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Mori M, Yoshii S, Noguchi M, Takagi D, Shimizu T, Ito H, Matsuo-Takasaki M, Nakamura Y, Takahashi S, Hamada H, Ohnuma K, Shiohama T, Hayashi Y. Generation of human induced pluripotent stem cell lines derived from four Rett syndrome patients with MECP2 mutations. Stem Cell Res 2024; 77:103432. [PMID: 38703668 DOI: 10.1016/j.scr.2024.103432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/16/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
Rett syndrome is characterized by severe global developmental impairments with autistic features and loss of purposeful hand skills. Here we show that human induced pluripotent stem cell (hiPSC) lines derived from four Japanese female patients with Rett syndrome are generated from peripheral blood mononuclear cells using Sendai virus vectors. The generated hiPSC lines showed self-renewal and pluripotency and carried heterozygous frameshift, missense, or nonsense mutations in the MECP2 gene. Since the molecular pathogenesis caused by MECP2 dysfunction remains unclear, these cell resources are useful tools to establish disease models and develop new therapies for Rett syndrome.
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Affiliation(s)
- Miyu Mori
- iPS Cell Advanced Characterization and Development Team, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan; Department of Materials Science and Bioengineering, Nagaoka University of Technology, 1603-1 Kami-Tomioka, Nagaoka, Niigata 940-2188, Japan
| | - Shoko Yoshii
- Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-0856, Japan
| | - Michiya Noguchi
- Cell Engineering Division, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
| | - Daigo Takagi
- iPS Cell Advanced Characterization and Development Team, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
| | - Tomoya Shimizu
- iPS Cell Advanced Characterization and Development Team, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
| | - Hidenori Ito
- iPS Cell Advanced Characterization and Development Team, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
| | - Mami Matsuo-Takasaki
- iPS Cell Advanced Characterization and Development Team, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
| | - Yukio Nakamura
- Cell Engineering Division, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
| | - Satoru Takahashi
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa City, Hokkaido 078-8510, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-0856, Japan
| | - Kiyoshi Ohnuma
- Department of Materials Science and Bioengineering, Nagaoka University of Technology, 1603-1 Kami-Tomioka, Nagaoka, Niigata 940-2188, Japan; Department of Science of Technology Innovation, Nagaoka University of Technology, 1603-1 Kami-Tomioka, Nagaoka, Niigata 940-2188, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-0856, Japan.
| | - Yohei Hayashi
- iPS Cell Advanced Characterization and Development Team, BioResource Research Center, RIKEN, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan.
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Nakamura H, Kikuchi A, Sakai H, Kamimura M, Watanabe Y, Onuma R, Takayama J, Tamiya G, Mashimo Y, Ebata R, Hamada H, Suenaga T, Onouchi Y, Kumaki S. Case Report: Identification of a CARD8 variant in all three patients with PFAPA syndrome complicated with Kawasaki disease. Front Pediatr 2024; 12:1340263. [PMID: 38510083 PMCID: PMC10952825 DOI: 10.3389/fped.2024.1340263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Background Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA syndrome), and Kawasaki disease (KD) are both considered to be disorders of the innate immune system, and the potential role of inflammasome activation in the immunopathogenesis of both diseases has been previously described. Case presentation Herein, we report the clinical courses of three patients who presented a rare combination of PFAPA syndrome and KD. Two patients who presented KD later developed the PFAPA syndrome, of whom one developed recurrent KD 2 years after the initial diagnosis. The third patient developed KD one year after the onset of PFAPA syndrome. The presence of both of these conditions within individual patients, combined with the knowledge that inflammasome activation is involved in both PFAPA syndrome and KD, suggests a shared background of inflammatory dysregulation. To elucidate the mechanism underlying shared inflammatory dysregulation, we investigated the roles of Nod-like receptors (NLRs) and their downstream inflammasome-related genes. All the patients had a frameshift variant in CARD8 (CARD8-FS). A previous study demonstrated a higher frequency of CARD8-FS, whose product loses CARD8 activity and activates the NLRP3 inflammasome, in patients with the PFAPA syndrome. Additionally, the NLRP3 inflammasome is known to be activated in patients with KD. Together, these results suggest that the CARD8-FS variant may also be essential in KD pathogenesis. As such, we analyzed the CARD8 variants among patients with KD. However, we found no difference in the variant frequency between patients with KD and the general Japanese population. Conclusions We report the clinical courses of three patients with a rare combination of PFAPA syndrome and KD. All the patients had the CARD8-FS variant. However, we could not find a difference in the variant frequency between patients with KD and the general Japanese population. As the frequency of KD is much higher than that of PFAPA among Japanese patients, and the cause of KD is multifactorial, it is possible that only a small portion of patients with KD harbor CARD8-FS as a causative gene.
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Affiliation(s)
- Haruhiko Nakamura
- Department of Pediatrics, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Atsuo Kikuchi
- Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan
| | - Hideyuki Sakai
- Department of Pediatrics, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Miki Kamimura
- Department of Pediatrics, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Yohei Watanabe
- Department of Pediatrics, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Ryoichi Onuma
- Department of Pediatrics, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Jun Takayama
- Department of Rare Disease Genomics, Tohoku University School of Medicine, Sendai, Japan
- Department of AI and Innovative Medicine, Tohoku University School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Gen Tamiya
- Department of Rare Disease Genomics, Tohoku University School of Medicine, Sendai, Japan
- Department of AI and Innovative Medicine, Tohoku University School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Yoichi Mashimo
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ryota Ebata
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Tomohiro Suenaga
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Satoru Kumaki
- Department of Pediatrics, National Hospital Organization Sendai Medical Center, Sendai, Japan
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Michitsuji T, Fukui S, Morimoto S, Endo Y, Nishino A, Nishihata S, Tsuji Y, Shimizu T, Umeda M, Sumiyoshi R, Koga T, Iwamoto N, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Ohtsubo H, Takaoka H, Hamada H, Tsuru T, Nawata M, Arinobu Y, Hidaka T, Tada Y, Kawakami A, Kawashiri SY. Clinical and ultrasound features of difficult-to-treat rheumatoid arthritis: A multicenter RA ultrasound cohort study. Scand J Rheumatol 2024; 53:123-129. [PMID: 38085537 DOI: 10.1080/03009742.2023.2277542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/27/2023] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The optimal strategy for difficult-to-treat (D2T) rheumatoid arthritis (RA) has not been identified, and the ultrasound characteristics of D2T RA have not been reported. We investigated the clinical characteristics and factors contributing to the outcome in D2T RA in a multicentre RA ultrasound observational cohort. METHOD We reviewed 307 Japanese patients diagnosed with RA who underwent treatment with biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). We compared the differences in patient characteristics between the D2T RA and non-D2T RA groups. We examined the factors contributing to a good response [defined as b/tsDMARD continuation and Clinical Disease Activity Index (CDAI) ≤ 10 at 12 months] in the D2T RA patient group. RESULTS Forty-three patients (14%) were categorized as D2T RA and the remaining 264 (86%) as non-D2T RA at baseline. The grey-scale (GS) score, disease duration, and CDAI at the initiation of treatment were significantly higher in the D2T RA group than in the non-D2T RA group. In contrast, the power Doppler (PD) score was not significantly different between the two groups. Of the 43 D2T RA patients, 20 achieved a good response. The introduction of CTLA4-Ig (n = 5) was significantly associated with a good response in analysis based on inverse probability weighting with propensity score. GS and PD scores at baseline were not significantly associated with therapeutic response at 12 months in D2T RA patients. CONCLUSIONS Patients with D2T RA had high clinical and ultrasound activity and poor responses to treatment with b/tsDMARDs. CTLA4-Ig was associated with a good response at 12 months in D2T RA patients.
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Affiliation(s)
- T Michitsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Fukui
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Morimoto
- Innovation Platform & Office for Precision Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Y Endo
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Nishino
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - S Nishihata
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Y Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M Umeda
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - R Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - N Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Y Ueki
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Yoshitama
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Eiraku
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Matsuoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Okada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - K Fujikawa
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Ohtsubo
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Takaoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Hamada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Tsuru
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - M Nawata
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Arinobu
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Hidaka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Tada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S-Y Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Center for Collaborative Medical Education and Development, Nagasaki University Institute of Biomedical Sciences, Nagasaki, Japan
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4
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Okunushi K, Kobayashi H, Yoh Y, Kunimatsu M, Shiohama T, Takatani T, Hamada H. A case report of a child with pulmonary hypertension associated with SARS-CoV-2 infection. Front Pediatr 2024; 12:1336589. [PMID: 38390278 PMCID: PMC10881764 DOI: 10.3389/fped.2024.1336589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
We encountered a pediatric case of pulmonary hypertension triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 14-year-old girl was brought to the emergency department of our hospital with fever, respiratory distress, and impaired consciousness. She tested positive for SARS-CoV-2 upon a polymerase chain reaction examination and had prolonged hypoxemia without pneumonia. An echocardiography revealed elevated right ventricular pressure. She was diagnosed with pilocytic astrocytoma at the age of 10 years and underwent a resection of a pituitary tumor. Hormone replacement therapy was administered postoperatively, but her growth hormones were not activated because of concerns about tumor recurrence. Echocardiography at the age of 13 years showed normal right ventricular pressure. On admission, she had an abnormal liver function, elevated liver fibrosis markers, a decreased platelet count, and hepatosplenomegaly, suggesting pulmonary and portal hypertension. The diagnosis was pulmonary hypertension associated with SARS-CoV-2 infection. The mechanism of the pulmonary hypertension was thought to be portal hypertension owing to growth hormone deficiency and SARS-CoV-2 infection. The patient's symptoms improved with oxygenation and bed rest without additional targeted pulmonary hypertension therapy, and her right ventricular pressure decreased. This case demonstrates that a pediatric patient with subclinical pulmonary hypertension may develop pulmonary hypertension triggered by SARS-CoV-2 infection.
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Affiliation(s)
- Kentaro Okunushi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hironobu Kobayashi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuri Yoh
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaya Kunimatsu
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomozumi Takatani
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
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5
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Murayama Y, Hamada H, Shiko Y, Onouchi Y, Kakimoto N, Ozawa Y, Hanaoka H, Hata A, Suzuki H. Risk factors for coronary artery abnormalities and resistance to immunoglobulin plus ciclosporin A therapy in severe Kawasaki disease: subanalysis of the KAICA trial, randomized trial for cicrosporin A as the first-line treatment. Front Pediatr 2023; 11:1321533. [PMID: 38161433 PMCID: PMC10755003 DOI: 10.3389/fped.2023.1321533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Background To investigate risk factors for coronary arterial abnormalities (CAAs) and resistance to treatment in patients with Kawasaki disease (KD) receiving intravenous immunoglobulin (IVIG) plus ciclosporin A (CsA) as the first-line treatment, we performed a subanalysis of baseline data of participants in the KAICA trial, a phase 3, randomized study (JMA-ILA00174). Methods All data of the patients enrolled in the KAICA trial, who had a Gunma score ≥5 at diagnosis and had been randomly assigned to either IVIG (2 g/kg/24 h) plus CsA (5 mg/kg/day for 5 days) (n = 86) or IVIG alone (n = 87), were subjected to this study. CAA was defined by a Z score ≥2.5 observed within 4 weeks after treatment initiation. Baseline data including genotypes of KD susceptibility genes were compared between subgroups of patients for CAA or treatment response for each treatment group. Backword-forward stepwise logistic regression analyses were performed. Results Pre-Z-max, defined as the maximum among Z scores on four coronary artery branches before treatment, was higher in patients with CAA in both treatment groups and was associated with CAA in IVIG plus CsA treatment group [odds ratio (OR) = 17.0]. High serum total bilirubin level was relevant to treatment resistance only in the IVIG plus CsA group (OR = 2.34). Conclusions Coronary artery enlargement before treatment is a major determinant of CAA even in KD patients treated with initial IVIG treatment intensified by addition of CsA. Baseline serum total bilirubin level was a risk factor associated with resistance to IVIG plus CsA.
