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Fujita Y, Yano T, Abe K, Nagano N, Kamiyama N, Fujito T, Mochizuki A, Koyama M, Kouzu H, Muranaka A, Naganara D, Tanno M, Miki T, Miura T. P6453Activation of necroptotic pathway by downregulated caspase-8 expression is associated with progression of left ventricular remodeling in nonischemic dilated cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Necroptosis, a form of programmed necrosis, has been suggested to be involved in the pathogenesis of various pathological conditions including heart failure. Protein expression of caspase-8, an endogenous inhibitor of necroptosis, is reported to be downregulated in human failing hearts, but its clinical significance remains unclear.
Methods
Endomyocardial biopsy specimens were obtained from patients with nonischemic dilated cardiomyopathy (n=57, 56.2±14.5 years old, 70% male). The area stained with antibodies against caspase-8 and phospho-MLKL-Ser358 was calculated using an image analyzer, and fibrotic and cardiomyocyte areas were determined by Masson's Trichrome staining. Using a level of median caspase-8 expression (6.04% of the area of the myocardium with caspase-8 signal), patients were classified into a high caspase-8 expression group (H-cas8) and a low caspase-8 expression group (L-cas8).
Results
Caspase-8 signals were detected in cytoplasm and intercalated disks of cardiomyocytes. Patients in the L-cas8 group was younger (51.3±13.1 vs. 61.2±14.3 years old) and had larger left ventricular end-diastolic volume (LVEDV: 174±49 vs. 131±41 ml), larger left ventricular end-systolic volume (LVESV: 123±51 vs. 87±39 ml), and higher ratio of mitral peak velocity of early filling to late diastolic filling (E/A: 1.94±1.48 vs. 1.12±0.66) compared with the H-cas8 group. Caspase-8 expression level was positively correlated with age (r=0.34, p=0.01) and negatively correlated with LVEDV (r=−0.47, p<0.01), LVESV (r=−0.40, p<0.01), and E/A (r=−0.39, p<0.01) in simple linear regression analysis. The extent of myocardial fibrosis was not correlated with caspase-8 expression level. Multiple regression analysis indicated that LVEDV, LVESV, and E/A were independent explanatory factors of caspase-8 expression level after adjusting age and sex. Phospho-MLKL signals, an index of activation of necroptotic pathway, were frequently observed in cytoplasm, intercalated disks, and nuclei in the L-cas8 group but not in the H-cas8 group.
Conclusion
Lower caspase-8 expression in cardiomyocytes was associated with increased phosphorylation of MLKL and larger left ventricular volume, suggesting that downregulated caspase-8 may contribute to progression of myocardial remodeling via activation of MLKL in human dilated cardiomyopathy.
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Ohhara Y, Kojima T, Honjo O, Yamada N, Sato T, Kunisaki M, Takamura K, Takashina T, Sukoh N, Tanaka H, Kawai Y, Fujita Y, Sugaya F, Hommura F, Harada T, Ryoichi H, Kinoshita I, Amano T, Oizumi S, Akita H. Prognostic factors for non-small cell lung cancer patients with driver mutation negative and brain metastases (HOT 1701). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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53
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Tien A, Li J, Bao X, DeRogatis A, Fujita Y, Pennington-Krygier C, Kim S, Mehta S, Sanai N. OS8.1 A phase 0/2 clinical trial of a CDK4/6 inhibitor in aggressive meningioma patients. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
New approaches are urgently needed for aggressive meningiomas, which remain largely incurable. Forkhead Box M1 (FOXM1) has been identified as a master transcription factor in aggressive meningiomas and Cyclin D-dependent Kinases (CDK) are positive regulators of cell-cycle entry, promoting tumorigenesis through FOXM1 activation. We evaluated the tumor pharmacokinetics (PK), tumor pharmacodynamics (PD), and preliminary clinical response of ribociclib, a selective CDK4/6-inhibitor, in aggressive meningioma patients.
MATERIAL AND METHODS
Eight aggressive WHO Grade II/III meningioma patients with intact RB expression were enrolled and administered oral ribociclib daily (900mg) for 5 days prior to tumor resection. Plasma, tumor, and cerebrospinal fluid (CSF) samples were collected at 2, 8, or 24 h after the last dose. Total and unbound drug concentrations were determined using a validated LC-MS/MS method. PD effects, including RB and FoxM1 phosphorylation, were compared to matched archival tissue. Patients with PK and PD responses in tumor tissue, defined as unbound ribociclib concentration > 5-fold in vitro IC50 (0.04µM) and >20% decrease in pRB levels, respectively, were enrolled into an exploratory Phase 2 cohort.
