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Iwasaki K, Okazaki A. Medication-related osteonecrosis of the jaw leading to sepsis in a patient with rheumatoid arthritis: A case report and clinical implications. Clin Case Rep 2023; 11:e7588. [PMID: 37334335 PMCID: PMC10276238 DOI: 10.1002/ccr3.7588] [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] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/22/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023] Open
Abstract
Key Clinical Message Chronic use of bisphosphonates, in combination with immunosuppressive therapy, increases the risk of jaw osteonecrosis. When sepsis occurs in patients receiving bisphosphonate, osteonecrosis of the jaw should be considered a potential source of infection. Abstract Reports of medication-related osteonecrosis of the jaw (MRONJ) accompanied by sepsis are limited. A 75-year-old female patient with rheumatoid arthritis, receiving treatment with bisphosphonate and abatacept, developed sepsis secondary to MRONJ. When sepsis occurs in patients receiving bisphosphonate, osteonecrosis of the jaw should be considered a potential source of infection.
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Affiliation(s)
- K. Iwasaki
- Department of Internal MedicineKaga Medical CenterKagaJapan
- Department of Respiratory MedicineKanazawa University Graduate School of Medical SciencesKanazawaJapan
| | - A. Okazaki
- Department of Internal MedicineKaga Medical CenterKagaJapan
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2
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Minami T, Tokiyasu AO, Kohri H, Abe Y, Iwasaki K, Taguchi T, Oda K, Suzuki S, Asai T, Tanaka SJ, Isayama S, Kanasaki M, Kodaira S, Fukuda Y, Kuramitsu Y. Mass-resolved ion measurement by particle counting analysis for characterizing relativistic ion beams driven by lasers. Rev Sci Instrum 2022; 93:113530. [PMID: 36461420 DOI: 10.1063/5.0101872] [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] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/09/2022] [Indexed: 06/17/2023]
Abstract
Particle counting analysis is a possible way to characterize GeV-scale, multi-species ions produced in laser-driven experiments. We present a multi-layered scintillation detector to differentiate multi-species ions of different masses and energies. The proposed detector concept offers potential advantages over conventional diagnostics in terms of (1) high sensitivity to GeV ions, (2) realtime analysis, and (3) the ability to differentiate ions with the same charge-to-mass ratio. A novel choice of multiple scintillators with different ion stopping powers results in a significant difference in energy deposition between the scintillators, allowing accurate particle identification in the GeV range. Here, we report a successful demonstration of particle identification for heavy ions, performed at the Heavy Ion Medical Accelerator in Chiba. In the experiment, the proposed detector setup showed the ability to differentiate particles with similar atomic numbers, such as C6+ and O8+ ions, and provided an excellent energy resolution of 0.41%-1.2% (including relativistic effect, 0.51%--1.6%).
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Affiliation(s)
- T Minami
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - A O Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Miyagi 982-0826, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - Y Abe
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Iwasaki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Taguchi
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Oda
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Suzuki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Asai
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum Science and Technology (QST), Kyoto 619-0215, Japan
| | - S J Tanaka
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Isayama
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - M Kanasaki
- Graduate School of Maritime Sciences, Kobe University, Hyogo 658-0022, Japan
| | - S Kodaira
- National Institute of Radiological Sciences (NIRS), National Institutes for Quantum Science and Technology (QST), Chiba 263-8555, Japan
| | - Y Fukuda
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum Science and Technology (QST), Kyoto 619-0215, Japan
| | - Y Kuramitsu
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
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Abe Y, Kohri H, Tokiyasu A, Minami T, Iwasaki K, Taguchi T, Asai T, Kanasaki M, Kodaira S, Fujioka S, Kuramitsu Y, Fukuda Y. A multi-stage scintillation counter for GeV-scale multi-species ion spectroscopy in laser-driven particle acceleration experiments. Rev Sci Instrum 2022; 93:063502. [PMID: 35778001 DOI: 10.1063/5.0078817] [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] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
Particle counting analysis (PCA) with a multi-stage scintillation detector shows a new perspective on angularly resolved spectral characterization of GeV-scale, multi-species ion beams produced by high-power lasers. The diagnosis provides a mass-dependent ion energy spectrum based on time-of-flight and pulse-height analysis of single particle events detected through repetitive experiments. With a novel arrangement of multiple scintillators with different ions stopping powers, PCA offers potential advantages over commonly used diagnostic instruments (CR-39, radiochromic films, Thomson parabola, etc.) in terms of coverage solid angle, detection efficiency for GeV-ions, and real-time analysis during the experiment. The basic detector unit was tested using 230-MeV proton beam from a synchrotron facility, where we demonstrated its potential ability to discriminate major ion species accelerated in laser-plasma experiments (i.e., protons, deuterons, carbon, and oxygen ions) with excellent energy and mass resolution. The proposed diagnostic concept would be essential for a better understanding of laser-driven particle acceleration, which paves the way toward all-optical compact accelerators for a range of applications.
