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Katoh N, Nakazato K, Uchinami Y, Kanehira T, Takahashi S, Koizumi F, Taguchi H, Nishioka K, Yasuda K, Tamura M, Takao S, Miyamoto N, Matsuura T, Kobashi K, Aoyama H. Evaluation of the Possibility of Dose Realignment Adaptation by Shifting the Isocenter in Proton Beam Therapy for Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e307. [PMID: 37785114 DOI: 10.1016/j.ijrobp.2023.06.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In pancreatic cancer, a tumor is surrounded by the gastrointestinal (GI) tract, which is subject to changes in location, shape, and contents. Due to these inter-fractional changes, proton beam therapy (PBT) for pancreatic cancer may result in unintentionally high doses to the GI tract. Daily adaptive re-planning can solve this problem, but is not yet established with PBT due to its resource intensive characteristics. This study aims to evaluate the GI tract dose using weekly computed tomography (CTw) and the possibility of dose realignment adaptation by shifting the isocenter (IC) of the PBT plan, which does not require re-planning. MATERIALS/METHODS We retrospectively analyzed 6 consecutive patients with unresectable pancreatic cancer treated with real-time-image gated PBT using a fiducial marker. The planning CT was scanned at the natural expiration of respiration and a PBT plan of 60 GyE in 25 fractions (baseline plan, PLANbase) was created. The CTw images were acquired the day before start of PBT and once a week during the PBT course thereafter. The PLANbase was rigidly transferred to the CTw based on the relationship between the three-dimensional coordinates of the fiducial marker and those of the IC in the PLANbase. The PLANeval was created by recalculating the PLANbase on the CTw. We evaluated the doses to the stomach, duodenum, and intestines in the PLANeval according to the following criteria: Dmax of the stomach < 60 GyE, duodenum and intestines < 55 GyE, and D1cc of the stomach < 55 GyE, duodenum and intestines < 54 GyE. In addition, we investigated the GI tract dose realignment adaptation for the PLANeval with its IC shifted 2mm, 4mm, and 6mm in each of 6 directions (right, left, ventral, dorsal, cranial, and caudal), respectively. RESULTS A total of 35 PLANeval were created for the CTw. In the PLANbase of the 6 patients, the average of Dmax and D1cc of the stomach, duodenum and intestines were 50.7 GyE (range, 46.7-53.6) and 50.0 GyE (45.0-53.2), 49.2 GyE (44.3-51.7) and 48.8 GyE (43.7-51.5), and 49.2 GyE (44.8-52.0) and 48.9 GyE (44.6-51.8), respectively. In the PLANeval, the average of Dmax and D1cc of the stomach, duodenum, and intestines were 53.3GyE (43.8-61.4) and 52.8 GyE (43.2-61.1), 51.0 GyE (36.1-60.0) and 50.3 GyE (35.4-59.8), and 52.5 GyE (36.6-61.0) and 51.9 (34.4-60.9) GyE, respectively. Twenty-two of the 35 PLANeval (63 %) did not meet at least one of the GI tract dose criteria. In 11 of 22 PLANeval with higher doses to the GI tract, the IC shift resulted in GI dose reductions and all dose criteria were met. The minimum amount of the IC shift required to meet the criteria was 2 mm for 8 plans and 4 mm for 3 plans. The remaining 11 PLANeval did not meet the criteria using dose realignment adaptation by shifting the isocenter. CONCLUSION Adaptive replanning is necessary for PBT for pancreatic cancers due to excessive GI tract doses in more than 60% of the plans. Dose realignment adaptation by shifting the IC, which does not require re-planning, may be an option in adaptive treatment strategies.
