H. Development of severe colitis in Takayasu arteritis treated with tocilizumab. Clin Rheumatol 2022; 41:1911-1918. [PMID: 35188603 DOI: 10.1007/s10067-022-06108-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 12/18/2022]
Abstract
Relapse of Takayasu arteritis (TAK) is frequent, and the use of biologics is required in refractory cases. Tocilizumab (TCZ), a biological agent used in TAK, is known to increase the incidence of diverticulitis in patients with rheumatoid arthritis. Adverse events of TCZ in TAK have been poorly recognised. This study aimed to investigate the occurrence of severe colitis among patients with TAK receiving TCZ. We enrolled 116 patients with TAK who met the criteria of the American College of Rheumatology and visited our department between 2018 and 2020. The occurrence of severe colitis and its clinical characteristics were retrospectively evaluated. TCZ was introduced in 34 of 116 patients (29.3%). Severe colitis that required hospitalisation was observed in three of the 34 patients receiving TCZ (8.8%). All patients were female and had Numano type V artery lesions, and the ascending colon was commonly affected. Wide lesions that reached the sigmoid colon, colonic perforation, bacteraemia, or positive stool cultures were observed in some patients. All patients received antibiotics and intestinal rest, and TCZ was resumed in one patient. IL-6 plays a physiological role in the intestine, including recovery from ischaemic damage. In addition to infectious aetiology, blocking the physiological roles of IL-6 by TCZ is considered important for the development of colitis in TAK. Severe colitis is an important adverse event in patients with TAK who receive TCZ. The risk of bloodstream infection associated with colitis should be recognised, especially in patients who have undergone vascular surgery. Key Points • Severe colitis was observed in 8.8% of patients with TAK receiving tocilizumab • Patients had type V artery lesions and ascending colon involvement and were under long-term use of corticosteroids • Inhibition of the physiological roles of IL-6 in the intestinal tract might also be involved.
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Affiliation(s)
- Kae Ishii
- Department of Haematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tsuyoshi Shirai
- Department of Haematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Yoichi Kakuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoaki Machiyama
- Department of Haematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroko Sato
- Department of Haematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomonori Ishii
- Department of Haematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hideo Harigae
- Department of Haematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroshi Fujii
- Department of Haematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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Mutoh T, Nagai T, Shirai T, Okazaki S, Sato H, Fujii H. Predictive factors for retention of golimumab over a median 4-year duration in Japanese patients with rheumatoid arthritis in a real-world setting: A retrospective study and literature review. Int J Rheum Dis 2022; 25:335-343. [PMID: 34989482 DOI: 10.1111/1756-185x.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/14/2021] [Accepted: 12/23/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate 6-year drug survival (median: 48.5 months) of golimumab and predictors for lack of efficacy leading to golimumab discontinuation in Japanese patients with rheumatoid arthritis (RA) in routine practice. METHODS This retrospective single-center study included 60 patients with RA treated with golimumab from November 2011 to August 2020. Patients were divided into 2 groups (retention, n = 28; withdrawal due to lack of efficacy, n = 24). The retention rate was assessed using the Kaplan-Meier method, and variables associated with golimumab discontinuation were identified using the Cox proportional hazard model. RESULTS The prevalence of concomitant methotrexate and no biologics use was significantly higher in the retention than in the withdrawal group. Overall drug survival of golimumab was 66.3%, 48.3%, and 24.5% at 12, 36, and 72 months, respectively. There were statistical differences in retention rates among groups stratified by initiation dose, methotrexate, and biologics use. Multivariate analysis revealed the factor associated with golimumab discontinuation as history of 1 (hazards ratio: 4.42, 95% CI: 1.35-19.93, P = .012) and ≥2 biologics use (7.49, 1.97-36.27, P = .003). CONCLUSIONS Prior exposure of increasing number of biologics was identified as the most important factor negatively affecting long-term golimumab retention in Japanese patients with RA.