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Affiliation(s)
- Y Abe
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - A Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Miyagi 982-0826, Japan
| | - T Minami
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Iwasaki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Taguchi
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Asai
- Graduate School of Maritime Sciences, Kobe University, Kobe 658-0022, Japan
| | - M Kanasaki
- Graduate School of Maritime Sciences, Kobe University, Kobe 658-0022, Japan
| | - S Kodaira
- National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba 263-8555, Japan
| | - S Fujioka
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - Y Kuramitsu
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - Y Fukuda
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), Kyoto 619-0215, Japan
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Watanabe O, Ko Y, Tsujii N, Takase Y, Ejiri A, Shinohara K, Peng Y, Iwasaki K, Yamada I, Yatomi G, Moeller C, Peng YK. Design of a finline antenna for current drive in TST-2. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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5
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Iwasaki K, Hamana H, Kishi H, Yamamoto T, Hiramitsu T, Okad M, Tomosugi T, Takeda A, Narumi S, Watarai Y, Miwa Y, Okumura M, Matsuoka Y, Horimi K, Muraguchi A, Kobayash T. The suppressive effect on CD4 T cell alloresponse against endothelial HLA-DR via PD-L1 induced by anti-A/B ligation. Clin Exp Immunol 2020; 202:249-261. [PMID: 32578199 DOI: 10.1111/cei.13482] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/27/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022] Open
Abstract
While donor-specific human leukocyte antigen (HLA) antibodies are a frequent cause for chronic antibody-mediated rejection in organ transplantation, this is not the case for antibodies targeting blood group antigens, as ABO-incompatible (ABO-I) organ transplantation has been associated with a favorable graft outcome. Here, we explored the role of CD4 T cell-mediated alloresponses against endothelial HLA-D-related (DR) in the presence of anti-HLA class I or anti-A/B antibodies. CD4 T cells, notably CD45RA-memory CD4 T cells, undergo extensive proliferation in response to endothelial HLA-DR. The CD4 T cell proliferative response was enhanced in the presence of anti-HLA class I, but attenuated in the presence of anti-A/B antibodies. Microarray analysis and molecular profiling demonstrated that the expression of CD274 programmed cell death ligand 1 (PD-L1) increased in response to anti-A/B ligation-mediated extracellular signal-regulated kinase (ERK) inactivation in endothelial cells that were detected even in the presence of interferon-γ stimulation. Anti-PD-1 antibody enhanced CD4 T cell proliferation, and blocked the suppressive effect of the anti-A/B antibodies. Educated CD25+ CD127- regulatory T cells (edu.Tregs ) were more effective at preventing CD4 T cell alloresponses to endothelial cells compared with naive Treg ; anti-A/B antibodies were not involved in the Treg -mediated events. Finally, amplified expression of transcript encoding PD-L1 was observed in biopsy samples from ABO-I renal transplants when compared with those from ABO-identical/compatible transplants. Taken together, our findings identified a possible factor that might prevent graft rejection and thus contribute to a favorable outcome in ABO-I renal transplantation.