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Affiliation(s)
- Yuri Murayama
- Department of Pediatrics, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuki Shiko
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuyuki Kakimoto
- Department of Pediatrics, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoshihito Ozawa
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Hideki Hanaoka
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Akira Hata
- Department of Public Health, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, School of Medicine, Wakayama Medical University, Wakayama, Japan
- Division of Pediatrics, Tsukushi Medical and Welfare Center, Iwade, Japan
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Yu X, Yang MC, Jindal AK, Alias A, Hung LC, Lin MT, Singh S, Hamada H. A collaborative study for incomplete Kawasaki disease in Asia. Int J Rheum Dis 2023; 26:2589-2591. [PMID: 37403835 DOI: 10.1111/1756-185x.14812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Xianyi Yu
- Asian Kawasaki Disease Clinical Research Network, Chiba, Japan
| | - Ming-Chun Yang
- Asian Kawasaki Disease Clinical Research Network, Chiba, Japan
| | | | - Amelia Alias
- Asian Kawasaki Disease Clinical Research Network, Chiba, Japan
| | - Liang-Choo Hung
- Asian Kawasaki Disease Clinical Research Network, Chiba, Japan
| | - Ming-Tai Lin
- Asian Kawasaki Disease Clinical Research Network, Chiba, Japan
| | - Surjit Singh
- Asian Kawasaki Disease Clinical Research Network, Chiba, Japan
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Sawada D, Kato H, Kaneko H, Kinoshita D, Funayama S, Minamizuka T, Takasaki A, Igarashi K, Koshizaka M, Takada-Watanabe A, Nakamura R, Aono K, Yamaguchi A, Teramoto N, Maeda Y, Ohno T, Hayashi A, Ide K, Ide S, Shoji M, Kitamoto T, Endo Y, Ogata H, Kubota Y, Mitsukawa N, Iwama A, Ouchi Y, Takayama N, Eto K, Fujii K, Takatani T, Shiohama T, Hamada H, Maezawa Y, Yokote K. Senescence-associated inflammation and inhibition of adipogenesis in subcutaneous fat in Werner syndrome. Aging (Albany NY) 2023; 15:9948-9964. [PMID: 37793000 PMCID: PMC10599740 DOI: 10.18632/aging.205078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/06/2023] [Indexed: 10/06/2023]
Abstract
Werner syndrome (WS) is a hereditary premature aging disorder characterized by visceral fat accumulation and subcutaneous lipoatrophy, resulting in severe insulin resistance. However, its underlying mechanism remains unclear. In this study, we show that senescence-associated inflammation and suppressed adipogenesis play a role in subcutaneous adipose tissue reduction and dysfunction in WS. Clinical data from four Japanese patients with WS revealed significant associations between the decrease of areas of subcutaneous fat and increased insulin resistance measured by the glucose clamp. Adipose-derived stem cells from the stromal vascular fraction derived from WS subcutaneous adipose tissues (WSVF) showed early replicative senescence and a significant increase in the expression of senescence-associated secretory phenotype (SASP) markers. Additionally, adipogenesis and insulin signaling were suppressed in WSVF, and the expression of adipogenesis suppressor genes and SASP-related genes was increased. Rapamycin, an inhibitor of the mammalian target of rapamycin (mTOR), alleviated premature cellular senescence, rescued the decrease in insulin signaling, and extended the lifespan of WS model of C. elegans. To the best of our knowledge, this study is the first to reveal the critical role of cellular senescence in subcutaneous lipoatrophy and severe insulin resistance in WS, highlighting the therapeutic potential of rapamycin for this disease.
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Affiliation(s)
- Daisuke Sawada
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hisaya Kato
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Hiyori Kaneko
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Daisuke Kinoshita
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichiro Funayama
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takuya Minamizuka
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Atsushi Takasaki
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Katsushi Igarashi
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Masaya Koshizaka
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Aki Takada-Watanabe
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Rito Nakamura
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kazuto Aono
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Ayano Yamaguchi
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Naoya Teramoto
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Yukari Maeda
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Tomohiro Ohno
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Aiko Hayashi
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Kana Ide
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Shintaro Ide
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Mayumi Shoji
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Takumi Kitamoto
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Yusuke Endo
- Laboratory of Medical Omics Research, Kazusa DNA Research Institute, Kisarazu, Japan
- Department of Omics Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideyuki Ogata
- Department of Plastic, Reconstructive, And Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshitaka Kubota
- Department of Plastic, Reconstructive, And Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuyuki Mitsukawa
- Department of Plastic, Reconstructive, And Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Iwama
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yasuo Ouchi
- Department of Regenerative Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Naoya Takayama
- Department of Regenerative Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koji Eto
- Department of Regenerative Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Katsunori Fujii
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
- Department of Pediatrics, International University of Welfare and Health School of Medicine, Narita, Japan
| | - Tomozumi Takatani
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
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Shiohama T, Maikusa N, Kawaguchi M, Natsume J, Hirano Y, Saito K, Takanashi JI, Levman J, Takahashi E, Matsumoto K, Yokota H, Hattori S, Tsujimura K, Sawada D, Uchida T, Takatani T, Fujii K, Naganawa S, Sato N, Hamada H. A Brain Morphometry Study with Across-Site Harmonization Using a ComBat-Generalized Additive Model in Children and Adolescents. Diagnostics (Basel) 2023; 13:2774. [PMID: 37685313 PMCID: PMC10487204 DOI: 10.3390/diagnostics13172774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Regional anatomical structures of the brain are intimately connected to functions corresponding to specific regions and the temporospatial pattern of genetic expression and their functions from the fetal period to old age. Therefore, quantitative brain morphometry has often been employed in neuroscience investigations, while controlling for the scanner effect of the scanner is a critical issue for ensuring accuracy in brain morphometric studies of rare orphan diseases due to the lack of normal reference values available for multicenter studies. This study aimed to provide across-site normal reference values of global and regional brain volumes for each sex and age group in children and adolescents. We collected magnetic resonance imaging (MRI) examinations of 846 neurotypical participants aged 6.0-17.9 years (339 male and 507 female participants) from 5 institutions comprising healthy volunteers or neurotypical patients without neurological disorders, neuropsychological disorders, or epilepsy. Regional-based analysis using the CIVET 2.1.0. pipeline provided regional brain volumes, and the measurements were across-site combined using ComBat-GAM harmonization. The normal reference values of global and regional brain volumes and lateral indices in our study could be helpful for evaluating the characteristics of the brain morphology of each individual in a clinical setting and investigating the brain morphology of ultra-rare diseases.
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Affiliation(s)
- Tadashi Shiohama
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Norihide Maikusa
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo 108-8639, Japan
- Department of Radiology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Masahiro Kawaguchi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Aichi, Japan; (M.K.)
| | - Jun Natsume
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Aichi, Japan; (M.K.)
- Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Aichi, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita 565-0871, Osaka, Japan
| | - Keito Saito
- Department of Pediatrics and Pediatric Neurology, Tokyo Women’s Medical University Yachiyo Medical Center, 477-96 Owadashinden, Yachiyo-shi 276-8524, Chiba, Japan
| | - Jun-ichi Takanashi
- Department of Pediatrics and Pediatric Neurology, Tokyo Women’s Medical University Yachiyo Medical Center, 477-96 Owadashinden, Yachiyo-shi 276-8524, Chiba, Japan
| | - Jacob Levman
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
- Department of Mathematics, Statistics and Computer Science, St. Francis Xavier University, 5005 Chapel Square, Antigonish, NS B2G 2W5, Canada
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA
- Nova Scotia Health Authority—Research, Innovation and Discovery Center for Clinical Research, 5790 University Avenue, Halifax, NS B3H 1V7, Canada
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
| | - Hajime Yokota
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
| | - Shinya Hattori
- Department of Radiology, Chiba University Hospital, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
| | - Keita Tsujimura
- Group of Brain Function and Development, Neuroscience Institute of the Graduate School of Science, Nagoya University, Nagoya 466-8550, Aichi, Japan
- Research Unit for Developmental Disorders, Institute for Advanced Research, Nagoya University, Nagoya 466-8550, Aichi, Japan
| | - Daisuke Sawada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
| | - Tomoko Uchida
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
| | - Tomozumi Takatani
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
| | - Katsunori Fujii
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
- Department of Pediatrics, International University of Welfare and Health School of Medicine, Narita 286-8520, Chiba, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Aichi, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba-shi 260-8677, Chiba, Japan
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Yoh Y, Shiohama T, Uchida T, Ebata R, Kobayashi H, Okunushi K, Kato M, Watanabe K, Nakashima M, Saitsu H, Hamada H. Case report: Progressive pulmonary artery hypertension in a case of megalencephaly-capillary malformation syndrome. Front Genet 2023; 14:1221745. [PMID: 37614820 PMCID: PMC10442816 DOI: 10.3389/fgene.2023.1221745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Abstract
Megalencephaly-capillary malformation syndrome (MCAP, OMIM # 602501) is caused by hyperactivity of the thephosphoinositide-3-kinase (PI3K)-Vakt murine thymoma viral oncogene homolog (AKT)-mammalian target of rapamycin (mTOR) pathway, which results in megalencephaly, capillary malformations, asymmetrical overgrowth, and connective tissue dysplasia. Herein, we report the case of a 7-month-old girl with MCAP due to a PIK3CA somatic mosaic variant who presented with atrial tachycardia, finally diagnosed as pulmonary arterial hypertension (PAH). Oxygen therapy and sildenafil decreased pulmonary blood pressure and improved atrial tachycardia. Previous studies reported an association between the PI3K/AKT/mTOR pathway and abnormal pulmonary arterial smooth muscle cell proliferation, which may be associated with PAH. PAH should be considered a potentially lethal complication in MCAP patients, even when no structural cardiac abnormalities are identified in the neonatal period.
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Affiliation(s)
- Yuri Yoh
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Tomoko Uchida
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Ryota Ebata
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | | | - Kentaro Okunushi
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Kazuki Watanabe
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mitsuko Nakashima
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hirotomo Saitsu
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
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10
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Yoshii S, Takatani T, Shiohama T, Takatani R, Konda Y, Hattori S, Yokota H, Hamada H. Brain structure alterations in girls with central precocious puberty. Front Neurosci 2023; 17:1215492. [PMID: 37547150 PMCID: PMC10398388 DOI: 10.3389/fnins.2023.1215492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Purpose Central precocious puberty (CPP) is puberty that occurs at an unusually early age with several negative psychological outcomes. There is a paucity of data on the morphological characteristics of the brain in CPP. This study aimed to determine the structural differences in the brain of patients with CPP. Methods We performed voxel- and surface-based morphometric analyses of 1.5 T T1-weighted brain images scanned from 15 girls with CPP and 13 age-matched non-CPP controls (NC). All patients with CPP were diagnosed by gonadotropin-releasing hormone (GnRH) stimulation test. The magnetic resonance imaging (MRI) data were evaluated using Levene's test for equality of variances and a two-tailed unpaired t-test for equality of means. False discovery rate correction for multiple comparisons was applied using the Benjamini-Hochberg procedure. Results Morphometric analyses of the brain scans identified 33 candidate measurements. Subsequently, increased thickness of the right precuneus was identified in the patients with CPP using general linear models and visualizations of cortical thickness with a t-statistical map and a random field theory map. Conclusion The brain scans of the patients with CPP showed specific morphological differences to those of the control. The features of brain morphology in CPP identified in this study could contribute to further understanding the association between CPP and detrimental psychological outcomes.
