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Zuo X, Liu D. Mechanism of immunomodulatory drug resistance and novel therapeutic strategies in multiple myeloma. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2022; 27:1110-1121. [PMID: 36121114 DOI: 10.1080/16078454.2022.2124694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The mechanism of immunomodulatory drugs (IMiDs) resistance to multiple myeloma (MM) cells has been gradually demonstrated by recently studies, and some potential novel strategies have been confirmed to have antimyeloma activity and be associated with IMiD activity in MM. METHODS This article searched the Pubmed library, reviewed some recently studies related to IMiD resistance to MM cells and summarized some potent agents to improve IMiD resistance to MM cells. RESULTS Studies have confirmed that cereblon is a primary direct protein target of IMiDs. IRF4 not only is affected by the IKZF protein but also can directly inhibit the expression of BMF and BIM, thereby promoting the survival of MM cells. Additionally, the expression of IRF4 and MYC also plays an important role in three important signaling pathways (Wnt, STAT3 and MAPK/ERK) related to IMiD resistance. Notably, MYC, a downstream factor of IRF4, may be upregulated by BRD4, and upregulation of MYC promotes cell proliferation in MM and disease progression. Recently, some novel therapeutic agents targeting BRD4, a histone modification-related 'reader' of epigenetic marks, or other important factors (e.g. TAK1) in relevant signaling pathways have been developed and they may provide new options for relapse/refractory MM therapy, such as BET inhibitors, CBP/EP300 inhibitors, dual-target BET-CBP/EP300 inhibitors, TAK1 inhibitors, and they may provide new options for relapsed/refractory MM therapy. CONCLUSIONS Accumulated studies have revealed that some key factors associated with the mechanism of IMiD resistance to MM cells. Some agents represent promising new therapeutics of MM to regulate the IRF4/MYC axis by inhibiting BRD4 expression or signaling pathway activation.
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Affiliation(s)
- Xiaojia Zuo
- Department of Hematology, Shanghai Gongli Hospital, The Second Military Medical University, Shanghai, People's Republic of China.,Department of Oncology and Hematology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China.,Guizhou Medical University, Guiyang, People's Republic of China
| | - Dingsheng Liu
- Department of Hematology, Shanghai Gongli Hospital, The Second Military Medical University, Shanghai, People's Republic of China
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2
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Håland E, Moen IN, Vandsemb EN, Starheim KK. TAK1-inhibitors did not reduce disease burden in a Vκ*MYC model of multiple myeloma. BMC Res Notes 2022; 15:352. [DOI: 10.1186/s13104-022-06237-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/17/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Objective
Multiple myeloma is a haematological malignancy characterized by proliferation of monoclonal plasma cells in the bone marrow. Development of resistance and minimal residual disease remain challenging in the treatment of multiple myeloma. Transforming growth factor-β activated kinase 1 (TAK1) has recently gained attention as a potential drug target in multiple myeloma. This study aimed at determining the in vivo effects of TAK1-inhibitors in a Vκ*MYC multiple myeloma mouse model.
Results
We treated mice carrying Vκ*MYC multiple myeloma cells with the TAK1-inhibitors 5Z-7-oxozeaenol and NG25. There were tendencies towards increased survival for both inhibitors, but only NG25 prolonged survival significantly. However, this effect was limited, and no differences in disease burden were observed for any of the treatments. In conclusion, although TAK1-inhibitors might prolong survival somewhat, they do not prevent disease in the Vκ*MYC mouse model of multiple myeloma.