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Affiliation(s)
- K Iwasaki
- Department of Kidney Disease and Transplant Immunology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - H Hamana
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - H Kishi
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - T Yamamoto
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - T Hiramitsu
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - M Okad
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - T Tomosugi
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - A Takeda
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - S Narumi
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Y Watarai
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Y Miwa
- Department of Kidney Disease and Transplant Immunology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - M Okumura
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Y Matsuoka
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - K Horimi
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - A Muraguchi
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - T Kobayash
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
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Takeuchi S, Watanabe T, Anegawa E, Sujino Y, Yagi N, Yoshitake K, Mochizuki H, Iwasaki K, Nakajima S, Kuroda K, Seguchi O, Yanase M, Tadokoro N, Yajima S, Fukushima S, Fujita T, Ogawa H, Fukushima N. The Development of Cardiac Allograft Vasculopathy Occurs in Early Intimal Thickening and Constrictive Remodeling in Long-Term Period; Long-Term Serial Intravascular Ultrasound Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.532] [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: 10/24/2022] Open
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Fukushima N, Yanase M, Watanabe T, Kuroda K, Nakajima S, Iwasaki K, Fujita T, Fukushima S, Tadokoro N, Kobayashi J. Mid-Term Effectiveness of Everolimus on Heart Transplant Recipients with Renal Dysfunction or Transplant Coronary Artery Atherosclerosis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.602] [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: 11/27/2022] Open
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8
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Watanabe T, Yanase M, Fujita T, Fukushima S, Nakajima S, Kuroda K, Iwasaki K, Yajima S, Tadokoro N, Mochizuki H, Anegawa E, Sujino Y, Yagi N, Yoshitake K, Kobayashi J, Fukushima N. Donor-Transmitted Atherosclerosis and the Occurrence of Cardiac Antibody-Mediated Rejection Influenced on the Development of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.537] [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: 10/24/2022] Open
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9
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Iwasaki K, Yoshitake K, Yagi N, Sujino Y, Anegawa E, Mochizuki H, Kuroda K, Nakajima S, Watanabe T, Seguchi O, Yanase M, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Incidence, Factors and Prognostic Impact of Re-Exploration for Bleedings after Continuous Flow Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.520] [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: 10/24/2022] Open
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10
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Nomoto M, Iwaki H, Tagawa M, Iwasaki K. Comparison of zonisamide with non-levodopa, anti-Parkinson’s disease drugs in the incidence of Parkinson’s disease-relevant symptoms. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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11
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. P1671Subclinical persistent hemolysis may affect late renal function deterioration after HeartMateII implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0428] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Late renal function dysfunction is an increasingly recognized complication in continuous flow left ventricular assist device (CF-LVAD) patients. Although hemolysis is prevalent in CF-LVAD patients and hemolysis may deteriorate renal function, the influence of persistent hemolysis on renal function in CF-LVAD patients remains to be investigated.
Purpose
To investigate the influence of persistent hemolysis on renal function in CF-LVAD patients, using lactate dehydrogenase (LDH) as a sensitive marker of hemolysis.
Methods
Excluding patients who died or underwent pump exchange for pump thrombosis, we retrospectively reviewed 65 consecutive adults who underwent HeartMateII implantation in our center from May 2011 to October 2017. Patient characteristics, chronotropic change of estimated glomerular filtration rate (eGFR) and LDH values weekly for 4 weeks and every 4 weeks between 4 and 48 weeks after implantation were collected. Then, calculating mean LDH during 48 weeks after implantation, study population was divided into low and high mean LDH groups at the median value of mean LDH.
