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Hamada Y, Fukutomi Y, Nakatani E, Saito A, Watai K, Kamide Y, Sekiya K, Nagai T, Harada K, Shiraishi Y, Oguma T, Asano K, Taniguchi M. Optimal Aspergillus fumigatus and Asp f 1 serum IgG cut-offs for the diagnosis of allergic bronchopulmonary aspergillosis. Allergol Int 2021; 70:74-80. [PMID: 32814668 DOI: 10.1016/j.alit.2020.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/22/2020] [Accepted: 07/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The presence of IgG antibodies (Abs) to Aspergillus fumigatus (Af) is a crucial diagnostic criterion for allergic bronchopulmonary aspergillosis (ABPA). Although precipitation is traditionally used to document IgG Abs, anti-Af serum IgG levels can also be measured by enzyme immunoassay (EIA). However, there are insufficient data on the optimal cut-offs to assess diagnostic performance of the EIA method. This study aimed to determine cut-off levels of IgG binding crude Af extracts or recombinant Asp f 1 (by ImmunoCAP®) and to compare their efficacy for ABPA diagnosis with Af-precipitating Abs. METHODS The age distribution of levels of IgG to crude extracts of Af (Af-IgG) and recombinant Asp f 1 (Asp f 1-IgG) was established using sera from 694 healthy controls (HC). Receiver operating characteristic analysis for Af-IgG and Asp f 1-IgG levels for the purpose of ABPA diagnosis was performed in 306 Af-sensitized asthma patients (including 49 ABPA), and cut-offs were determined. RESULTS An age-dependent decline in the levels of Af-IgG was observed in HC. Thus, cut-offs for Af-IgG levels were determined separately by age as 60 mg/L for patients aged <55 years, and 45 mg/L for those aged ≥55 years. For Asp f 1-IgG, 6.6 mg/L was set as the cut-off regardless of age. Although such IgG testing by EIA allowed a sufficiently good diagnostic performance, Af-precipitating Abs had better diagnostic applicability for ABPA. CONCLUSIONS We determined cut-offs for Af-IgG and Asp f 1-IgG measured by EIA, which can be useful in clinical settings where precipitating Abs are unavailable.
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Taniguchi M, Sekiya K, Kamide Y, Fukutomi Y, Watai K, Hamada Y, Nakamura Y, Ryu K, Fujita N, Yano K, Iwata M, Nagayama K, Mori A. [EOSINOPHILIC GRANULOMATOSIS WITH POLYANGITIS (EGPA)]. ARERUGI = [ALLERGY] 2020; 69:293-303. [PMID: 32684542 DOI: 10.15036/arerugi.69.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hayashi H, Fukutomi Y, Mitsui C, Kajiwara K, Watai K, Kamide Y, Nakamura Y, Hamada Y, Tomita Y, Sekiya K, Tsuburai T, Izuhara K, Wakahara K, Hashimoto N, Hasegawa Y, Taniguchi M. Omalizumab for Aspirin Hypersensitivity and Leukotriene Overproduction in Aspirin-exacerbated Respiratory Disease. A Randomized Controlled Trial. Am J Respir Crit Care Med 2020; 201:1488-1498. [PMID: 32142372 PMCID: PMC7301746 DOI: 10.1164/rccm.201906-1215oc] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale: Aspirin-exacerbated respiratory disease is characterized by severe asthma, nonsteroidal antiinflammatory drug hypersensitivity, nasal polyposis, and leukotriene overproduction. Systemic corticosteroid therapy does not completely suppress lifelong aspirin hypersensitivity. Omalizumab efficacy against aspirin-exacerbated respiratory disease has not been investigated in a randomized manner. Objectives: To evaluate omalizumab efficacy against aspirin hypersensitivity, leukotriene E4 overproduction, and symptoms during an oral aspirin challenge in patients with aspirin-exacerbated respiratory disease using a randomized design. Methods: We performed a double-blind, randomized, crossover, placebo-controlled, single-center study at Sagamihara National Hospital between August 2015 and December 2016. Atopic patients (20–79 yr old) with aspirin-exacerbated respiratory disease diagnosed by systemic aspirin challenge were randomized (1:1) to a 3-month treatment with omalizumab or placebo, followed by a >18-week washout period (crossover design). The primary endpoint was the difference in area under logarithm level of urinary leukotriene E4 concentration versus time curve in the intent-to-treat population during an oral aspirin challenge. Measurements and Main Results: Sixteen patients completed the study and were included in the analysis. The area under the logarithm level of urinary leukotriene E4 concentration versus time curve during an oral aspirin challenge was significantly lower in the omalizumab phase (median [interquartile range], 51.1 [44.5–59.8]) than in the placebo phase (80.8 [interquartile range, 65.4–87.8]) (P < 0.001). Ten of 16 patients (62.5%) developed oral aspirin tolerance up to cumulative doses of 930 mg in the omalizumab phase (P < 0.001). Conclusions: Omalizumab treatment inhibited urinary leukotriene E4 overproduction and upper/lower respiratory tract symptoms during an oral aspirin challenge, resulting in aspirin tolerance in 62.5% of the patients with aspirin-exacerbated respiratory disease.