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Koizumi F, Katoh N, Kanehira T, Kawamoto Y, Nakamura T, Kakisaka T, Uchinami Y, Taguchi H, Fujita Y, Takahashi S, Higaki H, Nishioka K, Yasuda K, Kinoshita R, Suzuki R, Miyamoto N, Yokota I, Kobashi K, Aoyama H. A Risk Prediction Model for Severe Radiation Induced Lymphopenia in Patients with Pancreatic Cancer Treated with Concurrent Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e309. [PMID: 37785118 DOI: 10.1016/j.ijrobp.2023.06.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In pancreatic cancer, radiation induced lymphopenia (RIL) is associated with a poor prognosis. However, normal tissue complication probability (NTCP) models predicting RIL in pancreatic cancer treated with concurrent chemoradiotherapy (CCRT) have yet to be developed. This study aims to develop a least absolute shrinkage and selection operator (LASSO)-based multivariate NTCP model to predict severe RIL in patients with pancreatic cancer during CCRT and to validate the model internally. MATERIALS/METHODS We retrospectively reviewed patients with localized pancreatic cancer who underwent CCRT using three-dimensional conformal radiation therapy from 2013 to 2021. The exclusion criteria were patients with distant metastasis; patients who did not complete RT due to tumor progression; patients who did not have absolute lymphocyte count (ALC) data available before or during RT. An ALC of < 0.5 K/μL during CCRT was defined as severe RIL. A NTCP model of severe RIL was developed by LASSO-based multivariate analysis. We used age, sex, Karnofsky performance status, maximum tumor size, carbohydrate antigen 19-9 level before RT, ALC before RT, volume of planning target volume (PTV), and dosimetric parameters for surrounding organs (including spleen, vertebrae, liver, bilateral kidneys, gastrointestinal tracts) as variables for LASSO. In addition, internal validation was performed by the bootstrap method. The predictive performance of the model was evaluated by the area under the curve (AUC) of the receiver operating characteristic curve and scaled Brier score. RESULTS Of the 131 patients included in the study, the median age was 68 years (range, 42-84), and 55% were male. The median ALC before RT was 1.37 K/µL (0.52-3.50). The median PTV volume was 315.4 ml (86.3-1079.3). The median dose of radiotherapy was 50.4 Gy (16.2-50.4), with 1.8 Gy per fraction. Combination chemotherapy was S-1 in 99 cases (75.6%) and gemcitabine in 32 cases (24.4%). Induction chemotherapy before CCRT was performed in 39 patients (29.8%). Severe RIL was observed in 84 (63.6%) patients. The LASSO showed that low baseline ALC (p = 0.0002), large PTV volume (p < 0.0001), and a large kidney V5 defined as the percentage of bilateral kidneys receiving 5 Gy or more (p = 0.0338) were selected as parameters of the prediction model for severe RIL (AUC = 0.917) and scaled Brier score was 0.511. As a result of internal validation by the bootstrap method, the average AUC was 0.918 (95% confidence interval, 0.849-0.954). CONCLUSION Severe RIL occurred frequently during CCRT for pancreatic cancer, and a NTCP model for severe RIL developed and validated internally in this study showed good predictive performance. External validation is needed before this NTCP model can be used as a benchmark for treatment planning to reduce the risk of severe RIL and for considering future treatment approaches.
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Otsuka M, Yasuda K, Minatogawa H, Fujita Y, Uchinami Y, Koizumi F, Suzuki R, Miyamoto N, Suzuki T, Tsushima N, Kano S, Taguchi J, Shimizu Y, Homma A, Shimizu S, Aoyama H. A Dosimetric Analysis of Locoregional Failure Using Deformable Image Registration in Hypopharyngeal Cancer After Sequential-Boost Intensity-Modulated Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shimizu S, Yoshimura T, Katoh N, Inoue T, Hashimoto T, Nishioka K, Takao S, Matsuura T, Miyamoto N, Ito Y, Umegaki K, Shirato H. Analysis of Beam Delivery Times and Dose Rates for the Treatment of Mobile Tumors Using Real Time Image Gated Spot-Scanning Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Miyamoto N, Miyamoto-Mikami E, Hirata K, Kimura N, Fuku N. Association analysis of theACTN3R577X polymorphism with passive muscle stiffness and muscle strain injury. Scand J Med Sci Sports 2017; 28:1209-1214. [DOI: 10.1111/sms.12994] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 12/25/2022]