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Affiliation(s)
- Shoko Yoshii
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomozumi Takatani
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Rieko Takatani
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yutaka Konda
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shinya Hattori
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Hajime Yokota
- Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
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11
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Kobayashi H, Kimura MY, Hasegawa I, Suganuma E, Ikehara Y, Azuma K, Ito T, Ebata R, Kurashima Y, Kawasaki Y, Shiko Y, Saito N, Iwase H, Lee Y, Noval Rivas M, Arditi M, Zuka M, Hamada H, Nakayama T. Increased Myosin light chain 9 expression during Kawasaki disease vasculitis. Front Immunol 2023; 13:1036672. [PMID: 36685558 PMCID: PMC9853906 DOI: 10.3389/fimmu.2022.1036672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Kawasaki disease (KD) is an acute systemic vasculitis that predominantly afflicts children. KD development is known to be associated with an aberrant immune response and abnormal platelet activation, however its etiology is still largely unknown. Myosin light chain 9 (Myl9) is known to regulate cellular contractility of both non-muscle and smooth muscle cells, and can be released from platelets, whereas any relations of Myl9 expression to KD vasculitis have not been examined. Methods Plasma Myl9 concentrations in KD patients and children with febrile illness were measured and associated with KD clinical course and prognosis. Myl9 release from platelets in KD patients was also evaluated in vitro. Myl9 expression was determined in coronary arteries from Lactobacillus casei cell wall extract (LCWE)-injected mice that develop experimental KD vasculitis, as well as in cardiac tissues obtained at autopsy from KD patients. Results and discussion Plasma Myl9 levels were significantly higher in KD patients during the acute phase compared with healthy controls or patients with other febrile illnesses, declined following IVIG therapy in IVIG-responders but not in non-responders. In vitro, platelets from KD patients released Myl9 independently of thrombin stimulation. In the LCWE-injected mice, Myl9 was detected in cardiac tissue at an early stage before inflammatory cell infiltration was observed. In tissues obtained at autopsy from KD patients, the highest Myl9 expression was observed in thrombi during the acute phase and in the intima and adventitia of coronary arteries during the chronic phase. Thus, our studies show that Myl9 expression is significantly increased during KD vasculitis and that Myl9 levels may be a useful biomarker to estimate inflammation and IVIG responsiveness to KD.
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Affiliation(s)
- Hironobu Kobayashi
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Experimental Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Motoko Y. Kimura
- Department of Experimental Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Chiba University “Synergy Institute for Futuristic Mucosal Vaccine Research and Development (cSIMVa), Japan Initiative for World-leading Vaccine Research and Development Centers, Japan Agency for Medical Research and Development (AMED), Chiba, Japan, Chiba, Japan
| | - Ichita Hasegawa
- Department of Experimental Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eisuke Suganuma
- Division of Infectious Diseases and Immunology, Allergy, Saitama Children’s Medical Center, Saitama, Japan
| | - Yuzuru Ikehara
- Department of Molecular and Tumor Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhiko Azuma
- Department of Molecular and Tumor Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshihiro Ito
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryota Ebata
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yosuke Kurashima
- Department of Innovative Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yohei Kawasaki
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yuki Shiko
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Naoki Saito
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Youngho Lee
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Magali Noval Rivas
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Moshe Arditi
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Masahiko Zuka
- Department of Forensic Medicine and Pathology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshinori Nakayama
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Japan Agency for Medical Research and Development (AMED)-Core Research for Evolutional Science and Technology (CREST), AMED, Chiba, Japan
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12
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Hamada H, Hayama T, Ijuin A, Miyakoshi A, Yamamoto M, Ueno H, Saito M, Tochihara S, Takeshima T, Tanoshima M, Takeshima K, Sakakibara H, Yumura Y, Miyagi E, Murase M. O-183 Frequent spontaneous abortion in pregnancies followed by ICSI using frozen sperm from patients with testicular germ cell tumor (TGCT). Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Despite the high rate of sperm chromosome abnormalities in testicular germ cell tumor (TGCT), why is newborn aneuploidy rate in pregnancies with TGCT patient normal?
Summary answer
Miscarriage rate is higher in the pregnancy of TGCT patients than of non-TGCT cancer patients, although the pregnancy rate in ICSI was not significantly different.
What is known already
Previous reports showed higher sperm aneuploidy in TGCT patients than control males. The sperm aneuploidy rate is high before treatment, and after radical treatments peaked at 6 months after treatment and remained high until 24 months after treatment. However, in the Swedish government base study, the rate of newborn malformations including aneuploidy in all pregnancy with TGCT patients was higher than without TGCT, but not statistically significant. In only natural pregnancies, the rate was not significantly different between the two groups. The cause for discrepancy within sperm aneuploidy and newborn aneuploidy was not well clarified.
Study design, size, duration
To clarify the mechanism for the purifying selection of aneuploid sperm in conception, we examined ICSI cases with TGCT patients that did not include natural sperm competition and compared to controls with non-TGCT cancer patient, who have normal rate of aneuploid sperm. By investigating ICSI outcomes, we aimed to determine which stage of embryonic development are affected by the sperm of TGCT patients.
Participants/materials, setting, methods
Under ethical review of Yokohama city university, the 10 TGCT patients (123 oocytes) and 16 non-TGCT cancer patients (251 oocytes) who underwent ICSI with their frozen sperm from 2012 to 2021 were enrolled. Fertilization, embryo viability and embryo transfer outcomes (pregnancy and miscarriage rate) were examined between two groups underwent ICSI with cryopreserved sperm for fertility preservation. Clinical information was retrospectively collected from medical records.
Main results and the role of chance
The patients' age of sperm cryopreservation was 21-56 years old. 10 cases of TGCT were diagnosed as seminoma (3), non seminoma (6), and unknown (2). 15 cases of non-TGCT were diagnosed as malignant blood diseases (9), prostate cancer (2), bladder cancer (1), and others (3). In both groups, all patients were treated by ICSI with cryopreserved sperm obtained prior to chemotherapy. The mean age of female partners in TGCT was 33.2±3.5 years and not different with 35.8±3.4 years in non-TGCT meaning no different age factor. The fertilization rate, viable embryo rate, pregnancy rate and chemical abortion rate of TGCT vs non-TGCT group were 76.4% vs 67.7%, 64.3% vs 61.7%, 37.1% vs 21.7%, 7.1% vs 23.1%, respectively. Those developmental evaluations were not significantly different between two groups. However, spontaneous abortion rate was significantly higher 46.2% in TGCT group than 10% in non-TGCT group (p < 0.05). Further, in our follow-up, no congenital malformations in the babies born in either group (5 babies in TGCT vs 7 babies in non-TGCT group). The outcome of ICSI using sperm in TGCT patients show normal pregnancy rate but include higher spontaneous abortions rate, suggesting aneuploid embryo were negatively purifying selected under post-implantation stage.
Limitations, reasons for caution
Because ICSI with fertility-preserving frozen sperm in TGCT patient is rare even in reproduction center in general university hospital, single center analysis is still small and limited. More case reports and studies for TGCT fertility preservation are needed for more accurate evaluation.
Wider implications of the findings
In TGCT patients, chromosome aberrations and DNA fragmentation of sperm may not be apparent in natural pregnancies with normal sperm competition, but may become apparent as spontaneous abortions when ICSI were performed, suggesting PGT-A can predict and avoid the hidden risk of repeated pregnancy loss in ICSI to TGCT patients.
Trial registration number
not applicable
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Affiliation(s)
- H Hamada
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - T Hayama
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
- Yokohama City University Medical Center , Gynecology, Yokohama, Japan
| | - A Ijuin
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
- Yokohama City University, Obstetrics and Gynecology , Yokohama, Japan
| | - A Miyakoshi
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - M Yamamoto
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - H Ueno
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - M Saito
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - S Tochihara
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - T Takeshima
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - M Tanoshima
- Yokohama City University Medical Center, Clinical Genetics , Yokohama, Japan
| | - K Takeshima
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - H Sakakibara
- Yokohama City University Medical Center , Gynecology, Yokohama, Japan
| | - Y Yumura
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - E Miyagi
- Yokohama City University, Obstetrics and Gynecology , Yokohama, Japan
| | - M Murase
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
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Otani T, Iwamoto H, Horimasu Y, Yamaguchi K, Sakamoto S, Masuda T, Miyamoto S, Nakashima T, Fujitaka K, Hamada H, Hattori N. Effect of dupilumab in a patient with severe asthma complicated with recurrent anaphylaxis: a case report. J Investig Allergol Clin Immunol 2022:0. [DOI: 10.18176/jiaci.0840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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14
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Ae R, Shibata Y, Furuno T, Sasahara T, Nakamura Y, Hamada H. Human Mobility and Droplet-Transmissible Pediatric Infectious Diseases during the COVID-19 Pandemic. IJERPH 2022; 19:ijerph19116941. [PMID: 35682525 PMCID: PMC9180602 DOI: 10.3390/ijerph19116941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 12/23/2022]
Abstract
The study tested the hypothesis that human mobility may be a potential factor affecting reductions in droplet-transmissible pediatric infectious diseases (PIDs) during the coronavirus disease-2019 (COVID-19) pandemic mitigation period in 2020. An ecological study was conducted using two publicly available datasets: surveillance on infectious diseases collected by the Japanese government and COVID-19 community mobility reports presented by Google. The COVID-19 community mobility reports demonstrated percentage reductions in the movement of people over time in groceries and pharmacies, parks, and transit stations. We compared the weekly trends in the number of patients with droplet-transmissible PIDs identified in 2020 with those identified in the previous years (2015–2019) and assessed the correlations between the numbers of patients and percentage decreases in human mobility during 2020. Despite experiencing their peak seasons, dramatic reductions were found in the numbers of patients with pharyngoconjunctival fever (PCF) and group A streptococcal (GAS) pharyngitis after the tenth week of 2020. Beyond the 20th week, no seasonal peaks were observed in the number of patients with all PIDs identified in 2020. Significant correlations were found between the percentage decreases in human mobility in transit stations and the number of patients with hand-foot-and-mouth disease (Pearson correlation coefficient [95% confidence interval]: 0.65 [0.44–0.79]), PCF (0.47 [0.21–0.67]), respiratory syncytial virus infection (0.45 [0.19–0.66]), and GAS pharyngitis (0.34 [0.06–0.58]). The highest correlations were found in places underlying potential human-to-human contacts among adults. These findings suggest that reductions in human mobility for adults might contribute to decreases in the number of children with droplet-transmissible PIDs by the potential prevention of adult-to-child transmission.
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Affiliation(s)
- Ryusuke Ae
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
| | - Yoshihide Shibata
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
- Department of Electrical and Computer Engineering, National Institute of Technology, Gifu College, 2236-2 Kamimakuwa, Motosu 501-0495, Gifu, Japan
| | - Toshiki Furuno
- Advanced Course for Interdisciplinary Technology Development, National Institute of Technology, Gifu College, 2236-2 Kamimakuwa, Motosu 501-0495, Gifu, Japan;
| | - Teppei Sasahara
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
| | - Yosikazu Nakamura
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, 477-96 Owada-Shinden, Yachiyo 276-0046, Chiba, Japan
- Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi 260-8670, Chiba, Japan
- Correspondence: ; Tel.: +81-474-50-6000
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15
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Takatani R, Yoshioka Y, Takahashi T, Watanabe M, Hisada A, Yamamoto M, Sakurai K, Takatani T, Shimojo N, Hamada H, Ochiya T, Mori C. Investigation of umbilical cord serum miRNAs associated with childhood obesity: A pilot study from a birth cohort study. J Diabetes Investig 2022; 13:1740-1744. [PMID: 35653294 PMCID: PMC9533040 DOI: 10.1111/jdi.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/05/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
We investigated umbilical cord serum microRNA (miRNA) profiles to identify biomarkers of a risk for obesity later in life. Participating children were divided into high‐ and low‐risk groups of obesity based on the timing of adiposity rebound and the body mass index (BMI) at 5 years and randomly selected from each group for this study. 3D‐Gene® Human miRNA Oligo Chip was performed using cord serum in five children of both groups. The most relevant miRNAs were confirmed in 33 children of the groups using the TaqMan® microRNA assay. We detected five cord serum miRNAs differentially expressed in children at high risk of obesity compared with the levels in children at low risk, namely, miR‐516‐3p and miR‐130a‐3p with increased levels and miR‐1260b, miR‐4709‐3p, and miR194‐3p with decreased levels. This study provides the first identification of altered umbilical cord serum miRNAs in childhood obesity.