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Mori A, Kouyama S, Yamaguchi M, Kumitani C, Ohtomo-Abe A, Sekiya K, Fukutomi Y, Taniguchi M, Ohtomo T, Kaminuma O. Control of steroid resistance by blocking costimulatory signal. World Allergy Organ J 2020. [DOI: 10.1016/j.waojou.2020.100211] [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] Open
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Sekiya K, Ito M, Takemura K, Fukushima H, Suzuki H, Nakanishi Y, Kataoka M, Iida N, Fuse H, Tobisu K, Koga F. Prognostic impact of controlling nutritional status (CONUT) score in metastatic renal cell carcinoma patients. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Tomita Y, Fukutomi Y, Irie M, Azekawa K, Hayashi H, Kamide Y, Sekiya K, Nakamura Y, Okada C, Shimoda T, Hasegawa Y, Taniguchi M. Acid-suppressive medication as a possible risk factor for late-onset asthma. Allergy 2020; 75:1247-1250. [PMID: 31697405 DOI: 10.1111/all.14099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mori A, Kouyama S, Yamaguchi M, Kumitani C, Ohtomo-Abe A, Fujita N, Iwata M, Nagayama K, Ryu K, Nakamura Y, Hamada Y, Hayashi H, Watai K, Kamide Y, Sekiya K, Fukutomi Y, Taniguchi M, Ohtomo T, Kaminuma O. Therapeutic approach to steroid-resistant asthma. THE JOURNAL OF IMMUNOLOGY 2020. [DOI: 10.4049/jimmunol.204.supp.65.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Background
To control therapy-resistant eosinophilia, synergistic effects of CTLA4-Ig and glucocorticoid was investigated on T cell-induced asthma model.
Methods
Ovalbumin (OVA) specific murine helper T cell (Th) clones were established from DO11.10 transgenic mice. To analyze steroid responsiveness in vitro, Th clones were cultured with antigen presenting cells and OVA in the presence of various concentration of dexamethasone (DEX). Proliferative responses were measured by incorporation of either 3H-thymidine or BrdU. For in vivo analysis, unprimed Balb/c mice were transferred with Th clones, challenged with OVA, and administered with DEX subcutaneously. CTLA4-Ig was administered intravenously. BALF was obtained 48 hours after the challenge, and the number of infiltrating cells was differentially counted.
Results
Steroid-sensitive (SS) and -resistant (SR) clones were selected based on the effect of DEX on the proliferative responses of antigen-stimulated Th clones. Airway infiltration of eosinophils of mice transferred with SS clones were effectively inhibited by the administration of DEX. In contrast, those of mice transferred with SR clones were not significantly inhibited by DEX. Addition of CTLA4-Ig into the culture significantly suppressed the proliferation of DEX-treated SR clones in vitro. Administration of CTLA4-Ig significantly suppressed eosinophil infiltration of SR asthma model transferred with SR clones in vivo. CTLA4-Ig and DEX synergistically suppressed in vitro proliferation of SS clones and in vivo BALF eosinophilia of mice transferred with SS clones.
Conclusion
Blocking costimulatory signal mediated through CD28 is a promising target to treat therapy-resistant eosinophilia.