RESULTS
The median CSF concentration of ribociclib was 0.25 µM. In tumor tissue, the median unbound ribociclib concentration was 1.36 µM and the median unbound tumor-to-plasma ratio was 5.34. Suppression of G1-to-S phase was inferred in tumors with declining FoxM1 phosphorylation (50%), RB phosphorylation (38%), and cellular proliferation (75%). Four patients demonstrated concurrent PK and PD responses and were graduated to continuous ribociclib therapy. At one year, two of these patients (one Grade II and one Grade III) demonstrate partial responses per RANO criteria.
CONCLUSION
Ribociclib achieves pharmacologically-active concentrations in aggressive meningioma tissue. Target modulation was demonstrated by a decrease in FOXM1-mediated tumor proliferation. Further investigation of ribociclib as a therapeutic strategy for aggressive meningiomas is warranted.
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Miyauchi T, Nomura T, Suzuki S, Takeda M, Peh J, Natsuga K, Fujita Y, Nishie W, Akiyama M, Shimizu H. 293 Pityriasis rubra pilaris type V with a heterozygous mutation in CARD14. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Matsumoto Y, Kabuki S, Sugawara A, Kitahara T, Akiba T, Fujita Y, Kawamata I, Yamada K, Amino K, Sasaki Y, Nishida M, Murakami K, Sugahara K, Saito N, Kunieda E. Basic evaluation of a novel 4D target and human body phantom. Phys Med Biol 2019; 64:145002. [PMID: 31146274 DOI: 10.1088/1361-6560/ab259c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Stereotactic body radiation therapy (SBRT) is usually verified with a dynamic phantom or solid phantom, but there is a demand for phantoms that can accurately simulate tumor dynamics within an individual that would allow customized validation in every patient. We developed a new 4D dynamic target phantom (multi-cell 4D phantom) that allows simulation of tumor movement in patients. The basic quality and dynamic reproducibility of this new phantom was verified in this investigation. The newly developed multi-cell 4D phantom comprises four main components: soft tissue, bones, lungs, and tumor (target). The phantom structure was based on computed tomography (CT) data of a male. In this study, we investigated the basic performance of a multi-cell 4D phantom. All the CT numbers of the phantom were very close to those of human data. The geometric maximum amplitudes were 4.57 mm in the lateral direction, 4.59 mm in the ventrodorsal direction, and 3.68 mm in the cranio-caudal direction. Geometric errors were 0.84, 0.58, and 0.40 mm, respectively. Movements of the abdominal surface were stable for 60 s. Repeated measurements show no actual differences in target movements between multiple measurements and indicated high reproducibility (r > 0.97). End-to-end tests using Gafchromic film revealed a gamma pass rate of 98% or above (2 mm/3%). Although our phantom performed limited reproducibility in the movement of the patient tumor at present, a satisfactory level of precision was confirmed in general. This is a very promising device for use in the verification of radiation therapy for moving targets.
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Kinoshita M, Ogawa Y, Hama N, Ujiie I, Shimada S, Fujita Y, Abe R, Kawamura T. 986 Neutrophil extracellular traps induced by causative drug-specific CD8+ T cells initiate and exacerbate Stevens-Johnson syndrome and toxic epidermal necrolysis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1062] [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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Takashima S, Shinkuma S, Fujita Y, Natsuga K, Yoshimoto N, Shichinohe R, Hatanaka K, Shimizu H. 368 Novel mevalonate kinase mutation in a patient with porokeratosis ptychotropica. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Imai T, Fujita Y, Motoki A, Takaoka H, Kanesaki T, Ota Y, Iwai S, Chisoku H, Ohmae M, Sumi T, Nakazawa M, Uzawa N. Surgical approaches for condylar fractures related to facial nerve injury: deep versus superficial dissection. Int J Oral Maxillofac Surg 2019; 48:1227-1234. [PMID: 30833093 DOI: 10.1016/j.ijom.2019.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/10/2019] [Accepted: 02/14/2019] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate the probability of facial nerve injury (FNI) in the treatment of condylar neck and subcondylar fractures (CN/SCFs) with percutaneous approaches and to identify factors predicting FNI. The data of 80 patients with 87 CN/SCFs were evaluated retrospectively. The primary outcome was FNI occurrence. The predictor variables were age, sex, aetiology, alcohol consumption, fracture site and pattern (dislocation or not), concomitant fractures, time interval to surgery, surgeon experience, plate type, and the dual classification of percutaneous approaches. The approaches were classified based on whether subcutaneous dissection traversed the marginal mandibular branch (MMB) deeply (deep group: submandibular and retroparotid approaches) or superficially (superficial group: transparotid, transmasseteric anteroparotid (TMAP), and high cervical-TMAP approaches). Twenty-two patients (27.5%) suffered FNI, of whom two in the deep group had permanent paralysis of the MMB. In the multivariate logistic regression model, deeply traversing surgery approaches (odds ratio 12.4, P=0.025) and the presence of a dislocated fracture (odds ratio 6.66, P=0.012) were associated with an increased risk of FNI. These results suggest that percutaneous approaches in the superficial group should be recommended for the treatment of CN/SCFs to reduce the risk of FNI.