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Affiliation(s)
- Rieko Takatani
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yusuke Yoshioka
- Department of Molecular and Cellular Medicine, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Tomoko Takahashi
- Department of Environmental Preventive Medicine (Yamada Bee Company, Inc.), Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Masahiro Watanabe
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Aya Hisada
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Tomozumi Takatani
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Shimojo
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takahiro Ochiya
- Department of Molecular and Cellular Medicine, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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16
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Hamada H, Soussi M, Chrigui R, Guellim S, Kahloul M, Naija W. Psychological impact of the covid-19 pandemic on the operating room paramedical staff. Eur Psychiatry 2022. [PMCID: PMC9565781 DOI: 10.1192/j.eurpsy.2022.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction the recent covid19 pandemic is not devoid of psychological risks on paramedical staff. Among them, those who work in the operating theaters are exposed to such risks. Objectives to determine the perceived stress level and the psychological impact of COVID-19 on paramedics in the operating room. Methods This is an observational, descriptive and analytical study carried out in the operating rooms of Sahloul University Hospital during a 3 month period. The data collection tool was a self-administered questionnaire composed of 5 main parts (socio-demographic characteristics, occupational characteristics, exposure to COVID-19, the Perceived Stress Scale (PSS) and the Hospital Anxiety and depression scale (HADS)). Results 96 paramedical staff participated in our study. The average perceived stress score was significantly higher among anesthetists. 48% of participants had anxiety. Anesthetists had significantly higher anxiety scores (p = 0.001). 26.1% of participants had definite depression. Of those with definite depression, 35.3% were anesthetists (p = 0.028). Factors significantly associated with the occurrence of anxiety were: psychiatric history, increased workload, contact with a positive coronavirus patient in the operating room, and severe perceived stress. However, the factors significantly associated with the occurrence of depression were: initial training in the management of covid-19 patients, personal infection with SARS-COV2 and severe perceived stress. Conclusions Covid-19 pandemic is causing significant symptoms of anxiety and depression among operation room staff. Primary and secondary prevention strategies must then be undertaken. Disclosure No significant relationships.
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17
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Shimamura A, Miyata K, Hamada H, Mitsuishi T. Coexistence of infantile hemangioma and capillary malformation on the abdomen of a Japanese boy. J Dermatol 2022; 49:e303-e304. [PMID: 35560243 DOI: 10.1111/1346-8138.16436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Akari Shimamura
- Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Kazunori Miyata
- Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan.,Department of Dermatology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.,Department of Pediatrics, Chiba University, Chiba, Japan
| | - Tsuyoshi Mitsuishi
- Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan.,Department of Dermatology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
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18
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Mitsuishi T, Miyata K, Ando A, Sano K, Takanashi JI, Hamada H. Author reply to "Onycholysis associated with Kawasaki disease: A comment on characteristic nail lesions in Kawasaki disease: Case series and literature review". J Dermatol 2022; 49:e293-e294. [PMID: 35460100 DOI: 10.1111/1346-8138.16408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/31/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Tsuyoshi Mitsuishi
- Department of Dermatology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.,Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Kazunori Miyata
- Department of Dermatology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Akiko Ando
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Kentaro Sano
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Jun-Ichi Takanashi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.,Department of Pediatrics, Chiba University, Chiba, Japan
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19
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Takeshita K, Ishiwada N, Takeuchi N, Ohkusu M, Ohata M, Hino M, Hishiki H, Takeda Y, Sakaida E, Takahashi Y, Shimojo N, Hamada H. Immunogenicity and safety of routine 13-valent pneumococcal conjugate vaccination outside recommended age range in patients with hematological malignancies and solid tumors. Vaccine 2022; 40:1238-1245. [DOI: 10.1016/j.vaccine.2022.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/13/2022] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
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20
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Okazaki N, Ikeda H, Honda T, Tsuno K, Inoue F, Takahashi S, Sakurai A, Ueki H, Noguchi Y, Hamada H, Igarashi S. The impact of vitamin D on the onset and progress of Kawasaki disease. Pediatr Int 2022; 64:e15191. [PMID: 35831250 DOI: 10.1111/ped.15191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/18/2022] [Accepted: 03/10/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The seasonal epidemic of Kawasaki disease (KD) in winter in Japan suggests that low vitamin D status may affect KD through the immune system. We aimed to evaluate the effect of vitamin D on the onset and clinical course of KD. METHODS We conducted a case-control study to compare 25-hydroxyvitamin D (25(OH)D) levels in KD patients admitted to our hospital between March 2018 and June 2021, with those in healthy controls from published Japanese data. In patients with KD, we evaluated the association of 25(OH)D levels with intravenous immunoglobulin resistance and coronary artery lesions. RESULTS We compared 290 controls and 86 age-group-adjusted patients with KD. The 25(OH)D levels in KD patients were lower than those in the controls (median: 17 vs. 29 ng/mL, P < 0.001). In winter, 25(OH)D levels in KD patients were lower than those in summer (median: 13 vs. 19 ng/mL). The adjusted odds ratios for the onset of KD were 4.9 (95% CI: 2.5-9.6) for vitamin D insufficiency (25(OH)D: 12-20 ng/mL) and 29.4 (95% CI: 12.5-78.2) for vitamin D deficiency (25(OH)D < 12 ng/mL). Among 110 KD patients, 25(OH)D levels at diagnosis of KD were not associated with intravenous immunoglobulin resistance or coronary artery lesions. CONCLUSIONS The 25(OH)D levels in patients with KD were lower than those in the controls, especially in winter. Lower 25(OH)D levels in winter were associated with an increased risk of KD onset. It remains to be elucidated whether the observed association has a causal relationship.
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Affiliation(s)
- Natsumi Okazaki
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Hiroyuki Ikeda
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Takafumi Honda
- Department of Pediatrics, Yachiyo Medical Center, Tokyo Women's Medical University of Medicine, Chiba, Japan
| | - Kazuma Tsuno
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Fumiya Inoue
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Satoko Takahashi
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Ayako Sakurai
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Hideaki Ueki
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Yasushi Noguchi
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shunji Igarashi
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
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21
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Hagiwara S, Shiohama T, Ogi T, Ichikawa T, Hamada H. Subtle infantile spasms presenting as hyperirritability in CK syndrome. Pediatr Int 2022; 64:e15335. [PMID: 36331250 DOI: 10.1111/ped.15335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/28/2022] [Accepted: 08/16/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Sho Hagiwara
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Tomoo Ogi
- Research Institute of Environmental Medicine (RIeM), Nagoya University, Nagoya, Japan
| | - Tomohiko Ichikawa
- Division of Clinical Genetics, Chiba University Hospital, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
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22
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Suzuki T, Suenaga T, Sakai A, Sugiyama M, Mizokami M, Mizukami A, Takasago S, Hamada H, Kakimoto N, Takeuchi T, Ueda M, Komori Y, Tokuhara D, Suzuki H. Case Report: Ciclosporin A for Refractory Multisystem Inflammatory Syndrome in Children. Front Pediatr 2022; 10:890755. [PMID: 35712624 PMCID: PMC9194446 DOI: 10.3389/fped.2022.890755] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/26/2022] [Indexed: 12/19/2022] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a new syndrome involving the development of severe dysfunction in multiple organs after severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. Because the pathophysiology of MIS-C remains unclear, a treatment strategy has not yet been established. We experienced a 12-year-old boy who developed MIS-C at 56 days after SARS-CoV-2 infection and for whom ciclosporin A (CsA) was effective as a third-line treatment. He had a high fever on day 1, and developed a rash on the trunk, swelling in the cervical region, and palmar erythema on day 2. On days 3, he developed conjunctivitis and lip redness, and fulfilled the criteria for classical Kawasaki disease (KD). Although intravenous immunoglobulin infusion (IVIG) was started on day 4, fever persisted and respiratory distress and severe abdominal pain developed. On day 5, because he fulfilled the criteria for MIS-C, methylprednisolone pulse was started for 3 days as a second-line treatment. However, he did not exhibit defervescence and the symptoms continued. Therefore, we selected CsA as a third-line treatment. CsA was so effective that he became defervescent and his symptoms disappeared. In order to clarify the relationship with treatment and the change of clinical conditions, we examined the kinetics of 71 serum cytokines to determine their relationships with his clinical course during the three successive treatments. We found that CsA suppressed macrophage-activating cytokines such as, IL-12(p40), and IL-18 with improvement of his clinical symptoms. CsA may be a useful option for additional treatment of patients with MIS-C refractory to IVIG + methylprednisolone pulse.
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Affiliation(s)
- Takayuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Tomohiro Suenaga
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Aiko Sakai
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaya Sugiyama
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayumi Mizukami
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Takasago
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuyuki Kakimoto
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Takashi Takeuchi
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Mina Ueda
- Department of Pediatrics, Wakayama Rousai Hospital, Wakayama, Japan
| | - Yuki Komori
- Department of Pediatrics, Wakayama Rousai Hospital, Wakayama, Japan
| | - Daisuke Tokuhara
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan.,Department of Pediatrics, Tsukushi Medical and Welfare Center, Iwade, Japan
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23
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Mitsuishi T, Miyata K, Ando A, Sano K, Takanashi JI, Hamada H. Characteristic nail lesions in Kawasaki disease: Case series and literature review. J Dermatol 2021; 49:232-238. [PMID: 34918369 DOI: 10.1111/1346-8138.16276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/30/2021] [Accepted: 11/29/2021] [Indexed: 12/17/2022]
Abstract
Kawasaki disease (KD) is vasculitis of unknown etiology in infants and young children. The diagnostic criteria for KD include major and minor symptoms, but various nail lesions are not described in detail. The aim of this study was to identify symptoms that are relatively found in nail of KD as diagnostic markers. After literature review, various nail lesions are classified as Beau's lines, leukonychia, onychomadesis, orange-brown chromonychia, and pincer nail deformity. The orange-brown chromonychia is the most common nail lesion in KD. In this study, the authors found three cases of KD with orange-brown chromonychia; two of these cases included rare dotted or splinter hemorrhages in the nail bed that were found on dermoscopic examination. The authors propose that these nail lesions, including hemorrhage of the nail bed, could be included as a helpful diagnosis of KD.