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Fukutomi Y, Teruuchi Y, Nakatani E, Minami T, Sasagawa Y, Fukushima M, Kamide Y, Sekiya K, Saito H, Teshima R, Adachi R, Taniguchi M. Allergen-specific IgG 4 over time: Observation among adults with hydrolyzed wheat protein allergy. Allergy 2019; 74:1584-1587. [PMID: 31077391 DOI: 10.1111/all.13866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Taniguchi M, Mitsui C, Hayashi H, Ono E, Kajiwara K, Mita H, Watai K, Kamide Y, Fukutomi Y, Sekiya K, Higashi N. Aspirin-exacerbated respiratory disease (AERD): Current understanding of AERD. Allergol Int 2019; 68:289-295. [PMID: 31235242 DOI: 10.1016/j.alit.2019.05.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022] Open
Abstract
The characteristics in AERD are severe adult-onset asthma, eosinophilic rhinosinusitis with nasal polyposis, and CysLT overproduction. The cause of AERD have remained unclear, however the decrease in the production of PGE2 caused by the reduction in COX-2 activity is considered to main pathological mechanism of AERD. The mast cell activation and the interaction between platelets and granulocytes are lead to the CysLT overproduction and severe eosinophilic inflammation. The ongoing activation of mast cells is important key pathogenesis in not only stable AERD but exacerbated AERD by aspirin and NSAIDs. In recent years, type 2 inflammation caused by ILC2 activation in patients with AERD have been attracting attention. Omalizumab is effective option for AERD via suppression of mast cell activation and CysLT overproduction. Dupilumab improves sinus symptoms especially in patients with AERD. In near future, anti-platelet drug, CRTH2 antagonist, and anti-TSLP antibody may be useful candidates of therapeutic options in patients with AERD.
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Watai K, Sekiya K, Hayashi H, Fukutomi Y, Taniguchi M. Effects of short-term smoking on lung function and airway hyper-responsiveness in young patients with untreated intermittent adult-onset asthma: retrospective cross-sectional study at a primary-tertiary care hospital in Japan. BMJ Open 2019; 9:e023450. [PMID: 31167855 PMCID: PMC6561610 DOI: 10.1136/bmjopen-2018-023450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE In daily clinical practice, smokers with asthma and with intermittent disease severity are frequently encountered. The effects of short-term smoking on lung function or disease presentation in younger patients with intermittent adult-onset asthma remain unclear. We sought to clarify the effects of short-term smoking (<10 pack-years) on lung function and airway hyper-responsiveness (AHR) in young patients with untreated intermittent adult-onset asthma. DESIGN Retrospective, cross-sectional study. SETTING A single primary-tertiary medical centre in Japan. PARTICIPANTS From patients who underwent bronchodilator reversibility tests between January 2004 and March 2011 (n=7291), 262 consecutive patients (age, 20-34 years) with untreated intermittent adult-onset asthma, including 157 never smokers and 105 current smokers within 10 pack-years, were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the association of the daily smoking frequency (number of cigarettes per day), smoking duration (years) and cumulative smoking history (pack-years) with postbronchodilator lung function. The secondary outcome was the association of the former three smoking parameters with AHR. RESULTS The daily smoking frequency, smoking duration and cumulative smoking history were significantly associated with decreased postbronchodilator lung function. Daily smoking of ≥11 cigarettes per day was also associated with marked AHR (OR 2.23; 95% CI 1.03 to 4.80), even after adjustment for age, sex, disease duration and body mass index. CONCLUSION Short-term active smoking in early adulthood may be associated with decreased lung function and AHR, even in patients with intermittent adult-onset asthma. Our findings suggest a benefit of never smoking, even for young patients with intermittent adult-onset asthma.