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Affiliation(s)
- Tomoyuki Mutoh
- Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan
| | - Taichi Nagai
- Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan
| | - Tsuyoshi Shirai
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Soshi Okazaki
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroko Sato
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Fujii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Gau M, Suga R, Hijikata A, Kashimada A, Takagi M, Nakagawa R, Takasawa K, Shirai T, Kashimada K, Morio T. A novel variant of NR5A1, p.R350W implicates potential interactions with unknown co-factors or ligands. Front Endocrinol (Lausanne) 2022; 13:1033074. [PMID: 36743925 PMCID: PMC9895113 DOI: 10.3389/fendo.2022.1033074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/29/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION NR5A1 and NR5A2 belong to an orphan nuclear receptor group, and approximately 60% of their amino acid sequences are conserved. Transcriptional regulation of NR5A receptors depends on interactions with co-factors or unidentified ligands. PURPOSE AND METHODS We employed in vitro and in silico analysis for elucidating the pathophysiology of a novel variant in the ligand-binding domain of NR5A1, p.R350W which was identified from a 46,XY patient with atypical genitalia. RESULTS In the study, [1] reporter assays demonstrated that R350 is essential for NR5A1; [2] 3D model analysis predicted that R350 interacted with endogenous ligands or unknown cofactors rather than stabilizing the structure; [3] R350 is not conserved in NR5A2 but is specifically required for NR5A1; and [4] none of the 22 known missense variants of the ligand binding domain satisfied all the previous conditions [1]-[3], suggesting the unique role of R350 in NR5A1. CONCLUSION Our data suggest that NR5A1 has unidentified endogenous ligands or co-activators that selectively potentiate the transcriptional function of NR5A1 in vivo.
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Affiliation(s)
- Maki Gau
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryota Suga
- School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Hijikata
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Ayako Kashimada
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryuichi Nakagawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kei Takasawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Shirai
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Kenichi Kashimada
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
- *Correspondence: Kenichi Kashimada,
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
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46
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Oba S, Hosoya T, Amamiya M, Mitsumura T, Kawata D, Sasaki H, Kamiya M, Yamamoto A, Ando T, Shimada S, Shirai T, Okamoto T, Tateishi T, Endo A, Aiboshi J, Nosaka N, Yamanouchi H, Ugawa T, Nagaoka E, Oi K, Tao S, Maejima Y, Tanaka Y, Tanimoto K, Takeuchi H, Tohda S, Hirakawa A, Sasano T, Arai H, Otomo Y, Miyazaki Y, Yasuda S. Arterial and Venous Thrombosis Complicated in COVID-19: A Retrospective Single Center Analysis in Japan. Front Cardiovasc Med 2021; 8:767074. [PMID: 34869681 PMCID: PMC8639692 DOI: 10.3389/fcvm.2021.767074] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 08/30/2021] [Accepted: 10/18/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Thrombosis is a characteristic complication in coronavirus disease 2019 (COVID-19). Since coagulopathy has been observed over the entire clinical course, thrombosis might be a clue to understanding the specific pathology in COVID-19. Currently, there is limited epidemiological data of COVID-19-associated thrombosis in the Japanese population and none regarding variant strains of SARS-CoV-2. Here, we elucidate the risk factors and the pattern of thrombosis in COVID-19 patients. Methods: The patients consecutively admitted to Tokyo Medical and Dental University Hospital with COVID-19 were retrospectively analyzed. SARS-CoV-2 variants of concern/interest (VOC/VOI) carrying the spike protein mutants E484K, N501Y, or L452R were identified by PCR-based analysis. All thrombotic events were diagnosed by clinical symptoms, ultrasonography, and/or radiological tests. Results: Among the 516 patients, 32 patients experienced 42 thromboembolic events. Advanced age, severe respiratory conditions, and several abnormal laboratory markers were associated with the development of thrombosis. While thrombotic events occurred in 13% of the patients with a severe respiratory condition, those events still occurred in 2.5% of the patients who did not require oxygen therapy. Elevated D-dimer and ferritin levels on admission were independent risk factors of thrombosis (adjusted odds ratio 9.39 and 3.11, 95% confidence interval 2.08-42.3, and 1.06-9.17, respectively). Of the thrombotic events, 22 were venous, whereas 20 were arterial. While patients with thrombosis received anticoagulation and antiinflammatory therapies with a higher proportion, the mortality rate, organ dysfunctions, and bleeding complications in these patients were higher than those without thrombosis. The incidence of thrombosis in COVID-19 became less frequent over time, such as during the replacement of the earlier strains of SARS-CoV-2 by VOC/VOI and during increased use of anticoagulatory therapeutics. Conclusion: This study elucidated that elevated D-dimer and ferritin levels are useful biomarkers of thrombosis in COVID-19 patients. The comparable incidence of arterial thrombosis with venous thrombosis and the development of thrombosis in less severe patients required further considerations for the management of Japanese patients with COVID-19. Further studies would be required to identify high-risk populations and establish appropriate interventions for thrombotic complications in COVID-19.