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Tenshin H, Teramachi J, Ashtar M, Hiasa M, Inoue Y, Oda A, Tanimoto K, Shimizu S, Higa Y, Harada T, Oura M, Sogabe K, Hara T, Sumitani R, Maruhashi T, Sebe M, Tsutsumi R, Sakaue H, Endo I, Matsumoto T, Tanaka E, Abe M. TGF‐β‐activated kinase‐1 inhibitor LL‐Z1640‐2 reduces joint inflammation and bone destruction in mouse models of rheumatoid arthritis by inhibiting NLRP3 inflammasome, TACE, TNF‐α and RANKL expression. Clin Transl Immunology 2022; 11:e1371. [PMID: 35079379 PMCID: PMC8770968 DOI: 10.1002/cti2.1371] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/29/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023] Open
Affiliation(s)
- Hirofumi Tenshin
- Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Jumpei Teramachi
- Department of Oral Function and Anatomy, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan
| | - Mohannad Ashtar
- Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Masahiro Hiasa
- Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Yusuke Inoue
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Asuka Oda
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Kotaro Tanimoto
- Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - So Shimizu
- Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Yoshiki Higa
- Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Takeshi Harada
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Masahiro Oura
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Kimiko Sogabe
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Tomoyo Hara
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Ryohei Sumitani
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Tomoko Maruhashi
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Mayu Sebe
- Department of Nutrition and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Rie Tsutsumi
- Department of Nutrition and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Hiroshi Sakaue
- Department of Nutrition and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Itsuro Endo
- Department of Bioregulatory Sciences Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Toshio Matsumoto
- Fujii Memorial Institute of Medical Sciences Tokushima University Tokushima Japan
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
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Håland E, Moen IN, Veidal E, Hella H, Misund K, Slørdahl TS, Starheim KK. TAK1-inhibitors are cytotoxic for multiple myeloma cells alone and in combination with melphalan. Oncotarget 2021; 12:2158-2168. [PMID: 34676048 PMCID: PMC8522844 DOI: 10.18632/oncotarget.28073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022] Open
Abstract
Multiple myeloma (MM) is an incurable cancer caused by malignant transformation of plasma cells. Transforming growth factor-β activated kinase 1 (MAP3K7, TAK1) is a major regulator of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and mitogen-activated protein kinase (MAPK) signaling. Both NF-κB and MAPK control expression of genes with vital roles for drug resistance in MM. TAK1 is an attractive drug target as it switches these survival pathways to cell death. Our analysis showed that patients with high MAP3K7 expression in the tumor had shorter overall and progression free survival. The TAK1-inhibitors NG25 and 5Z-7-oxozeaenol (5Z-7) were cytotoxic to MM cell lines and patient cells. NG25 reduced expression of MYC and E2F controlled genes, involved in tumor cell growth, cell cycle progression and drug resilience. TAK1 can be activated by genotoxic stress. NG25 and 5Z-7 induced both synergistic and additive cytotoxicity in combination with the alkylating agent melphalan. Melphalan activated TAK1, NF-κB, and the MAPKs p38 and c-Jun N-terminal kinase (JNK), as well as a transcriptional UV-response. This was blocked by NG25, and instead apoptosis was activated. MM induce elevated bone-degradation resulting in myeloma bone disease (MBD), which is the main cause of disability and morbidity in MM patients. NG25 and 5Z-7 reduced differentiation and viability of human bone degrading osteoclasts, suggesting that TAK1-inhibition can have a double beneficial effect for patients. In sum, TAK1 is a promising drug target for MM treatment.
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Affiliation(s)
- Erling Håland
- CEMIR Centre of Molecular Inflammation Research, IKOM, NTNU, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Ingrid Nyhus Moen
- CEMIR Centre of Molecular Inflammation Research, IKOM, NTNU, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Hematology, St. Olavs University Hospital, Trondheim, Norway
| | - Elias Veidal
- CEMIR Centre of Molecular Inflammation Research, IKOM, NTNU, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Hanne Hella
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Kristine Misund
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Tobias S Slørdahl
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Hematology, St. Olavs University Hospital, Trondheim, Norway
| | - Kristian K Starheim
- CEMIR Centre of Molecular Inflammation Research, IKOM, NTNU, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Hematology, St. Olavs University Hospital, Trondheim, Norway
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Myeloma-Bone Interaction: A Vicious Cycle via TAK1-PIM2 Signaling. Cancers (Basel) 2021; 13:cancers13174441. [PMID: 34503251 PMCID: PMC8431187 DOI: 10.3390/cancers13174441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Myeloma cells interact with their ambient cells in the bone, such as bone marrow stromal cells, osteoclasts, and osteocytes, resulting in enhancement of osteoclastogenesis and inhibition of osteoblastogenesis while enhancing their growth and drug resistance. The activation of the TAK1–PIM2 signaling axis appears to be vital for this mutual interaction, posing it as an important therapeutic target to suppress tumor expansion and ameliorate bone destruction in multiple myeloma. Abstract Multiple myeloma (MM) has a propensity to develop preferentially in bone and form bone-destructive lesions. MM cells enhance osteoclastogenesis and bone resorption through activation of the RANKL–NF-κB signaling pathway while suppressing bone formation by inhibiting osteoblastogenesis from bone marrow stromal cells (BMSCs) by factors elaborated in the bone marrow and bone in MM, including the soluble Wnt inhibitors DKK-1 and sclerostin, activin A, and TGF-β, resulting in systemic bone destruction with loss of bone. Osteocytes have been drawn attention as multifunctional regulators in bone metabolism. MM cells induce apoptosis in osteocytes to trigger the production of factors, including RANKL, sclerostin, and DKK-1, to further exacerbate bone destruction. Bone lesions developed in MM, in turn, provide microenvironments suited for MM cell growth/survival, including niches to foster MM cells and their precursors. Thus, MM cells alter the microenvironments through bone destruction in the bone where they reside, which in turn potentiates tumor growth and survival, thereby generating a vicious loop between tumor progression and bone destruction. The serine/threonine kinases PIM2 and TAK1, an upstream mediator of PIM2, are overexpressed in bone marrow stromal cells and osteoclasts as well in MM cells in bone lesions. Upregulation of the TAK1–PIM2 pathway plays a critical role in tumor expansion and bone destruction, posing the TAK1–PIM2 pathway as a pivotal therapeutic target in MM.