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Tomita Y, Fukutomi Y, Irie M, Azekawa K, Hayashi H, Kamide Y, Sekiya K, Nakamura Y, Okada C, Shimoda T, Hasegawa Y, Taniguchi M. Obesity, but not metabolic syndrome, as a risk factor for late-onset asthma in Japanese women. Allergol Int 2019; 68:240-246. [PMID: 30473411 DOI: 10.1016/j.alit.2018.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 10/18/2018] [Accepted: 10/25/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Several cross-sectional studies have suggested an association between obesity and asthma. However, few studies have investigated this relationship longitudinally, especially in middle-aged subjects. Although metabolic syndrome is a well-known risk factor for many non-communicable diseases, its contribution to asthma remains controversial. METHODS From 2008, specific health checkups for metabolic syndrome have been conducted throughout Japan. To seek relationships of obesity and metabolic syndrome with late-onset asthma in Japan, we analyzed data collected from health insurance claims and specific health checkups for metabolic syndrome at three large health insurance societies. Among subjects aged 40-64 years (n = 9888), multivariate logistic regression analyses were performed to investigate the relationships of obesity and metabolic syndrome in fiscal year 2012 (from April 2012 to March 2013) with the incidence of late-onset asthma in the following two years (from April 2013 to March 2015). RESULTS In women, BMI 25-29.9 kg/m2 or ≥30 kg/m2, waist circumference ≥90 cm, and waist-to-height ratio ≥0.5 were shown to be significant risk factors for asthma, with adjusted odds ratios (95% CI) of 1.92 (1.35-2.75), 2.24 (1.23-4.09), 1.89 (1.30-2.75), and 1.53 (1.15-2.03), respectively. Significance was retained even after adjustment for metabolic syndrome, and there were no significant relationships between metabolic syndrome itself and the incidence of asthma in men or women. CONCLUSIONS Only the obesity measures, not metabolic syndrome, were shown to be significant risk factors for the incidence of late-onset asthma but only in middle-aged Japanese women, and not in men.
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Akio M, Kouyama S, Yamaguchi M, Kumitani C, Ohtomo-Abe A, Fujita N, Iwata M, Nagayama K, Ryu K, Nakamura Y, Tomita Y, Hamada Y, Hayashi H, Watai K, Kamide Y, Sekiya K, Fukutomi Y, Taniguchi M, Ohtomo T, Kaminuma O. Synergistic suppression of T cell-induced eosinophilia by glucocorticoid and CTLA4-Ig. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hiyama T, Kuno H, Sekiya K, Tsushima S, Sakai O, Kusumoto M, Kobayashi T. Bone Subtraction Iodine Imaging Using Area Detector CT for Evaluation of Skull Base Invasion by Nasopharyngeal Carcinoma. AJNR Am J Neuroradiol 2018; 40:135-141. [PMID: 30523140 DOI: 10.3174/ajnr.a5906] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/22/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Conventional CT has generally lower detectability of bone marrow invasion than MR imaging due to lower tissue contrast. The purpose of this study was to compare the diagnostic performance of conventional CT alone or in combination with bone subtraction iodine imaging using area detector CT for the evaluation of skull base invasion in patients with nasopharyngeal carcinoma. MATERIALS AND METHODS Forty-four consecutive patients who underwent contrast-enhanced CT using 320-row area detector CT and contrast-enhanced MR imaging for nasopharyngeal carcinoma staging between April 2012 and November 2017 were enrolled in this retrospective study. Bone subtraction iodine images were generated by subtracting pre- and postcontrast volume scans using a high-resolution deformable registration algorithm. Two blinded observers evaluated skull base invasion at multiple sites (sphenoid body, clivus, bilateral base of the pterygoid process, and petrous bone) using conventional CT images alone or in combination with bone subtraction iodine images. Examination of MR and CT images by an experienced neuroradiologist was the reference standard for evaluating sensitivity, specificity, and area under the receiver operating characteristic curve. RESULTS Twenty-six patients (59%) showed skull base invasion at 84 sites on the reference standard. Conventional CT plus bone subtraction iodine images showed higher sensitivity (92.9% versus 78.6%, P = .02) and specificity (95.6% versus 86.1%, P = .01) than conventional CT images alone for evaluating skull base invasion. The area under the receiver operating characteristic curve for conventional CT plus bone subtraction iodine (0.98) was significantly larger (P < .001) than the area under the receiver operating characteristic curve for conventional CT alone (0.90). CONCLUSIONS Conventional CT plus bone subtraction iodine performs more closely to the accuracy of combining CT and MR imaging compared with conventional CT alone.