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Yamashiro K, Tanaka R, Ueno Y, Miyamoto N, Urabe T, Takahashi T, Tsuji H, Asahara T, Nomoto K, Yamashiro Y, Hattori N. Bacterial translocation and fecal organic acids in stroke patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kamo H, Miyamoto N, Tanaka R, Ueno Y, Watanabe M, Kurita N, Hira K, Shimada Y, Kuroki T, Yamashiro K, Urabe T, Hattori N. Analysis for usefulness of worsen score; The predicting score for the deterioration of acute ischemic stroke. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maki T, Choi Y, Miyamoto N, Shindo A, Kaji S, Takahashi R, Lo E, Arai K. A-kinase anchor protein 12 is indispensable for oligodendrocyte maturation in white matter. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sakurai M, Ueno Y, Tanaka R, Yamashiro K, Miyamoto N, Hira K, Kurita N, Urabe T, Hattori N. Age stratification and impact of eicosapentaenoic and docosahexaenoic to arachidonic acid ratios in ischemic stroke patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shojima Y, Ueno Y, Tanaka R, Yamashiro K, Miyamoto N, Hira K, Kurita N, Nakashima S, Urabe T, Hattori N. Predictors of mortality and the risk of recurrent vascular events in ischemic stroke patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ito M, Campbell R, Kan A, Miyamoto N, Tsuboyama S, Kurokawa Y. THE POSSIBILITY OF COUPLES LIFE STORY PROJECT REDUCING CAREGIVERS BURDEN. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shimizu S, Katoh N, Hashimoto T, Nishioka K, Yoshimura T, Takao S, Matsuura T, Miyamoto N, Umegaki K, Shirato H. Analysis of Durations and Dose Rates for Treatment of Moving Liver Tumors Using Real-Time Image Gated Spot Scanning Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kanehira T, Matsuura T, Takao S, Matsuzaki Y, Fujii Y, Fujii T, Miyamoto N, Inoue T, Katoh N, Shimizu S, Umegaki K, Shirato H. TH-CD-209-11: Simulation Study of Real-Time-Image Gating On Spot Scanning Proton Therapy for Lung Tumors. Med Phys 2016. [DOI: 10.1118/1.4958205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fujii T, Matsuura T, Takao S, Miyamoto N, Matsuzaki Y, Fujii Y, Umegaki K, Shimizu S, Shirato H. SU-F-I-11: Software Development for 4D-CBCT Research of Real-Time-Image Gated Spot Scanning Proton Therapy. Med Phys 2016. [DOI: 10.1118/1.4955839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kawasaki R, Sugimoto K, Miyamoto N, Kinoshita M, Horinouchi H, Sasaki K. Percutaneous transfer of an acute popliteal artery embolism to a deep femoral artery using balloon embolectomy technique: initial results. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kuwata Y, Kasuya T, Miyamoto N, Wada M. Development of a long-slot microwave plasma source. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2016; 87:02C104. [PMID: 26932114 DOI: 10.1063/1.4932989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 20 cm long 10 cm wide microwave plasma source was realized by inserting two 20 cm long 1.5 mm diameter rod antennas into the plasma. Plasma luminous distributions around the antennas were changed by magnetic field arrangement created by permanent magnets attached to the source. The distributions appeared homogeneous in one direction along the antenna when the spacing between the antenna and the source wall was 7.5 mm for the input microwave frequency of 2.45 GHz. Plasma density and temperature at a plane 20 cm downstream from the microwave shield were measured by a Langmuir probe array at 150 W microwave power input. The measured electron density and temperature varied over space from 3.0 × 10(9) cm(-3) to 5.8 × 10(9) cm(-3), and from 1.1 eV to 2.1 eV, respectively.
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Miyamoto N, Okajima Y, Romero CF, Kuwata Y, Kasuya T, Wada M. Dust particle diffusion in ion beam transport region. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2016; 87:02C106. [PMID: 26932116 DOI: 10.1063/1.4934813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Dust particles of μm size produced by a monoplasmatron ion source are observed by a laser light scattering. The scattered light signal from an incident laser at 532 nm wavelength indicates when and where a particle passes through the ion beam transport region. As the result, dusts with the size more than 10 μm are found to be distributed in the center of the ion beam, while dusts with the size less than 10 μm size are distributed along the edge of the ion beam. Floating potential and electron temperature at beam transport region are measured by an electrostatic probe. This observation can be explained by a charge up model of the dust in the plasma boundary region.
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Guégan R, Sueyoshi K, Anraku S, Yamamoto S, Miyamoto N. Sandwich organization of non-ionic surfactant liquid crystalline phases as induced by large inorganic K4Nb6O17 nanosheets. Chem Commun (Camb) 2016; 52:1594-7. [PMID: 26660331 DOI: 10.1039/c5cc08948d] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
While retaining its lamellar liquid crystal phase, K4Nb6O17 nanosheets were used as a template to sandwich and stabilize an alkylpoly(ethylene oxide) nonionic surfactant-water system showing monodomain (lamella) formation within the inorganic niobate sheets that appears to be not dependent on the surfactant liquid crystalline state in solution but more its concentration.