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6
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Teramachi J, Tenshin H, Hiasa M, Oda A, Bat-Erdene A, Harada T, Nakamura S, Ashtar M, Shimizu S, Iwasa M, Sogabe K, Oura M, Fujii S, Kagawa K, Miki H, Endo I, Haneji T, Matsumoto T, Abe M. TAK1 is a pivotal therapeutic target for tumor progression and bone destruction in myeloma. Haematologica 2021; 106:1401-1413. [PMID: 32273474 PMCID: PMC8094086 DOI: 10.3324/haematol.2019.234476] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Indexed: 12/31/2022] Open
Abstract
Along with tumor progression, the bone marrow microenvironment is skewed in multiple myeloma (MM), which underlies the unique pathophysiology of MM and confers aggressiveness and drug resistance in MM cells. TGF-b-activated kinase-1 (TAK1) mediates a wide range of intracellular signaling pathways. We demonstrate here that TAK1 is constitutively overexpressed and phosphorylated in MM cells, and that TAK1 inhibition suppresses the activation of NF-κB, p38MAPK, ERK and STAT3 in order to decrease the expression of critical mediators for MM growth and survival, including PIM2, MYC, Mcl- 1, IRF4, and Sp1, along with a substantial reduction in the angiogenic factor VEGF in MM cells. Intriguingly, TAK1 phosphorylation was also induced along with upregulation of vascular cell adhesion molecule-1 (VCAM-1) in bone marrow stromal cells (BMSC) in cocultures with MM cells, which facilitated MM cell-BMSC adhesion while inducing IL-6 production and receptor activator of nuclear factor κ-B ligand (RANKL) expression by BMSC. TAK1 inhibition effectively impaired MM cell adhesion to BMSC to disrupt the support of MM cell growth and survival by BMSC. Furthermore, TAK1 inhibition suppressed osteoclastogenesis enhanced by RANKL in cocultures of bone marrow cells with MM cells, and restored osteoblastic differentiation suppressed by MM cells or inhibitory factors for osteoblastogenesis overproduced in MM. Finally, treatment with the TAK1 inhibitor LLZ1640-2 markedly suppressed MM tumor growth and prevented bone destruction and loss in mouse MM models. Therefore, TAK1 inhibition may be a promising therapeutic option targeting not only MM cells but also the skewed bone marrow microenvironment in MM.