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Watai K, Fukutomi Y, Hayashi H, Kamide Y, Sekiya K, Taniguchi M. Epidemiological association between multiple chemical sensitivity and birth by caesarean section: a nationwide case-control study. Environ Health 2018; 17:89. [PMID: 30547814 PMCID: PMC6295056 DOI: 10.1186/s12940-018-0438-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Multiple chemical sensitivity (MCS) is characterized by recurrent nonspecific symptoms that are attributed to exposure to trace levels of environmental agents. Although the clinical symptoms of MCS have been described in several studies, the risk factors for this condition remain unclear. Our aim was to clarify the risk factors for MCS and the association between MCS and birth by caesarean section. METHODS We conducted a nationwide case-control study of Japanese individuals (aged 20-65 years) with physician-diagnosed MCS (183 cases) and without MCS (345 controls). The study participants were selected from among 150,000 people in a web-based research panel with approximately 1,000,000 registrants. They completed an online survey including questions on their sociodemographic characteristics, birth history (i.e., birth by caesarean section), and other potential risk factors for MCS. Multivariate logistic regression analysis was employed to determine the association between sociodemographic characteristics and the risk of MCS. RESULTS The proportions of case and control subjects who were born by caesarean section were 39.9 and 7.0%, respectively. The association between birth by caesarean section and MCS was significant even after adjusting for potential confounders (adjusted odds ratio: 6.15; 95% confidence interval: 3.13-12.1). A history of agricultural work, mouth breathing, ≥11 vaccinations in the past 10 years, and residing in a new home (< 1 year-old) ≥3 times were also significantly associated with MCS. CONCLUSION Our data indicate an epidemiological link between MCS and birth by caesarean section. Moreover, we show that factors other than chemical exposure may be associated with the development of MCS.
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Watai K, Fukutomi Y, Hayashi H, Nakamura Y, Hamada Y, Tomita Y, Mitsui C, Kamide Y, Sekiya K, Asano K, Taniguchi M. De novo sensitization to Aspergillus fumigatus in adult asthma over a 10-year observation period. Allergy 2018; 73:2385-2388. [PMID: 30030925 DOI: 10.1111/all.13566] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/15/2018] [Indexed: 02/05/2023]
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Watai K, Fukutomi Y, Hayashi H, Iwata M, Nagayama K, Nakamura Y, Tanaka J, Hamada Y, Ryu K, Tomita Y, Mistui C, Kamide Y, Sekiya K, Mori A, Asano K, Taniguchi M. New sensitization to Aspergillus fumigatus in adult asthma over a 10-year observation period. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.pa3911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hayashi H, Fukutomi Y, Mitsui C, Watai K, Tomita Y, Kamide Y, Sekiya K, Tsuburai T, Horita A, Saito I, Hasegawa Y, Taniguchi M. Th1-related disease development during omalizumab treatment: Two cases with severe asthma. Allergol Int 2018; 67:405-407. [PMID: 29191372 DOI: 10.1016/j.alit.2017.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/11/2017] [Accepted: 10/23/2017] [Indexed: 11/19/2022] Open
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Tanaka H, Nakatani E, Fukutomi Y, Sekiya K, Kaneda H, Iikura M, Yoshida M, Takahashi K, Tomii K, Nishikawa M, Kaneko N, Sugino Y, Shinkai M, Ueda T, Tanikawa Y, Shirai T, Hirabayashi M, Aoki T, Kato T, Iizuka K, Fujii M, Taniguchi M. Identification of patterns of factors preceding severe or life-threatening asthma exacerbations in a nationwide study. Allergy 2018; 73:1110-1118. [PMID: 29197099 PMCID: PMC6668009 DOI: 10.1111/all.13374] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reducing near-fatal asthma exacerbations is a critical problem in asthma management. OBJECTIVES To determine patterns of factors preceding asthma exacerbations in a real-world setting. METHODS In a nationwide prospective study of 190 patients who had experienced near-fatal asthma exacerbation, cluster analysis was performed using asthma symptoms over the 2-week period before admission. RESULTS Three distinct clusters of symptoms were defined employing the self-reporting of a visual analogue scale. Cluster A (42.1%): rapid worsening within 7.4 hours from moderate attack to admission, young to middle-aged patients with low Body mass index and tendency to depression who had stopped anti-asthma medications, smoked, and hypersensitive to environmental triggers and furred pets. Cluster B (40.0%): fairly rapid worsening within 48 hours, mostly middle-aged and older, relatively good inhaled corticosteroid (ICS) or ICS/long-acting beta-agonist (LABA) compliance, and low perception of dyspnea. Cluster C (17.9%): slow worsening over 10 days before admission, high perception of dyspnea, smokers, and chronic daily mild-moderate symptoms. There were no differences in overuse of short-acting beta-agonists, baseline asthma severity, or outcomes after admission for patients in these 3 clusters. CONCLUSION To reduce severe or life-threatening asthma exacerbation, personalized asthma management plans should be considered for each cluster. Improvement of ICS and ICS/LABA compliance and cessation of smoking are important in cluster A. To compensate for low perception of dyspnea, asthma monitoring of peak expiratory flow rate and/or exhaled nitric oxide would be useful for patients in cluster B. Avoidance of environmental triggers, increase usual therapy, or new anti-type 2 response-targeted therapies should be considered for cluster C.