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Nohara T, Fujita Y, Takashima S, Natsuga K, Shimizu H. Image Gallery: Multiple localized lipoatrophy in recessive dystrophic epidermolysis bullosa. Br J Dermatol 2019; 180:e64. [PMID: 30821372 DOI: 10.1111/bjd.17356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Numao T, Fujita Y, Ichikawa K, Ide S, Katori H, Shimada T, Ota K, Ikeda Y, Amimoto K. Leftward Optical Shift Induces Bias in Line Bisection: A Study with Healthy Subjects Using a Head-mounted Display. Prog Rehabil Med 2019; 4:20190008. [PMID: 32789255 DOI: 10.2490/prm.20190008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/11/2019] [Indexed: 11/09/2022] Open
Abstract
Objective The purpose of this study was to verify the effect on spatial perception in healthy young subjects of an unconscious leftward optical shift created by a head-mounted display (HMD) with an offset camera. Methods We recruited 40 healthy right-handed adults who were divided into four groups according to the hand used in the tests and the visual direction displayed by the HMD (centered or 10° left). Each of the four groups (n = 10) undertook line bisection tasks across four combinations of variables: using a finger/stick or a mouse to point at a touch panel located 60 or 120 cm away from the subject. Results According to the results, regardless of the hand used, when the index finger or a stick was used (reaching condition), the line bisection point was displaced significantly to the left of the center. Additionally, a major left-displacement trend was observed in the short-distance reaching task, which did not require the use of a stick. In contrast, the long-distance task required a stick to be used, and the left displacements were all smaller than those for the short-distance tasks that used the index finger. Conclusion This finding may be explained by the subjects having sufficient experience coordinating hand and eye movements in the condition where they used their dominant hand and reached with their own arms without using a stick.
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Montaner-Pizá A, Rubio B, Mücher D, Orrigo S, Simpson E, Gelletly W, Agramunt J, Algora A, Bender C, Fujita Y, Ganioglu E, Guadilla V, Hellgartner S, Reichert S. New Results on Excited States in the one-particle one-hole nucleus 56Co measured with MINIBALL detectors. EPJ WEB OF CONFERENCES 2019. [DOI: 10.1051/epjconf/201922301042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The non-yrast states of the odd-odd nucleus 56Co have been investigated by studying the γ-rays induced in the predominantly fusion-evaporation reaction 56Fe(p,n γ)56Co at an incident energy of 10 MeV. The γ-rays were measured in-beam with four high-resolution MINIBALL-triple germanium (Ge) detectors. The experiment provided excellent data in γ-γ coincidences. The complex level scheme of 56Co was constructed mainly based on the analysis of these γ-γ coincidences. The angular distributions of the γ-rays were also analysed and allowed us to assign spin-parity values to most of the excited states in this nucleus. Despite the extensive work previously done studying the 56Co nucleus, the analysis presented in this work has resulted in a large improvement in the knowledge of its structure.
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Nomura T, Takeda M, Peh JT, Miyauchi T, Suzuki S, Fujita Y, Uesugi T, Shimizu H. Loss-of-function mutation in DSG1 underlies focal palmoplantar keratoderma. J Eur Acad Dermatol Venereol 2018; 33:e137-e138. [PMID: 30451323 DOI: 10.1111/jdv.15349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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63
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Gonai T, Toya Y, Nakamura S, Kawasaki K, Yanai S, Fujita Y, Uesugi N, Kimura T, Otsuka K, Sugai T, Matsumoto T. Gastrointestinal: Idiopathic myointimal hyperplasia of mesenteric veins. J Gastroenterol Hepatol 2018; 33:1939. [PMID: 30084114 DOI: 10.1111/jgh.14384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/09/2018] [Indexed: 12/09/2022]
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64
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Nakahara Y, Oizumi S, Mizugaki H, Fujita Y, Harada T, Takashina T, Ko R, Watanabe K, Hotta T, Minemura H, Saeki S, Yagishita S, Hamada A. Phase II trial of afatinib in elderly patients over 75 years of age with EGFR mutation positive NSCLC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy425.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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65
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Seike M, Inoue A, Sugawara S, Morita S, Hosomi Y, Ikeda S, Watanabe K, Takahashi K, Fujita Y, Harada T, Minato K, Takamura K, Kobayashi K, Nukiwa T. Phase III study of gefitinib (G) versus gefitinib+carboplatin+pemetrexed (GCP) as first-line treatment for patients (pts) with advanced non-small cell lung cancer (NSCLC) with EGFR mutations (NEJ009). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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66