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Affiliation(s)
- Jumpei Teramachi
- Dept. of Histology-Oral Histology and Dept. of Hematology, Tokushima University,Tokushima, Japan
| | - Hirofumi Tenshin
- Dept. of Hematology and Orthodontics and Dentofacial Orthopedics,Tokushima University, Japan
| | - Masahiro Hiasa
- Dept. of Hematology and Orthodontics and Dentofacial Orthopedics,Tokushima University, Japan
| | - Asuka Oda
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Ariunzaya Bat-Erdene
- Dept of Hematology, Tokushima University and University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Takeshi Harada
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Shingen Nakamura
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Mohannad Ashtar
- Dept. of Hematology and Orthodontics and Dentofacial Orthopedics,Tokushima University, Japan
| | - So Shimizu
- Dept. of Hematology and Orthodontics and Dentofacial Orthopedics,Tokushima University, Japan
| | - Masami Iwasa
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Kimiko Sogabe
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Masahiro Oura
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Shiro Fujii
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Kumiko Kagawa
- Department of Hematology, Tokushima University, Tokushima, Japan
| | - Hirokazu Miki
- Division of Transfusion Medicine and Cell Therapy, Tokushima University Hospital, Tokushima, Japan
| | - Itsuro Endo
- Department of Chronomedicine, Tokushima University, Tokushima, Japan
| | - Tatsuji Haneji
- Department of Histology and Oral Histology, Tokushima University, Tokushima, Japan
| | - Toshio Matsumoto
- Fujii Memorial Institute of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Masahiro Abe
- Department of Hematology, Tokushima University, Tokushima, Japan
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7
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Ashtar M, Tenshin H, Teramachi J, Bat-Erdene A, Hiasa M, Oda A, Tanimoto K, Shimizu S, Higa Y, Harada T, Oura M, Sogabe K, Nakamura S, Fujii S, Sumitani R, Miki H, Udaka K, Takahashi M, Kagawa K, Endo I, Tanaka E, Matsumoto T, Abe M. The Roles of ROS Generation in RANKL-Induced Osteoclastogenesis: Suppressive Effects of Febuxostat. Cancers (Basel) 2020; 12:E929. [PMID: 32283857 PMCID: PMC7226249 DOI: 10.3390/cancers12040929] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022] Open
Abstract
Receptor activator of NF-κB ligand (RANKL), a critical mediator of osteoclastogenesis, is upregulated in multiple myeloma (MM). The xanthine oxidase inhibitor febuxostat, clinically used for prevention of tumor lysis syndrome, has been demonstrated to effectively inhibit not only the generation of uric acid but also the formation of reactive oxygen species (ROS). ROS has been demonstrated to mediate RANKL-mediated osteoclastogenesis. In the present study, we therefore explored the role of cancer-treatment-induced ROS in RANKL-mediated osteoclastogenesis and the suppressive effects of febuxostat on ROS generation and osteoclastogenesis. RANKL dose-dependently induced ROS production in RAW264.7 preosteoclastic cells; however, febuxostat inhibited the RANKL-induced ROS production and osteoclast (OC) formation. Interestingly, doxorubicin (Dox) further enhanced RANKL-induced osteoclastogenesis through upregulation of ROS production, which was mostly abolished by addition of febuxostat. Febuxostat also inhibited osteoclastogenesis enhanced in cocultures of bone marrow cells with MM cells. Importantly, febuxostat rather suppressed MM cell viability and did not compromise Dox's anti-MM activity. In addition, febuxostat was able to alleviate pathological osteoclastic activity and bone loss in ovariectomized mice. Collectively, these results suggest that excessive ROS production by aberrant RANKL overexpression and/or anticancer treatment disadvantageously impacts bone, and that febuxostat can prevent the ROS-mediated osteoclastic bone damage.
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Affiliation(s)
- Mohannad Ashtar
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Oral Sciences, Tokushima 770-8503, Japan; (M.A.); (K.T.); (S.S.); (Y.H.)
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Hirofumi Tenshin
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (M.H.); (E.T.)
| | - Jumpei Teramachi
- Department of Tissue Regeneration, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan;
| | - Ariunzaya Bat-Erdene
- Department of Immunology, School of Bio-Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia;
| | - Masahiro Hiasa
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (M.H.); (E.T.)
| | - Asuka Oda
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Kotaro Tanimoto
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Oral Sciences, Tokushima 770-8503, Japan; (M.A.); (K.T.); (S.S.); (Y.H.)
| | - So Shimizu
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Oral Sciences, Tokushima 770-8503, Japan; (M.A.); (K.T.); (S.S.); (Y.H.)
| | - Yoshiki Higa
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Oral Sciences, Tokushima 770-8503, Japan; (M.A.); (K.T.); (S.S.); (Y.H.)
| | - Takeshi Harada
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Masahiro Oura
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Kimiko Sogabe
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Shingen Nakamura
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Shiro Fujii
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Ryohei Sumitani
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Hirokazu Miki
- Division of Transfusion Medicine and Cell Therapy, Tokushima University Hospital, Tokushima 770-8503, Japan;
| | - Kengo Udaka
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Mamiko Takahashi
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Kumiko Kagawa
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
| | - Itsuro Endo
- Department of Chronomedicine, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan;
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (M.H.); (E.T.)
| | - Toshio Matsumoto
- Fujii Memorial Institute of Medical Sciences, Tokushima University, Tokushima 770-8503, Japan;
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan; (A.O.); (T.H.); (M.O.); (K.S.); (S.N.); (S.F.); (R.S.); (K.U.); (M.T.); (K.K.)
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