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Minami T, Fukutomi Y, Sekiya K, Akasawa A, Taniguchi M. Hand eczema as a risk factor for food allergy among occupational kitchen workers. Allergol Int 2018; 67:217-224. [PMID: 28874315 DOI: 10.1016/j.alit.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND An increasing number of studies in children is highlighting the importance of transdermal routes of exposure to food allergens through damaged skin in the pathogenesis of food allergies. However, data on this in adults are limited. A few case-series studies has documented development of food allergy among kitchen workers with hand eczema after direct contact exposure to foods. METHODS To explore the significance of hand eczema as a risk factor for food allergies in adults at the epidemiological level, we performed a cross-sectional web-based questionnaire survey on kitchen workers whose exposures were classed as occupational (cooks and food handlers, n = 1592) or non-occupational (housewives, n = 1915). Logistic regression was used to explore the association between the presence/severity of hand eczema and the risk of food allergy after adjustment for potential confounders. RESULTS Current hand eczema and current diagnosed food allergy were more common among occupational kitchen workers (OKW) than among non-occupational kitchen workers (NOKW) (32.3%-vs-29.9% and 9.9%-vs-3.8%, respectively). Current hand eczema was significantly associated with increased risk of current diagnosed food allergy in OKW (adjusted odds ratio 2.4, 95% CI 1.6-3.7). Those with more severe hand eczema were more likely to suffer from allergic symptoms for foods, and diagnosed food allergy. CONCLUSIONS This study illustrates a significant public health problem in the adult population, documenting a major impact of hand eczema on the ongoing adult food allergy epidemic.
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Mori A, Kouyama S, Yamaguchi M, Kumitani C, Ohtomo A, Nakamura Y, Tomita Y, Hamada H, Kamide Y, Hayashi H, Watai K, Mitsui C, Sekiya K, Fukutomi Y, Taniguchi M, Ohtomo T, Kaminuma O. In vitro and in vivo analysis of T cell-induced bronchoconstriction. J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kuno H, Sakamaki K, Fujii S, Sekiya K, Otani K, Hayashi R, Yamanaka T, Sakai O, Kusumoto M. Comparison of MR Imaging and Dual-Energy CT for the Evaluation of Cartilage Invasion by Laryngeal and Hypopharyngeal Squamous Cell Carcinoma. AJNR Am J Neuroradiol 2018; 39:524-531. [PMID: 29371253 DOI: 10.3174/ajnr.a5530] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 11/10/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Dual-energy CT can distinguish iodine-enhanced tumors from nonossified cartilage and has been investigated for evaluating cartilage invasion in patients with laryngeal and hypopharyngeal squamous cell carcinomas. In this study, we compared the diagnostic accuracy of MR imaging and of a combination of weighted-average and iodine overlay dual-energy CT images in detecting cartilage invasion by laryngeal and hypopharyngeal squamous cell carcinomas, in particular thyroid cartilage invasion. MATERIALS AND METHODS Fifty-five consecutive patients who underwent 3T MR imaging and 128-slice dual-energy CT for preoperative initial staging of laryngeal or hypopharyngeal squamous cell carcinomas were included. Two blinded observers evaluated laryngeal cartilage invasion on MR imaging and dual-energy CT using a combination of weighted-average and iodine-overlay images. Pathologic findings of surgically resected specimens were used as the reference standard for evaluating sensitivity, specificity, and the areas under the receiver operating characteristic curve of both modalities for cartilage invasion by each type of cartilage and for all cartilages together. Sensitivity and specificity were compared using the McNemar test and generalized linear mixed models. RESULTS Dual-energy CT showed higher specificity than MR imaging for diagnosing all cartilage together (84% for MR imaging versus 98% for dual-energy CT, P < .004) and for thyroid cartilage (64% versus 100%, P < .001), with a similar average area under the curve (0.94 versus 0.95, P = .70). The sensitivity did not differ significantly for all cartilages together (97% versus 81%, P = .16) and for thyroid cartilage (100% versus 89%, P = .50), though there was a trend toward increased sensitivity with MR imaging. CONCLUSIONS Dual-energy CT showed higher specificity and acceptable sensitivity in diagnosing laryngeal cartilage invasion compared with MR imaging.