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Affiliation(s)
- Tsuyoshi Mitsuishi
- Department of Dermatology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan.,Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Kazunori Miyata
- Department of Dermatology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Akiko Ando
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Kentaro Sano
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Jun-Ichi Takanashi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan.,Department of Pediatrics, Chiba University, Chiba, Japan
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24
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Kobayashi T, Nakano T, Ogata H, Sato N, Yamaide F, Yamashita Y, Chikaraishi K, Hino M, Nishino I, Ichimura Y, Okiyama N, Hamada H. A 10-year-old girl with low-grade B cell lymphoma complicated by anti-nuclear matrix protein 2 autoantibody-positive juvenile dermatomyositis. Rheumatology (Oxford) 2021; 61:e143-e145. [PMID: 34897378 DOI: 10.1093/rheumatology/keab922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/25/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Toshiyuki Kobayashi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Taiji Nakano
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Hitoshi Ogata
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Noriko Sato
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Fumiya Yamaide
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Yoshiharu Yamashita
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Koji Chikaraishi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Moeko Hino
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience,National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yuki Ichimura
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
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25
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Ae R, Shibata Y, Kosami K, Nakamura Y, Hamada H. Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic. J Pediatr 2021; 239:50-58.e2. [PMID: 34324881 PMCID: PMC8591269 DOI: 10.1016/j.jpeds.2021.07.053] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/28/2021] [Accepted: 07/20/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the epidemiologic association between Kawasaki disease and common pediatric infectious diseases (PIDs) identified during the coronavirus disease 2019 (COVID-19) pandemic period to confirm whether the infection-triggered theory is a plausible hypothesis for the pathogenesis of Kawasaki disease. STUDY DESIGN A retrospective epidemiologic study was conducted using datasets obtained from Web-based surveillance of Kawasaki disease and PIDs in Japan. We compared weekly numbers of patients who developed Kawasaki disease and specific PIDs between 2020 and 2017-2019 and evaluated the association between the percent reduction in the number of patients with these diseases. RESULTS A total of 868 patients developed Kawasaki disease in 2020. During the social distancing period in 2020, the number of patients with Kawasaki disease was approximately 35% lower than in 2017-2019. Time from the onset of Kawasaki disease until the first hospital visit did not differ significantly among the examined years. The proportion of older children with Kawasaki disease decreased more than that of infants with Kawasaki disease (age <1 year), resulting in a significant difference in the proportion of infant patients between 2020 and 2017-2019 (24% vs 19%; P < .01). The number of patients with incomplete Kawasaki disease was unchanged from that of previous years. The weekly percent reduction in patient numbers differed between Kawasaki disease and PIDs during 2020, with no strong correlation between the 2 diseases. CONCLUSIONS Our data indicate that parents of patients with Kawasaki disease did not avoid hospital visits during the COVID-19 pandemic period. The findings indicate the possibility that triggering Kawasaki disease might be associated with presently unidentified respiratory pathogen(s) that potentially might be acquired from both within and outside the household.
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Affiliation(s)
- Ryusuke Ae
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Yoshihide Shibata
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan,Department of Electrical and Computer Engineering, National Institute of Technology, Gifu College, Gifu, Japan
| | - Koki Kosami
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Yosikazu Nakamura
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
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26
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Asaki Y, Sugiura K, Yasukawa K, Hamada H, Takanashi JI. Spontaneous tracheal rupture caused by acute asthma exacerbation. Pediatr Int 2021; 63:1541-1543. [PMID: 34894381 DOI: 10.1111/ped.14907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/09/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Yumie Asaki
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Kenta Sugiura
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Kumi Yasukawa
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Jun-Ichi Takanashi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
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27
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Endo Y, Kawashiri SY, Nishino A, Michitsuji T, Tomokawa T, Nishihata S, Okamoto M, Tsuji Y, Tsuji S, Shimizu T, Sumiyoshi R, Igawa T, Koga T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Otsubo H, Takaoka H, Hamada H, Tsuru T, Nawata M, Arinobu Y, Hidaka T, Tada Y, Kawakami A. Ultrasound efficacy of targeted-synthetic disease-modifying anti-rheumatic drug treatment in rheumatoid arthritis: a multicenter prospective cohort study in Japan. Scand J Rheumatol 2021; 51:259-267. [PMID: 34474646 DOI: 10.1080/03009742.2021.1927389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study investigated the effectiveness of treatment with Janus kinase (JAK) inhibitors in rheumatoid arthritis (RA) assessed by ultrasonography (US) activity, and the influence of patient characteristics and previous treatments. METHOD This prospective study assessed 60 treatment initiations among 53 Japanese patients diagnosed with RA who underwent treatment with JAK inhibitors during June 2013 to February 2020. Of the 53 patients, seven patients were enrolled in duplicate because they were treated with two different JAK inhibitors at different periods. For each case, the improvement rate on the power Doppler (PD) score was assessed at 6 month follow-up. Median improvement rate of PD score was used to classify cases as either US responders or non-responders, and patient characteristics were compared between the two groups. RESULTS All indicators of clinical disease activity and US activity showed a significant improvement at 3 months compared with baseline. Although the JAK inhibitor-cycler group and the interleukin-6 (IL-6) inhibitor inadequate response (IR) group tended to show a later improvement for US activity, all indicators of clinical disease activity and US activity showed a significant improvement at 6 months compared with baseline for both groups. Multivariate analysis showed that concomitant methotrexate use and an IR to the previous biologic or targeted-synthetic disease-modifying anti-rheumatic drug (b/tsDMARD) treatment were independently and significantly associated with US responders. CONCLUSION Use of a JAK inhibitor in combination with methotrexate and an absence of IR to any previous b/tsDMARDs demonstrated superior effectiveness for patients with RA.
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Affiliation(s)
- Y Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - S-Y Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Michitsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Tomokawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - S Nishihata
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - M Okamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Y Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - S Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - R Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - N Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - K Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - M Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - H Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Y Ueki
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Yoshitama
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Eiraku
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Matsuoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Okada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - K Fujikawa
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Otsubo
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Takaoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Hamada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Tsuru
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - M Nawata
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Arinobu
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Hidaka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Tada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
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28
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Hayama T, Ijuin A, Ueno H, Hamada H, Miyakoshi A, Nishi M, Saito M, Hamanoue H, Komeya M, Takeshima T, Kuroda S, Sakakibara H, Yumura Y, Miyagi E, Murase M. P–572 Purifying selection for aneuploidy cells in mosaicism embryo at post-implantation stage. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Why low ratio mosaicism embryos develop to normal karyotype babies?
Summary answer
Our in vitro implantation assay clarified purifying selection for aneuploid cells in post implantation embryos.
What is known already
There are some reports about healthy live birth after transfer of mosaic embryos, which was reported for the first time from Italy in 2015. It is also reported that the abnormal cell is screened with the mouse in the embryo development, and only a normal cell contributes to the development. But it has not been examined in human.
Study design, size, duration
To clarify the change of aneuploid cells and mitochondrial activity in human embryo, we biopsied several parts from one blastocyst and examined karyotype. After in vitro implantation assay for biopsied embryos, we compared the karyotype of biopsy sample with that of cultured cell mass.
Participants/materials, setting, methods
Under the ethical review of Yokohama City University and informed consent with patients, we collected human surplus blastocysts those are donated after successful clinical treatment or discarded because of poor development grade. We biopsied multiple parts from one blastocyst and cultured the biopsied embryos, and extracted whole DNA from the biopsy samples and cultured embryos. Karyotyping by next generation sequencing were performed.
Main results and the role of chance
We analyzed 34 samples from 11 embryos, including 25 biopsy sample from 11 embryos and 9 cell mass from 7 cultured embryos. In the karyotype tracking results, even though biopsy sample analysis before the culture were uniformed aneuploid or chromosome mosaic, the developing embryo cell mass had normal karyotype. In one embryo as an example, among the three biopsied extra trophectoderm samples from that, two of them were mosaic, and one of them had uniformed chromosome 21 trisomy and chromosome 16 mosaic monosomy. But the embryo formed multiple cell mass in implantation assay. We examined karyotype of three cell mass, and the result from all were normal karyotype. We suggested that the chromosome aberration cells were screened in the human embryo development, and when the function was not carried out the embryo stopped the development.
Limitations, reasons for caution
Because of small number of samples available, we need more samples for a more accurate evaluation. Furthermore, we cannot evaluate the absolute mechanism that cells with chromosome aberration decreases.
Wider implications of the findings: Conventional PGT-A techniques are based on uniformed embryos developing hypothesized past time. As showed in some clinical reports, PGT-A can reduce of spontaneous abortion and chance of embryo transfer. Thinking about aneuploid cell purifying system in embryo development, effectiveness of PGT-A should be more questionable for infertility treatment.
Trial registration number
A200326004
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Affiliation(s)
- T Hayama
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Ijuin
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Ueno
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamada
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Miyakoshi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Nishi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Saito
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamanoue
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Komeya
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - T Takeshima
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - S Kuroda
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Sakakibara
- Yokohama City University Medical Center, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - Y Yumura
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - E Miyagi
- Yokohama City University, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - M Murase
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
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29
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Suzuki J, Abe K, Matsui T, Honda T, Yasukawa K, Takanashi JI, Hamada H. Kawasaki Disease Shock Syndrome in Japan and Comparison With Multisystem Inflammatory Syndrome in Children in European countries. Front Pediatr 2021; 9:625456. [PMID: 33816399 PMCID: PMC8017212 DOI: 10.3389/fped.2021.625456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/25/2021] [Indexed: 02/01/2023] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a severe Kawasaki-like illness that was first linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in European countries in the spring of 2020 and has been suggested to have overlap with Kawasaki disease shock syndrome (KDSS). There are few reports of MIS-C from Asia. This observational study aimed to identify the clinical features in children presenting with KDSS in Japan over a 5-year period and to summarize similarities and differences between KDSS and MIS-C. We retrospectively collected data on patient characteristics, clinical signs and symptoms, treatment, and prognosis including coronary artery abnormalities (CAAs), which were compared with data of patients with KDSS worldwide and patients with MIS-C from a review. KDSS was identified in 6 (1.1%) of 552 patients with Kawasaki disease (KD) treated at a single institution in Japan between 2015 and 2020 (1 in 2020). In patients with KDSS in Japan or worldwide vs. patients with MIS-C, KDSS was more likely to have a diagnosis of complete KD (100, 70 vs. 6.3%), a higher incidence of CAAs (50, 65 vs. 11%), and a greater requirement for vasoactive agonists (67, 67 vs. 43%) because of circulatory shock (100, 50 vs. 26%). Both KDSS and MIS-C had good prognosis (mortality 0, 6.7 vs. 1.7%). Although KDSS in Japan and MIS-C show some overlap in clinical symptoms, they are unlikely to be the same disease entity. KDSS is more likely to have a cardiovascular phenotype with CAAs and requires treatment with cardiovascular agents.
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Affiliation(s)
- Junko Suzuki
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Kota Abe
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Takuya Matsui
- Pediatric Critical Care Medicine, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Takafumi Honda
- Pediatric Critical Care Medicine, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Kumi Yasukawa
- Pediatric Critical Care Medicine, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Jun-ichi Takanashi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
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30
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Endo Y, Kawashiri SY, Nishino A, Okamoto M, Tsuji S, Shimizu T, Sumiyoshi R, Igawa T, Koga T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Otsubo H, Takaoka H, Hamada H, Tsuru T, Nagano S, Arinobu Y, Hidaka T, Tada Y, Kawakami A. Discrepancy between clinical and ultrasound remissions in rheumatoid arthritis: a multicentre ultrasound cohort study in Japan. Scand J Rheumatol 2021; 50:436-441. [PMID: 33719841 DOI: 10.1080/03009742.2021.1876914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Using multicentre ultrasound (US) cohort data among patients with rheumatoid arthritis (RA), we aimed to identify baseline factors that permit differentiation between two patient cohorts achieving US remission and clinical remission, and to determine the factors contributing to the discrepancy.Method: We reviewed 248 Japanese patients diagnosed with RA who underwent treatment with biological disease-modifying anti-rheumatic drugs at 13 centres. We performed US assessments of the synovia of 22 joints. We assessed the percentages of patients with clinical remission and US remission, defined as total power Doppler scores of 0 at 12 months.Results: The 87 patients who achieved US remission were divided into a group that achieved both clinical and US remission (n = 53) and a group that achieved US remission only (n = 34). Baseline factors that were significantly and independently associated with clinical remission at 12 months among patients who also achieved US remission included short disease duration, the presence of concomitant methotrexate use, and low patient global assessment score (p < 0.05, p < 0.05, and p < 0.005, respectively).Conclusions: RA patients with baseline high patient global assessment scores and long disease duration at baseline were unlikely to achieve clinical remission even after achieving US remission. Objective joint assessments using US provide additional information of potential importance for the management of RA.