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Affiliation(s)
- Seiya Oba
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tadashi Hosoya
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Miki Amamiya
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Daisuke Kawata
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hirokazu Sasaki
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Mari Kamiya
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Akio Yamamoto
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takahiro Ando
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sho Shimada
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Akira Endo
- Trauma and Acute Critical Care Medical Center, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Junichi Aiboshi
- Trauma and Acute Critical Care Medical Center, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Nobuyuki Nosaka
- Department of Intensive Care Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hideo Yamanouchi
- Department of Intensive Care Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Toyomu Ugawa
- Department of Intensive Care Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Eiki Nagaoka
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Keiji Oi
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Susumu Tao
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yukie Tanaka
- Research Core, Institute of Research, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kousuke Tanimoto
- Research Core, Institute of Research, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Genome Laboratory, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroaki Takeuchi
- Department of Molecular Virology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shuji Tohda
- Clinical Laboratory, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Akihiro Hirakawa
- Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Medical Center, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shinsuke Yasuda
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Nakae S, Kitamura M, Fujiwara D, Sawa M, Shirai T, Fujii I, Tada T. Structure of mitogen-activated protein kinase kinase 1 in the DFG-out conformation. Acta Crystallogr F Struct Biol Commun 2021; 77:459-464. [PMID: 34866601 DOI: 10.1107/s2053230x21011687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/04/2021] [Indexed: 01/04/2023] Open
Abstract
Eukaryotic protein kinases contain an Asp-Phe-Gly (DFG) motif, the conformation of which is involved in controlling the catalytic activity, at the N-terminus of the activation segment. The motif can be switched between active-state (DFG-in) and inactive-state (DFG-out) conformations: however, the mechanism of conformational change is poorly understood, partly because there are few reports of the DFG-out conformation. Here, a novel crystal structure of nonphosphorylated human mitogen-activated protein kinase kinase 1 (MEK1; amino acids 38-381) complexed with ATP-γS is reported in which MEK1 adopts the DFG-out conformation. The crystal structure revealed that the structural elements (the αC helix and HRD motif) surrounding the active site are involved in the formation/stabilization of the DFG-out conformation. The ATP-γS molecule was bound to the canonical ATP-binding site in a different binding mode that has never been found in previously determined crystal structures of MEK1. This novel ATP-γS binding mode provides a starting point for the design of high-affinity inhibitors of nonphosphorylated inactive MEK1 that adopts the DFG-out conformation.
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Affiliation(s)
- Setsu Nakae
- Graduate School of Science, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan
| | - Maho Kitamura
- Graduate School of Science, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan
| | - Daisuke Fujiwara
- Graduate School of Science, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan
| | - Masaaki Sawa
- Carna Biosciences Inc., BMA 3F 1-5-5 Minatojima-Minamimachi, Chuo-ku, Kobe 650-0047, Japan
| | - Tsuyoshi Shirai
- Department of Bioscience, Nagahama Institute of Bio-Science and Technology, 1266 Tamura, Nagahama 526-0829, Japan
| | - Ikuo Fujii
- Graduate School of Science, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan
| | - Toshiji Tada
- Graduate School of Science, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan
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48
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Hijikata A, Shionyu-Mitsuyama C, Nakae S, Shionyu M, Ota M, Kanaya S, Hirokawa T, Nakajima S, Watashi K, Shirai T. Evaluating cepharanthine analogues as natural drugs against SARS-CoV-2. FEBS Open Bio 2021; 12:285-294. [PMID: 34850606 PMCID: PMC8727928 DOI: 10.1002/2211-5463.13337] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 10/04/2021] [Revised: 11/01/2021] [Accepted: 11/27/2021] [Indexed: 12/12/2022] Open
Abstract
Cepharanthine (CEP) is a natural biscoclaurine alkaloid of plant origin and was recently demonstrated to have anti‐severe acute respiratory syndrome coronavirus 2 (anti‐SARS‐CoV‐2) activity. In this study, we evaluated whether natural analogues of CEP may act as potential anti‐coronavirus disease 2019 drugs. A total of 24 compounds resembling CEP were extracted from the KNApSAcK database, and their binding affinities to target proteins, including the spike protein and main protease of SARS‐CoV‐2, NPC1 and TPC2 in humans, were predicted via molecular docking simulations. Selected analogues were further evaluated by a cell‐based SARS‐CoV‐2 infection assay. In addition, the efficacies of CEP and its analogue tetrandrine were assessed. A comparison of the docking conformations of these compounds suggested that the diphenyl ester moiety of the molecules was a putative pharmacophore of the CEP analogues.