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Sekiya K, Nishimura M, Suehiro F, Nishimura H, Hamada T, Kato Y. Enhancement of Osteogenesis by Concanavalin a in Human Bone Marrow Mesenchymal Stem Cell Cultures. Int J Artif Organs 2018; 31:708-15. [DOI: 10.1177/039139880803100804] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigates concanavalin A (ConA) as a novel factor that may enhance osteogenesis of mesenchymal stem cells (MSCs) in vitro. Various factors, such as cytokine bone morphogenetic protein-2 (BMP-2), have been studied for their possible promotion of MSC osteogenesis in vivo and in vitro. However, the factor that might be safer, more effective, and less expensive than these has not been determined. We therefore cultured human MSCs in osteogenic medium in the presence or absence of ConA, and used calcium assays to compare the effects of ConA and BMP-2 on MSC calcification. We also used enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction (PCR) to evaluate the expression levels of bone-specific markers. ConA and BMP-2 enhanced calcification with comparable effectiveness. The combination of ConA and BMP-2 further enhanced calcification slightly but significantly. ConA also increased osteocalcin and BMP-2 protein levels in MSC culture medium. Furthermore, ConA increased osteocalcin, RUNX2, BMP-2, BMP-4, and BMP-6 mRNA expression levels. However, the gene expression pattern of ConA-stimulated MSCs was different from that of MSCs stimulated by BMP-2. Together, these results suggest that ConA and BMP-2 enhance MSC osteogenesis via different pathways. ConA-induced bone formation in MSC cultures may be useful in regenerative medicine or tissue engineering in clinical studies, as well as in basic research on bone formation.
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Tsuburai T, Kamide Y, Nakamura Y, Tomita Y, Hamada Y, Watai K, Hayashi H, Sekiya K, Mitsui C, Fukutomi Y, Mori A, Taniguchi M. DIFFERENCES IN FRACTION OF EXHALED NITRIC OXIDE VALUES MEASURED BY TWO HAND-HELDED ANALYZERS (NObreath ® AND NIOX Vero ®). ARERUGI = [ALLERGY] 2017; 66:204-208. [PMID: 28515402 DOI: 10.15036/arerugi.66.204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The fraction of exhaled nitric oxide (FENO) is a useful marker of asthma control. The FENO measurement with two hand-helded analyzers (NObreath® and NIOX Vero®) may be more affordable, no studies have examined the differences in FENO values measured with those methods in adult. METHODS The study population comprised 44 subjects at our outpatient clinic. FeNO values (FENOb and FENOv) were measured by two methods (NObreath® and NIOX Vero®). RESULTS FENOb values were significantly correlated with FENOv (r = 0.911, p < 0.001). However, FENOv values were high compared with FENOb (FENOv = 1.40 × FENOb). CONCLUSION Differences exist in the values of FENO measured by two hand-helded analyzers: conversion equations are needed to compare the FENO values between these methods.
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Tsuburai T, Kamide Y, Nakamura Y, Tomita Y, Hamada Y, Watai K, Hayashi H, Sekiya K, Mitsui C, Fukutomi Y, Mori A, Taniguchi M. A CASE OF BRONCHIAL ASTHMA WITH HYPEREOSINOPHILIA WITH EFFECTIVE SAIBOKUTOU THERAPY. ARERUGI = [ALLERGY] 2017; 66:231-234. [PMID: 28515405 DOI: 10.15036/arerugi.66.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 42 year old woman visited on our hospital because of cough, sputum, pruritus and erythema. She showed peripheral blood eosinophilia, high level of FENO, bronchial hyperresponsiveness. Diagnosis of bronchial asthma and atopic dermatitis was made, but she rejected therapy except for Saibokutou, a Kampo herbal medicine. After 1 year, her symptoms and her laboratory data were improved.
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Watai K, Sekiya K, Taniguchi M. Epidemiological link between multiple chemical sensitivity/idiopathic environmental intolerance and birth by caesarean section. Toxicol Lett 2017. [DOI: 10.1016/j.toxlet.2017.07.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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