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Affiliation(s)
- Y Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - S-Y Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - M Okamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - S Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - R Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - N Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - K Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - M Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - H Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Y Ueki
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Yoshitama
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Eiraku
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Matsuoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Okada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - K Fujikawa
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Otsubo
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Takaoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Hamada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Tsuru
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - S Nagano
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Arinobu
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Hidaka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Tada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
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31
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Takasago S, Sakai A, Sugiyama M, Mizokami M, Hamada H, Ishizaka Y, Miyoshi-Akiyama T, Matsunaga A, Ueno M, Shichino H, Mizukami A. Case Report: Changes in Cytokine Kinetics During the Course of Disease in a Japanese Patient With Multisystem Inflammatory Syndrome in Children. Front Pediatr 2021; 9:702318. [PMID: 34368030 PMCID: PMC8335158 DOI: 10.3389/fped.2021.702318] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/21/2021] [Indexed: 01/12/2023] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a severe disease that is reportedly linked to coronavirus disease 2019. Affected patients present with gastrointestinal symptoms and cardiovascular dysfunction, in addition to Kawasaki disease-like features, suggesting the potential for overlapping disease mechanisms. Kawasaki disease has been reported among individuals of East Asian ethnicities, whereas there is minimal clinical literature regarding the occurrence of MIS-C among individuals of Asian ethnicities. A few reports thus far have described changes in cytokine kinetics during the course of disease in patients with MIS-C. We followed the temporal cytokine kinetics in a 9-year-old Japanese girl who exhibited a classical trajectory of MIS-C. The patient exhibited right cervical swelling and pain, abdominal pain, vomiting, and lip reddening, which developed 31 days after she was diagnosed with severe acute respiratory syndrome coronavirus-2 infection. The patient was diagnosed with Kawasaki disease on her fifth day of illness; because she fulfilled the criteria for MIS-C, she was also diagnosed with this disease on her fifth day of illness. Her fever rapidly resolved upon administration of intravenous immunoglobulin, aspirin, and prednisolone. On the patient's sixth day of illness, she developed acute myocarditis, which was treated with two diuretics and one vasodilator; the myocarditis ameliorated within a few days. Analyses of temporal kinetics for 71 serum cytokines revealed several patterns of cytokine changes that were consistent with the patient's clinical course of disease. Importantly, there was a clear distinction between cytokines that did and did not decrease rapidly following post-treatment fever resolution. These findings may be useful for the assessment of disease status and selection of therapy in patients with similar symptoms; they may also provide insights for basic and clinical research regarding MIS-C.
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Affiliation(s)
- Satoshi Takasago
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Aiko Sakai
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaya Sugiyama
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Miyoshi-Akiyama
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mikako Ueno
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Shichino
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayumi Mizukami
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
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32
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Kobayashi T, Ayusawa M, Suzuki H, Abe J, Ito S, Kato T, Kamada M, Shiono J, Suda K, Tsuchiya K, Nakamura T, Nakamura Y, Nomura Y, Hamada H, Fukazawa R, Furuno K, Matsuura H, Matsubara T, Miura M, Takahashi K. Revision of diagnostic guidelines for Kawasaki disease (6th revised edition). Pediatr Int 2020; 62:1135-1138. [PMID: 33001522 DOI: 10.1111/ped.14326] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/19/2020] [Accepted: 05/11/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Tohru Kobayashi
- Department of Management and Strategy, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Mamoru Ayusawa
- Department of Pediatrics and Child Health, Nihon University, Itabashi-ku, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Jun Abe
- Division of Advanced Medicine for Virus Infections, Research Institute, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Shuichi Ito
- Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Taichi Kato
- Pediatrics/Developmental Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masahiro Kamada
- Pediatric Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Junko Shiono
- Pediatric Cardiology, Ibaraki Children's Hospital, Mito, Japan
| | - Kenji Suda
- Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
| | - Keiji Tsuchiya
- Department of Pediatrics, Japanese Red Cross Medical Center, Tokyo, Japan
| | | | | | - Yuichi Nomura
- Pediatrics, Kagoshima City Hospital, Kagoshima, Japan
| | - Hiromichi Hamada
- Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | | | - Kenji Furuno
- Kawasaki Disease Center, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Hiroyuki Matsuura
- Departments of Pediatrics, Toho University School of Medicine, Tokyo, Japan
| | - Tomoyo Matsubara
- Pediatrics, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Masaru Miura
- Cardiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Kei Takahashi
- Pathology, Toho University School of Medicine, Tokyo, Japan
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Endo Y, Koga T, Kawashiri SY, Morimoto S, Nishino A, Okamoto M, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Hamada H, Tsuru T, Nagano S, Arinobu Y, Hidaka T, Tada Y, Kawakami A. Significance of anti-Ro/SSA antibodies in the response and retention of abatacept in patients with rheumatoid arthritis: a multicentre cohort study. Scand J Rheumatol 2020; 50:15-19. [PMID: 32880228 DOI: 10.1080/03009742.2020.1772361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: To determine whether the positivity of baseline anti-Ro/Sjögren's syndrome antigen A (SSA) antibodies influences the response to abatacept, we compared therapeutic responses between anti-Ro/SSA antibody-negative and -positive patients with rheumatoid arthritis (RA) using a multicentre RA ultrasonography prospective cohort. Method: We reviewed Japanese patients with RA who started abatacept as the first biological disease-modifying anti-rheumatic drug between June 2013 and April 2018. We assessed 28-joint Disease Activity Score-erythrocyte sedimentation rate (DAS28-ESR) change between baseline and 6 or 12 months after treatment in RA patients treated with abatacept, and European League Against Rheumatism (EULAR) response at 6 and 12 months. The Global OMERACT-EULAR Synovitis Score (GLOESS) was calculated at baseline and at 6 and 12 months. Results: Overall, 51 patients were enrolled and divided into anti-Ro/SSA antibody-negative and -positive groups of 35 and 16, respectively. Median age at baseline was significantly higher in the anti-Ro/SSA antibody-negative group (p = 0.04). The retention rate and percentage of EULAR good responders at 12 months were significantly higher in the anti-Ro/SSA antibody-negative group (both p = 0.02). Anti-Ro/SSA antibody-negative patients exhibited larger decreases in both DAS28-ESR and DAS28-C-reactive protein at 12 months than anti-Ro/SSA antibody-positive patients (p = 0.02 and 0.04, respectively). GLOESS decreased significantly at 6 months in anti-Ro/SSA antibody-negative patients (p = 0.03). Multivariate analyses showed that anti-Ro/SSA antibody positivity was an independent factor associated with change in the DAS28-ESR at 6 months (p < 0.05). Conclusion: Anti-Ro/SSA antibody positivity predicts a poor response to abatacept and low retention rate.
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Affiliation(s)
- Y Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - T Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - S-Y Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - S Morimoto
- Innovation Platform and Office for Precision Medicine, Graduate School of Biomedical Sciences, Nagasaki University , Nagasaki, Japan
| | - A Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - M Okamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - S Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - A Takatani
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - T Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - R Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - T Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - N Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - K Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - M Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - H Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - T Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan
| | - Y Ueki
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - T Yoshitama
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - N Eiraku
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - N Matsuoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - A Okada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - K Fujikawa
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - H Hamada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - T Tsuru
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - S Nagano
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - Y Arinobu
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - T Hidaka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - Y Tada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
| | - A Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan
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Fukazawa R, Kobayashi J, Ayusawa M, Hamada H, Miura M, Mitani Y, Tsuda E, Nakajima H, Matsuura H, Ikeda K, Nishigaki K, Suzuki H, Takahashi K, Suda K, Kamiyama H, Onouchi Y, Kobayashi T, Yokoi H, Sakamoto K, Ochi M, Kitamura S, Hamaoka K, Senzaki H, Kimura T. JCS/JSCS 2020 Guideline on Diagnosis and Management of Cardiovascular Sequelae in Kawasaki Disease. Circ J 2020; 84:1348-1407. [PMID: 32641591 DOI: 10.1253/circj.cj-19-1094] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Mamoru Ayusawa
- Department of Pediatrics and Child Health, Nihon University School of Medicine
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center
| | - Masaru Miura
- Department of Cardiology, Tokyo Metropolitan Children's Medical Center
| | - Yoshihide Mitani
- Department of Pediatrics, Mie University Graduate School of Medicine
| | - Etsuko Tsuda
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
| | - Hiroyuki Nakajima
- Department of Cardiovascular Surgery, Saitama Medical University International Medical Center
| | | | - Kazuyuki Ikeda
- Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Kazuhiko Nishigaki
- Department of Cardiology & Respirology, Gifu University Graduate School of Medicine
| | | | - Kei Takahashi
- Department of Pathology, Toho University Ohashi Medical Center
| | - Kenji Suda
- Department of Pediatrics and Child Health, Kurume University School of Medicine
| | - Hiroshi Kamiyama
- Department of Pediatrics and Child Health, Nihon University School of Medicine
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine
| | - Tohru Kobayashi
- Department of Management and Strategy, Clinical Research Center, National Center for Child Health and Development
| | | | - Kisaburo Sakamoto
- Department of Cardiovascular Surgery, Mt. Fuji Shizuoka Children's Hospital
| | | | - Soichiro Kitamura
- President Emeritus, National Cerebral and Cardiovascular Center.,Board of Director, Japan Cardiovascular Research Foundation
| | - Kenji Hamaoka
- Pediatric Cardiology ad Kawasaki Disease Center, Uji-Tokushukai Medical Center
| | - Hideaki Senzaki
- Pediatric Cardiology and Intensive Care, Kitasato University School of Medicine
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
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Ito Y, Matsui T, Abe K, Honda T, Yasukawa K, Takanashi JI, Hamada H. Aspirin Dose and Treatment Outcomes in Kawasaki Disease: A Historical Control Study in Japan. Front Pediatr 2020; 8:249. [PMID: 32478021 PMCID: PMC7241278 DOI: 10.3389/fped.2020.00249] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022] Open
Abstract
Aspirin has been used as a concomitant drug in the treatment of Kawasaki disease (KD). In recent years, there has been discussion concerning whether high-dose aspirin is appropriate for treatment in the acute phase of KD. We retrospectively investigated the incidence of coronary artery abnormalities (CAAs) and the antipyretic effect of 30 to 50 mg/kg/day aspirin, the minimum and the maximum approved doses in Japan. This was a single-center, non-randomized, retrospective, historical cohort study. Patients were routinely treated with 50 mg/kg/day aspirin (50-mg Group) between 2007 and April 2014, and with 30 mg/kg/day aspirin (30-mg Group) between May 2014 and 2016. All patients were given initial and, if necessary, subsequent intravenous immunoglobulin (IVIG) 2.0 g/kg. The primary endpoint was incidence of CAAs defined as a CA diameter with a Z score ≥2.5 at treatment week 4. The secondary endpoint was incidence of further treatment. Incidences were compared using inverse probability weighting analysis adjusting for age, sex, and risk scores. In 587 patients, there was no significant difference in incidence of CAAs (odds ratio in 30-mg Group 0.769, 95% confidence interval (CI): 0.537-1.101, p = 0.151). Risk of further treatment after the first IVIG in the 30-mg Group was significantly higher than that in the 50-mg Group (odds ratio 1.379, 95% CI: 1.051-1.811, p = 0.021). Although this study has some limitations, the findings suggest that aspirin 50 mg/kg/day may have no significant effect on improving incidence of CAAs compared with 30 mg/kg/day but may have a lower rate of further treatment.