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Affiliation(s)
- Atsushi Hijikata
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Japan
| | | | - Setsu Nakae
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Japan
| | - Masafumi Shionyu
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Japan
| | - Motonori Ota
- Department of Complex Systems Science, Graduate School of Informatics, Nagoya University, Japan
| | - Shigehiko Kanaya
- Computational Biology Laboratory Division of Information Science, Graduate School of Science and Technology, Nara Institute of Science and Technology (NAIST), Ikoma, Japan
| | - Takatsugu Hirokawa
- Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Japan.,Transborder Medical Research Center, University of Tsukuba, Japan.,Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Shogo Nakajima
- Department of Virology II, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Koichi Watashi
- Department of Virology II, National Institute of Infectious Diseases, Shinjuku-ku, Japan.,Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Shinjuku-ku, Japan.,Department of Applied Biological Sciences, Tokyo University of Science, Noda, Japan
| | - Tsuyoshi Shirai
- Faculty of Bioscience, Nagahama Institute of Bio-Science and Technology, Japan
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49
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Sugihara T, Nakaoka Y, Uchida HA, Yoshifuji H, Maejima Y, Watanabe Y, Amiya E, Tanemoto K, Miyata T, Umezawa N, Manabe Y, Ishizaki J, Shirai T, Nagafuchi H, Hasegawa H, Miyamae T, Niiro H, Ito S, Ishii T, Isobe M, Harigai M. Establishing Clinical Remission Criteria and the Framework of a Treat-To-Target Algorithm for Takayasu arteritis: Results of a Delphi Exercise Carried out by an Expert Panel of the Japan Research Committee of the Ministry of Health, Labour, and Welfare for intractable vasculitis. Mod Rheumatol 2021; 32:930-937. [PMID: 34850081 DOI: 10.1093/mr/roab081] [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] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/04/2021] [Accepted: 09/11/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To develop a proposal for remission criteria and a framework for a treat-to-target (T2T) algorithm for Takayasu arteritis (TAK). METHODS A study group of the large-vessel vasculitis group of the Japanese Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS) consists of 10 rheumatologists, 5 cardiologists, 1 nephrologist, 1 vascular surgeon, 1 cardiac surgeon, and 2 pediatric rheumatologists. A Delphi survey of remission criteria items was circulated among the study group over 4 reiterations. To develop the T2T algorithm, the study group conducted four face-to-face meetings and two rounds of Delphi together with 3 patients. RESULTS Initial literature review resulted in a list of 117 candidate items for remission criteria, of which 56 items with a mean score of ≥4 (0-5) were extracted including disease activity domains and treatment/comorbidity domains. The study group provided six overarching principles for the T2T algorithm, two recommendations on treatment goals, five on evaluation of disease activity and imaging findings including PET-CT, and two on treatment intensification. CONCLUSIONS We developed a T2T algorithm and proposals for standardized remission criteria by means of a Delphi exercise. These will guide future evaluation of different TAK treatment regimens.
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Affiliation(s)
- Takahiko Sugihara
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yoshikazu Nakaoka
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan.,Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Haruhito A Uchida
- Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiko Watanabe
- First Department of Physiology, Kawasaki Medical School, Kurashiki, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, Tokyo, Japan.,Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Tokyo, Japan
| | - Kazuo Tanemoto
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Tetsuro Miyata
- Department of Medical Education, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Natsuka Umezawa
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Manabe
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan.,Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jun Ishizaki
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tsuyoshi Shirai
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroko Nagafuchi
- Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hitoshi Hasegawa
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Takako Miyamae
- Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Hiroaki Niiro
- Department of Medical Education, Kyushu University, Fukuoka, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan
| | - Tomonori Ishii
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | | | - Masayoshi Harigai
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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Shirai T, Kakuta Y, Fujii H. Distinct Autoantibodies Against Endothelial Protein C Receptor in Ulcerative Colitis. Gastroenterology 2021; 161:1724-1725. [PMID: 33773994 DOI: 10.1053/j.gastro.2021.03.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Yoichi Kakuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Japan
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