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Miyamoto N, Hirata K, Kanehisa H. Effects of hamstring stretching on passive muscle stiffness vary between hip flexion and knee extension maneuvers. Scand J Med Sci Sports 2015; 27:99-106. [DOI: 10.1111/sms.12620] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2015] [Indexed: 12/01/2022]
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Yamada T, Miyamoto N, Matsuura T, Takao S, Matsuzaki Y, Fujii Y, Koyano H, Nihongi H, Umezawa M, Matsuda K, Umegaki K, Shirato H. SU-E-T-266: Development of Evaluation System of Optimal Synchrotron Controlling Parameter for Spot Scanning Proton Therapy with Multiple Gate Irradiations in One Operation Cycle. Med Phys 2015. [DOI: 10.1118/1.4924628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Miyamoto N, Takao S, Matsuura T, Matsuzaki Y, Yamada T, Fujii Y, Matsuo Y, Kidani T, Egashira Y, Umekawa T, Shimizu S, Shirato H, Umegaki K. WE-EF-303-05: Development and Commissioning of Real-Time Imaging Function for Respiratory-Gated Spot-Scanning Proton Beam Therapy. Med Phys 2015. [DOI: 10.1118/1.4925996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Umegaki K, Matsuura T, Takao S, Matsuzaki Y, Yamada T, Fujii Y, Miyamoto N, Shimizu S, Shirato H. TH-CD-BRA-10: Startup Experience of the New Proton Beam Therapy System with Gated Spot Scanning and Real-Time Tumor-Tracking. Med Phys 2015. [DOI: 10.1118/1.4926235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fujii Y, Matsuura T, Takao S, Matsuzaki Y, Yamada T, Miyamoto N, Shimizu S, Umegaki K, Shirato H. SU-E-T-496: Influence of the Intrafraction Patient Repositioning On Spot Scanning Proton Therapy for Prostate Cancer. Med Phys 2015. [DOI: 10.1118/1.4924858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Matsuura T, Fujii Y, Takao S, Yamada T, Matsuzaki Y, Miyamoto N, Takayanagi T, Fujitaka S, Shimizu S, Shirato H, Umegaki K. SU-D-304-01: Development of An Applicator for Treating Shallow and Moving Tumors with Respiratory-Gated Spot-Scanning Proton Therapy Using Real-Time Image Guidance. Med Phys 2015. [DOI: 10.1118/1.4923860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yatomi Y, Tanaka R, Shimada Y, Yamashiro K, Liu M, Mitome-Mishima Y, Miyamoto N, Ueno Y, Urabe T, Hattori N. Type 2 diabetes reduces the proliferation and survival of oligodendrocyte progenitor cells in ishchemic white matter lesions. Neuroscience 2015; 289:214-23. [PMID: 25592431 DOI: 10.1016/j.neuroscience.2014.12.054] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/22/2014] [Accepted: 12/30/2014] [Indexed: 01/02/2023]
Abstract
Diabetes mellitus (DM) is a major risk factor for stroke and it exacerbates tissue damage after ischemic insult. Diabetes is one of the important causes of the progression of white matter lesion, however, the pathological mechanisms remain unclear. The present study evaluated the influences of type 2 DM on ischemic subcortical white matter injury and the recruitment of oligodendrocyte progenitor cells (OPCs) under chronic cerebral hypoperfusion using type 2 diabetic (db/db) mice. After bilateral common carotid artery stenosis (BCAS), the rarefaction in the white matter was more severe in db/db mice than in db/+ mice, and the number of glutathione S-transferase-pi (GST-pi)-positive mature oligodendrocytes (OLG) was lower in db/db mice than in db/+ mice at 4 and 8 weeks after ischemia. There were no significant differences in the number of single-stranded DNA (ssDNA)-positive apoptotic cells in the deep white matter between the db/db and db/+ mice. We found a transient increase in the platelet-derived growth factor receptor-α (PDGFRα)-positive OPCs in white matter lesions after ischemia. However, significantly fewer PDGFRα-positive OPCs were detected in db/db than db/+ mice from 4weeks after BCAS. The number of Ki67-positive proliferating cells in the deep white matter was significantly lower in db/db mice than in db/+ mice from 4 to 8weeks after BCAS. Most of the Ki67-positive cells were PDGFRα-positive OPCs. Finally, we assessed the survival of 5-bromo-2'-deoxyuridine (BrdU)-positive proliferating cells in ischemic white matter, and found significantly poorer survival of BrdU/PDGFRα-positive OPCs or BrdU/GST-pi-positive OLGs in the db/db mice compared to the db/+ mice in the white matter after BCAS. Our findings suggest that the type 2 DM mice exhibited more severe white matter injury 8 weeks after chronic ischemia. Decreased proliferation and survival of OPCs may play an important role in the progression of white matter lesions after ischemia in diabetics.
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