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Affiliation(s)
- Yu Ito
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Takuya Matsui
- Department of Pediatric Intensive Care, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Kota Abe
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Takafumi Honda
- Department of Pediatric Intensive Care, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Kumi Yasukawa
- Department of Pediatric Intensive Care, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Jun-Ichi Takanashi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
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Furudate A, Hirose S, Abe K, Kawashima A, Hashimoto K, Yamazaki S, Kamei K, Ishiwada N, Hamada H, Sato M. Infantile Aspergillus fumigatus ventriculitis successfully treated with monitoring of plasma and cerebrospinal fluid voriconazole concentration level. J Infect Chemother 2020; 26:132-135. [DOI: 10.1016/j.jiac.2019.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/19/2019] [Accepted: 06/28/2019] [Indexed: 11/29/2022]
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Affiliation(s)
- Kyung-Yil Lee
- The Catholic University of Korea, College of Medicine, Seoul, South Korea
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Miika Arvonen
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
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Kawase-Koga Y, Kimoto A, Hamada H, Watanabe M, Chikazu D. Simple predictive technique to establish the osteotomy line for intraoral vertical ramus osteotomy. Br J Oral Maxillofac Surg 2019; 58:238-239. [PMID: 31862117 DOI: 10.1016/j.bjoms.2019.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Y Kawase-Koga
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - A Kimoto
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - H Hamada
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - M Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - D Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
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39
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Takanashi JI, Murofushi Y, Hirai N, Sano K, Matsuo E, Saito K, Yasukawa K, Hamada H. Prognostic value of MR spectroscopy in patients with acute excitotoxic encephalopathy. J Neurol Sci 2019; 408:116636. [PMID: 31879119 DOI: 10.1016/j.jns.2019.116636] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/25/2019] [Accepted: 12/14/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE Acute excitotoxic encephalopathy is the most common encephalopathy syndrome in Japan, and consists of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and mild encephalopathy associated with excitotoxicity (MEEX). Neurological sequelae remain in approximately 70% of patients with AESD, however, it is difficult to predict the prognosis early in the course. We evaluated the brain metabolites observed on MRS as to whether they can predict the neurological outcome. METHODS 16 previously healthy Japanese patients with excitotoxic encephalopathy (8 with AESD and 8 with MEEX) were included in this study. MR spectroscopy (MRS) was acquired from the fronto-parietal white matter (TR/TE = 5000/30 msec) with a 3.0 T scanner. Quantification of metabolites was performed using an LCModel. Neurological outcome was assessed with the Pediatric Cerebral Performance Category score, score 1 being classified as G1 (normal), scores 2 and 3 as G2 (mild to moderate), and scores 4-6 as G3 (severe). RESULTS MRS data which predict a poor neurological outcome (G2 and 3) include the following: decreased N-acetyl aspartate (NAA) (sensitivity 88%, specificity 100%), decreased creatine (47%, 100%), increased lactate (47%, 100%), and decreased glutamate (sensitivity 35%, specificity 100%). Limited to the acute stage within seven days of onset, those for a poor prognosis are as follows, decreased NAA (88%, 100%), decreased creatine (38%, 100%), and increased lactate (38%, 100%). CONCLUSION MRS is useful for prognosis prediction of acute excitotoxic encephalopathy. Decreased NAA will be the most effective metabolite for neurological prognosis prediction.
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Affiliation(s)
- Jun-Ichi Takanashi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan.
| | - Yuka Murofushi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Nozomi Hirai
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Kentaro Sano
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Emiyu Matsuo
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Keito Saito
- Department of Medical Technology and Image Laboratory, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Kumi Yasukawa
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan
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40
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Endo Y, Koga T, Kawashiri SY, Morimoto S, Nishino A, Okamoto M, Eguchi M, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Hamada H, Tsuru T, Nagano S, Arinobu Y, Hidaka T, Tada Y, Kawakami A. Anti-citrullinated protein antibody titre as a predictor of abatacept treatment persistence in patients with rheumatoid arthritis: a prospective cohort study in Japan. Scand J Rheumatol 2019; 49:13-17. [DOI: 10.1080/03009742.2019.1627411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Y Endo
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Koga
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S-Y Kawashiri
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - S Morimoto
- Innovation Platform and Office for Precision Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - A Nishino
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - M Okamoto
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - M Eguchi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Tsuji
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - A Takatani
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Shimizu
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - R Sumiyoshi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Igawa
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - N Iwamoto
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Ichinose
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M Tamai
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - H Nakamura
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Origuchi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Y Ueki
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Yoshitama
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Eiraku
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Matsuoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Okada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - K Fujikawa
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Hamada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Tsuru
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - S Nagano
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Arinobu
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Hidaka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Tada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Kawakami
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
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Mayumi M, Obata-Yasuoka M, Hamada H, Satoh T, Tanaka Y, Masumoto K. Fetal magnetic resonance imaging is a useful modality for prenatal diagnosis of obstructed hemivagina and ipsilateral renal anomaly syndrome. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4606.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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42
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Yamazaki‐Nakashimada MA, Deguchi K, Gámez‐González B, Ulloa‐Gutierrez R, Hamada H. Orange‐brown chromonychia: A valid sign in Kawasaki disease in children of different ethnicities. Int J Rheum Dis 2019; 22:1160-1161. [DOI: 10.1111/1756-185x.13587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/25/2019] [Accepted: 04/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
| | - Kuntaro Deguchi
- Department of Pediatrics, Yachiyo Medical Center Tokyo Women´s Medical University Yachiyo Chiba Japan
| | - Berenise Gámez‐González
- Servicio Inmunología y Alergia Hospital Infantil de Especialidades de Chihuahua Chihuahua Mexico
| | - Rolando Ulloa‐Gutierrez
- Servicio de Infectología Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera” San José Costa Rica
| | - Hiromichi Hamada
- Department of Pediatrics, Yachiyo Medical Center Tokyo Women´s Medical University Yachiyo Chiba Japan
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Ebata R, Yasukawa K, Nagai K, Saito Y, Higashi K, Homma J, Takada N, Takechi F, Saito N, Kobayashi H, Okunushi K, Hamada H, Kohno Y, Hanaoka H, Shimojo N. Sivelestat sodium hydrate treatment for refractory Kawasaki disease. Pediatr Int 2019; 61:438-443. [PMID: 30916859 DOI: 10.1111/ped.13851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/16/2019] [Accepted: 03/20/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is still no definite treatment for refractory Kawasaki disease (KD). In this pilot study, we evaluated the safety and efficacy of a new protocol consisting of sivelestat sodium hydrate (SSH) combined with additional i.v. immunoglobulin (IVIG) for KD resistant to initial IVIG therapy. METHODS This study is a prospective non-randomized, open-label and single-arm study undertaken in a population of refractory KD patients at Chiba University Hospital from December 2006 to March 2016. The subjects had KD resistant to initial IVIG (2 g/kg) and received SSH (0.2 mg/kg/h for 5 days) combined with additional IVIG (2 g/kg) as a second-line therapy. We evaluated the safety and efficacy of the treatment during the study period. RESULTS Forty-six KD patients were enrolled in this study and no serious adverse event was noted. Of these, 45 patients were evaluated for the incidence of coronary artery lesions, which occurred in one patient (2.2%; 95% CI: 0.5-15.2). Twenty-eight (62.2%) responded promptly and were afebrile after the therapy. The median total duration of fever was 8 days (range, 6-28 days). CONCLUSIONS Additional IVIG combined with SSH as a second-line therapy for KD refractory to initial IVIG therapy was safe and well tolerated and could be a promising option for severe KD. Further investigations are expected to clarify the safety and timing of SSH treatment for KD.
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Affiliation(s)
- Ryota Ebata
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Kumi Yasukawa
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Kazue Nagai
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yuko Saito
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Kouji Higashi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Jun Homma
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Nobuyuki Takada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Fumie Takechi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Naoki Saito
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Hironobu Kobayashi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Kentaro Okunushi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Japan
| | - Yoichi Kohno
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
| | - Hideki Hanaoka
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Naoki Shimojo
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Yachiyo, Japan
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Hamada H, Suzuki H, Onouchi Y, Ebata R, Terai M, Fuse S, Okajima Y, Kurotobi S, Hirai K, Soga T, Ishiguchi Y, Okuma Y, Takada N, Yanai M, Sato J, Nakayashiro M, Ayusawa M, Yamamoto E, Nomura Y, Hashimura Y, Ouchi K, Masuda H, Takatsuki S, Hirono K, Ariga T. 307. EFFICACY OF PRIMARY TREATMENT WITH IMMUNOGLOBULIN PLUS CYCLOSPORINE FOR PREVENTION OF CORONARY ARTERY ABNORMALITIES IN KAWASAKI DISEASE PATIENTS PREDICTED TO BE AT INCREASED RISK OF IVIG NON- RESPONSE (KAICA STUDY): A CONTROLLED, PHASE 3, RANDOMISED, OPEN-LABEL, BLINDED-ENDPOINTS TRIAL. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez063.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - Ryota Ebata
- Chiba University Graduate School of Med Chiba, Japan
| | | | | | | | | | | | - Takashi Soga
- Showa University Northern Yokohama Hospital Yokohama, Japan
| | | | - Yoshiaki Okuma
- National Center for Global Health and Medicine Shinjuku, Japan
| | | | | | - Junichi Sato
- Funabashi Municipal Medical Center Funabashi, Japan
| | - Mami Nakayashiro
- Okinawa Pref Nambu & Children’s Medical Center Shimajiri-gun, Japan
| | | | | | | | | | | | - Hiroshi Masuda
- National Center for Child Health and Development Setagaya, Japan
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Hamada H, Suzuki H, Onouchi Y, Ebata R, Terai M, Fuse S, Okajima Y, Kurotobi S, Hirai K, Soga T, Ishiguchi Y, Okuma Y, Takada N, Yanai M, Sato J, Nakayashiro M, Ayusawa M, Yamamoto E, Nomura Y, Hashimura Y, Ouchi K, Masuda H, Takatsuki S, Hirono K, Ariga T, Higaki T, Otsuki A, Terauchi M, Aoyagi R, Sato T, Fujii Y, Fujiwara T, Hanaoka H, Hata A. Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised controlled, open-label, blinded-endpoints, phase 3 trial. Lancet 2019; 393:1128-1137. [PMID: 30853151 DOI: 10.1016/s0140-6736(18)32003-8] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/07/2018] [Accepted: 08/21/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Genetic studies have indicated possible involvement of the upregulated calcium-nuclear factor of activated T cells pathway in the pathogenesis of Kawasaki disease. We aimed to assess safety and efficacy of ciclosporin, an immunosuppressant targeting this pathway, for protection of patients with Kawasaki disease against coronary artery abnormalities. METHODS We did a randomised, open-label, blinded endpoints trial involving 22 hospitals in Japan between May 29, 2014, and Dec 27, 2016. Eligible patients predicted to be at higher risk for intravenous immunoglobulin (IVIG) resistance were randomly assigned to IVIG plus ciclosporin (5 mg/kg per day for 5 days; study treatment) or IVIG (conventional treatment) groups, stratified by risk score, age, and sex. The primary endpoint was incidence of coronary artery abnormalities using Japanese criteria during the 12-week trial, assessed in participants who received at least one dose of study drug and who visited the study institution at least once during treatment. This trial is registered to Center for Clinical Trials, Japan Medical Association, number JMA-IIA00174. FINDINGS We enrolled 175 participants. One patient withdrew consent after enrolment and was excluded and one patient (in the study treatment group) was excluded from analysis because of lost echocardiography data. Incidence of coronary artery abnormalities was lower in the study treatment group than in the conventional treatment group (12 [14%] of 86 patients vs 27 [31%] of 87 patients; risk ratio 0·46; 95% CI 0·25-0·86; p=0·010). No difference was found in the incidence of adverse events between the groups (9% vs 7%; p=0·78). INTERPRETATION Combined primary therapy with IVIG and ciclosporin was safe and effective for favourable coronary artery outcomes in Kawasaki disease patients who were predicted to be unresponsive to IVIG. FUNDING Japan Agency for Medical Research and Development (grant CCT-B-2503).