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Kawano Y, Sasaki T, Yamaguchi H, Hirano K, Nishio M, Satouchi M, Hosokawa S, Morinaga R, Komiya K, Inoue K, Fujita Y, Toyozawa R, Kimura T, Takahashi K, Nishikawa K, Kishimoto J, Nakanishi Y, Okamoto I. P1.16-21 Phase I / II Study of Carboplatin, Nab-Paclitaxel, and Concurrent Radiotherapy for Patients with Locally Advanced NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.990] [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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67
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Mai Y, Nishie W, Izumi K, Yoshimoto N, Morita Y, Watanabe M, Toyonaga E, Ujiie H, Iwata H, Fujita Y, Nomura T, Sato-Matsumura KC, Shimizu S, Shimizu H. Detection of anti-BP180 NC16A autoantibodies after the onset of dipeptidyl peptidase-IV inhibitor-associated bullous pemphigoid: a report of three patients. Br J Dermatol 2018; 179:790-791. [PMID: 29624639 DOI: 10.1111/bjd.16656] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Okamura T, Kakino A, Miura K, Fujiyoshi A, Kadota A, Fujita Y, Zaid M, Usami Y, Hisamastu T, Horiuchi S, Kunimura A, Sugiyama D, Kondo K, Sawamura T, Ueshima H. 51Serum modified high density lipoprotein levels assessed by a novel assay was associated with coronary artery calcification in an apparently healthy population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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69
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Kakino A, Fujita Y, Horiuchi S, Ke LY, Tsai MH, Chen CH, Sawamura T. P3780Adiponectin forms a complex with electronegative L5 LDL in human plasma and inhibits its atherogenic effects. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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70
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Koyama M, Furuhashi M, Nagano N, Fujita Y, Moniwa N, Yano T, Doi T, Takahashi T, Ohnishi H, Miura T. P3508Cardiac iodine-123 metaiodobenzylguanidine imaging predicts frequent hypotension during hemodialysis in patients with end-stage renal disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miyazawa H, Fujita Y, Iwata H, Ishikawa Y, Nishio S, Ishijima K, Shinmei Y, Takeichi T, Goto K, Oi R, Akiyama M, Shimizu H. Two cases of generalized pustular psoriasis complicated by IgG4-related disease. Br J Dermatol 2018; 179:537-539. [PMID: 29709076 DOI: 10.1111/bjd.16712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Suzuki S, Nomura T, Ohguchi Y, Takeda M, Miyauchi T, Mizuno O, Shinkuma S, Fujita Y, Shimizu H. 804 Readthrough and nonsense-mediated mRNA decay of SERPINB7 nonsense mutant transcripts in Nagashima-type palmoplantar keratosis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.814] [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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Wataya-Kaneda M, Ohno Y, Fujita Y, Yokozeki H, Niizeki H, Ogai M, Fukai K, Nagai H, Yoshida Y, Hamada I, Hio T, Shimizu K, Murota H. 1054 Sirolimus gel treatment for tuberous sclerosis complex involving facial angiofibromas and cephalic plaques: A multicenter randomized controlled trial. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1067] [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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Fujita Y, Matsumura W, Shinkuma S, Takashima S, Suzuki S, Nomura T, Nakamura H, Inoie M, Shimizu H. 524 Cultured epidermal autograft from clinically revertant skin in recessive dystrophic epidermolysis bullosa. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Niimi K, Usami K, Fujita Y, Abe M, Furukawa M, Suyama Y, Sakai Y, Kamioka M, Shibata N, Park EJ, Sato S, Kiyono H, Yoneyama H, Kitazawa H, Watanabe K, Nochi T, Aso H. Development of immune and microbial environments is independently regulated in the mammary gland. Mucosal Immunol 2018; 11:643-653. [PMID: 29346344 DOI: 10.1038/mi.2017.90] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 09/21/2017] [Indexed: 02/04/2023]
Abstract
Breastfeeding is important for mammals, providing immunological and microbiological advantages to neonates, together with the nutritional supply from the mother. However, the mechanisms of this functional diversity in the mammary gland remain poorly characterized. Here, we show that, similar to the gastrointestinal tract, the mammary gland develops immune and microbial environments consisting of immunoglobulin A (IgA) and the microflora, respectively, both of which are important for protecting neonates and the mother from infectious diseases. The IgA production and microflora development are coordinated in the gastrointestinal tract but seem to be independently regulated in the mammary gland. In particular, the chemokine (C-C motif) ligand 28 and poly-Ig receptor, crucial molecules for the IgA production in milk, were expressed normally in germ-free lactating mice but were almost undetectable in postweaning mothers, regardless of the microflora presence. Our findings offer insights into potentially improving the quality of breastfeeding, using both immunological and microbiological approaches.
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