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Affiliation(s)
- Hiromichi Hamada
- Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Pediatrics, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University of Medicine, Wakayama, Japan
| | | | - Ryota Ebata
- Department of Pediatrics, Chiba University, Chiba, Japan
| | - Masaru Terai
- Department of Pediatrics, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan
| | - Shigeto Fuse
- Department of Pediatrics, NTT Sapporo Medical Center, Sapporo, Japan
| | | | | | - Katsuki Hirai
- Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Takashi Soga
- Department of Pediatrics, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yukiko Ishiguchi
- Department of Pediatric Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yoshiaki Okuma
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuyuki Takada
- Department of Pediatrics, Kimitsu Chuo Hospital, Chiba, Japan
| | - Masaaki Yanai
- Department of Pediatrics, Kumamoto Regional Medical Center, Kumamoto, Japan
| | - Junichi Sato
- Department of Pediatrics, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Mami Nakayashiro
- Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Okinawa, Japan
| | - Mamoru Ayusawa
- Department of Pediatrics, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Eiichi Yamamoto
- Department of Pediatrics, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Yuichi Nomura
- Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan
| | - Yuya Hashimura
- Department of Pediatrics, Takatsuki General Hospital, Osaka, Japan
| | - Kazunobu Ouchi
- Department of Pediatrics, Kawasaki Medical School Hospital, Okayama, Japan
| | - Hiroshi Masuda
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| | | | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | - Takashi Higaki
- Department of Regional Pediatrics and Perinatology, Graduate School of Medicine, Ehime University, Ehime, Japan
| | - Akio Otsuki
- Department of Pediatrics, Komatsu Municipal Hospital, Ishikawa, Japan
| | - Moe Terauchi
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Reiko Aoyagi
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Takatoshi Sato
- Department of Pediatrics, Funabashi Municipal Medical Center, Funabashi, Japan; Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Yasuhisa Fujii
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Tadami Fujiwara
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Hideki Hanaoka
- Clinical Research Centre, Chiba University Hospital, Chiba, Japan
| | - Akira Hata
- Department of Public Health, Chiba University, Chiba, Japan.
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46
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Thiha K, Mashimo Y, Suzuki H, Hamada H, Hara T, Tanaka T, Ito K, Hata A, Onouchi Y. 178. INVESTIGATION OF RARE VARIATIONS OF ORAI1 GENE AND THEIR ASSOCIATION WITH KAWASAKI DISEASE. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez060.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kyaw Thiha
- Japan Kawasaki Disease Genome Consortium
| | | | | | | | | | | | | | - Akira Hata
- Chiba University Graduate School of Medicine Chiba, Japan
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Abstract
AIMS The aim of this study was to examine whether hips with unilateral osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) have significant asymmetry in femoral length, and to determine potential related factors. PATIENTS AND METHODS We enrolled 90 patients (82 female, eight male) with DDH showing unilateral OA changes, and 43 healthy volunteers (26 female, 17 male) as controls. The mean age was 61.8 years (39 to 93) for the DDH groups, and 71.2 years (57 to 84) for the control group. Using a CT-based coordinate measurement system, we evaluated the following vertical distances: top of the greater trochanter to the knee centre (femoral length GT), most medial prominence of the lesser trochanter to the knee centre (femoral length LT), and top of the greater trochanter to the medial prominence of the lesser trochanter (intertrochanteric distance), along with assessments of femoral neck anteversion and neck shaft angle. RESULTS The percentages of hips with an absolute difference of > 5 mm in femoral GT and LT lengths were significantly larger in the DDH group (24% for both) compared with those of the control group (2% and 7%, respectively). The femoral length GT of the affected femur was significantly shorter in Crowe I and longer in Crowe IV than that of the unaffected side. The affected-to-unaffected difference of the intertrochanteric distance showed positive correlation with that of the femoral length GT in Crowe I and Crowe II/III, and negative correlation with that of the femoral length LT in the Crowe I and Crowe IV groups. CONCLUSION Hips with unilateral end-stage OA secondary to DDH show significant asymmetry in femoral length between both the greater and lesser trochanter and the knee compared with controls. The intertrochanteric distance was a morphological factor related to femoral-length asymmetry. When undertaking total hip arthroplasty (THA) in the presence of DDH, long leg radiographs or CT measurements should be used to assess true leg-length discrepancy. Cite this article: Bone Joint J 2019;101-B:297-302.
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Affiliation(s)
- K Tamura
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| | - M Takao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - H Hamada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - W Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| | - T Sakai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - N Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan
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48
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Hisakura Y, Hisamitsu I, Sugihara M, Tanifuji SI, Hamada H. Material Behavior in the Plasticizing Cylinder of an Injection Molding of the Vent Type. INT POLYM PROC 2018. [DOI: 10.3139/217.3572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Thermoplastic injection molding is applied in a wide variety of products. It is known that volatile components generated when resin melts cause structural defects during the thermoplastic injection process. Not only that, the pre-injection preparation work including drying the material and maintaining the metal mold, have become standard procedures to prevent these defects, but these procedures deteriorate productivity. Vent-type injection molding involves the use of cylinders featuring a vent hole at the center of the plasticizing cylinder. Although it is a conventional molding method, there are many issues including resin leakage from a vent hole and difficulty of material replacements. These issues prevented it from widespread application. Moreover, the vent-type plasticization process has not been examined theoretically or systematically. In order to maximize and generalize functions of vent-type molding, it is necessary to clarify the flow behavior of resin in the vent cylinder. In this study, we verified the flow behavior of resin in the vent-type plasticization cylinder through experimentation and simulation. In the simulation, using the flow analysis method, the filling rate inside the screw was determined by the pressure distribution inside the screw. In the experiments, the molding condition that causes venting up was verified by changing the screw rotation rates and the supply amount of the resin, for determining the filling rate of resin inside the screw. The filling rates obtained through the simulation and the experiment are almost the same. The result suggests that this simulation is very effective for predicting the filling rate.
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Affiliation(s)
- Y. Hisakura
- Konica Minolta Inc. , Toyokawa-shi, Aichi , Japan
| | - I. Hisamitsu
- Konica Minolta Inc. , Toyokawa-shi, Aichi , Japan
| | - M. Sugihara
- Konica Minolta Inc. , Toyokawa-shi, Aichi , Japan
| | | | - H. Hamada
- Kyoto Institute of Technology , Sakyo-ku, Kyoto , Japan
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49
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Gámez-González LB, Hamada H, Cisneros Castolo M, Honda T, Yasukawa K, Takanashi JI. Vital Signs as Predictor Factors of Intravenous Immunoglobulin Resistance in Patients With Kawasaki Disease. Clin Pediatr (Phila) 2018; 57:1148-1153. [PMID: 29486579 DOI: 10.1177/0009922818759320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Kawasaki disease (KD) is the most common cause of acquired heart disease in children. Intravenous immunoglobulin (IVIG) may significantly lower the frequency of coronary artery complications. However, some patients do not respond to initial therapy and are at higher risk of developing coronary artery lesion. A retrospective analysis of data from 419 KD patients was performed. The patients were divided into IVIG responders (n = 318) and IVIG nonresponders (n = 101). Multivariate logistic regression analysis revealed neutrophil percentage, albumin, aspartate aminotransferase, heart rate, and body temperature were independent predictors of IVIG resistance. We generated a predictive scoring system by assigning 1 point for the presence of these parameters (neutrophil >80%, albumin <3.4 g/dL, aspartate aminotransferase >100 IU/L, heart rate >146 bpm, and body temperature >38.8°C). This scoring system had a sensitivity of 76.2% and specificity of 64.8%, and a positive predictive value of 40.1% and a negative predictive value of 89.4%. Vital signs may be helpful to detect KD patients with IVIG resistance.
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Affiliation(s)
- Luisa Berenise Gámez-González
- 1 Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan.,2 Department of Allergy and Clinical Immunology, Children's Hospital Chihuahua City, México
| | - Hiromichi Hamada
- 1 Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan
| | | | - Takafumi Honda
- 1 Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan
| | - Kumi Yasukawa
- 1 Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan
| | - Jun-Ichi Takanashi
- 1 Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan
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50
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Kim HJ, Yun SW, Yu JJ, Yoon KL, Lee KY, Kil HR, Kim GB, Han MK, Song MS, Lee HD, Ha KS, Sohn S, Ebata R, Hamada H, Suzuki H, Kamatani Y, Kubo M, Ito K, Onouchi Y, Hong YM, Jang GY, Lee JK. Identification of LEF1 as a Susceptibility Locus for Kawasaki Disease in Patients Younger than 6 Months of Age. Genomics Inform 2018; 16:36-41. [PMID: 30304924 PMCID: PMC6187808 DOI: 10.5808/gi.2018.16.2.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/11/2018] [Indexed: 01/25/2023] Open
Abstract
Kawasaki disease (KD) is an acute febrile vasculitis predominately affecting infants and children. The dominant incidence age of KD is from 6 months to 5 years of age, and the incidence is unusual in those younger than 6 months and older than 5 years of age. We tried to identify genetic variants specifically associated with KD in patients younger than 6 months or older than 5 years of age. We performed an age-stratified genome-wide association study using the Illumina HumanOmni1-Quad BeadChip data (296 cases vs. 1,000 controls) and a replication study (1,360 cases vs. 3,553 controls) in the Korean population. Among 26 candidate single nucleotide polymorphisms (SNPs) tested in replication study, only a rare nonsynonymous SNP (rs4365796: c.1106C>T, p.Thr369Met) in the lymphoid enhancer binding factor 1 (LEF1) gene was very significantly associated with KD in patients younger than 6 months of age (odds ratio [OR], 3.07; pcombined = 1.10 × 10-5), whereas no association of the same SNP was observed in any other age group of KD patients. The same SNP (rs4365796) in the LEF1 gene showed the same direction of risk effect in Japanese KD patients younger than 6 months of age, although the effect was not statistically significant (OR, 1.42; p = 0.397). This result indicates that the LEF1 gene may play an important role as a susceptibility gene specifically affecting KD patients younger than 6 months of age.
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Affiliation(s)
- Hea-Ji Kim
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Sin Weon Yun
- Department of Pediatrics, Chung-Ang University Hospital, Seoul 06973, Korea
| | - Jeong Jin Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Kyung Lim Yoon
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
| | - Kyung-Yil Lee
- Department of Pediatrics, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon 34943, Korea
| | - Hong-Ryang Kil
- Department of Pediatrics, Chungnam National University Hospital, Daejeon 35015, Korea
| | - Gi Beom Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul 03080, Korea
| | - Myung-Ki Han
- Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Korea
| | - Min Seob Song
- Department of Pediatrics, Inje University Busan Paik Hospital, Busan 47392, Korea
| | - Hyoung Doo Lee
- Department of Pediatrics, Pusan National University Hospital, Busan 49241, Korea
| | - Kee Soo Ha
- Department of Pediatrics, Korea University Ansan Hospital, Ansan 15355, Korea
| | - Sejung Sohn
- Department of Pediatrics, Ewha Womans University Hospital, Seoul 07985, Korea
| | - Ryota Ebata
- Department of Pediatrics, Chiba-University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women's Medical University Yachivo Medical Center, Yachivo 276-8524, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Michiaki Kubo
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Kaoru Ito
- Laboratory for Cardiovascular Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Yoshihiro Onouchi
- Laboratory for Cardiovascular Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Young Mi Hong
- Department of Pediatrics, Ewha Womans University Hospital, Seoul 07985, Korea
| | - Gi Young Jang
- Department of Pediatrics, Korea University Ansan Hospital, Ansan 15355, Korea
| | - Jong-Keuk Lee
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul 05505, Korea
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