Results
The median value of mean LDH was 304 U/l. Compared with low LDH patients, though high LDH patients were more likely female and had smaller body surface area, there were no significant difference in pre-operative eGFR between the groups (66.0±23.7 vs. 70.2±25.7 ml/min/1.73m2, p=0.495). After 40 weeks after implantation, high LDH patients had significantly lower eGFR than low LDH patients (71.0±23.7 vs. 87.1±31.4 ml/min/1.73m2, p=0.024). In multivariate linear regression analysis, mean LDH [parameter estimate: −0.10 (95% CI: −0.17 to −0.04), p=0.003] and post-operative pulse pressure [parameter estimate: 0.71 (95% CI: 0.05 to 1.37), p=0.036] were significantly associated with eGFR change during 48 weeks after HeartMateII implantation.
Univariate and multivariate linear regression analysis for eGFR change Univariate parameter estimate 95% CI p value Multivariate parameter estimate 95% CI p value Bilirubin, mg/dl 9.97 3.82 to 16.13 0.002 6.55 −0.43 to 13.53 0.065 BNP, pg/ml 0.01 0.00 to 0.02 0.044 0.00 −0.01 to 0.01 0.528 Mean LDH during 4 to 48 weeks, U/l −0.11 −0.18 to −0.05 <0.001 −0.10 −0.17 to −0.04 0.003 Pre-operative right atrial pressure, mmHg 1.43 0.35 to 2.51 0.010 −0.06 −1.52 to 1.40 0.935 Post-operative pulse pressure, mmHg 0.77 0.03 to 1.52 0.042 0.71 0.05 to 1.37 0.036
Conclusions
High mean LDH and low pulse pressure were associated with a significant decrease in eGFR late after HeartMateII implantation. Subclinical persistent hemolysis may be associated with late renal function deterioration in CF-LVAD patients.
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Affiliation(s)
- K Iwasaki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - O Seguchi
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - H Mochizuki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kimura
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kumai
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - K Kuroda
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - S Nakajima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - T Watanabe
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - M Yanase
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Matsumoto
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - S Fukushima
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - T Fujita
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - J Kobayashi
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - N Fukushima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
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Kimura Y, Seguchi O, Mochizuki H, Iwasaki K, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Matsumoto Y, Fukushima S, Yanase M, Fujita T, Kobayashi J, Fukushima N. Role of Gallium-SPECT-CT in Predicting Outcomes of Patients with Ventricular Assist Device-Specific Percutaneous Driveline Infection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.800] [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: 11/30/2022] Open
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13
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Adjedj J, Picard F, Mogi S, Iwasaki K, Aoumeur H, Alansari O, Agudze E, Wijns W, Varenne O. In vitro flow and optical coherence tomography comparison of two bailout techniques after failed after provisional T-stenting for bifurcation percutaneous coronary interventions. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.044] [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: 11/27/2022]
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14
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Terminal Ileac Ulcers Mimicked Post-transplantation Lymphoproliferative Disorder in a Heart Recipient Treated With Everolimus: A Case Report. Transplant Proc 2018; 50:4053-4056. [PMID: 30577313 DOI: 10.1016/j.transproceed.2018.08.025] [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] [Received: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023]
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized and potentially fatal complication of cardiac transplantation that commonly involves the gastrointestinal tract. Herein, we report a case of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers mimicking PTLD in a heart recipient treated with everolimus (EVL). A 40-year-old man underwent heart transplantation for dilated cardiomyopathy 3 years prior to the current admission and was treated with tacrolimus and EVL. He was admitted to a local hospital because of fever, abdominal pain, and diarrhea. His symptoms persisted and, 3 weeks later, hematochezia occurred; thus, he was transferred to our hospital. As computed tomography and 18F-fluorodeoxyglucose positron emission tomography showed bowel-wall thickening of the terminal ileum, gastrointestinal PTLD was initially suspected. However, although colonoscopy- performed after switching EVL to mycophenolate mofetil (MMF)-showed terminal ileac ulcers, the histologic examination revealed no findings corresponding to PTLD. As EVL may delay ulcer healing, MMF was maintained for 3 months. After repeated colonoscopy showed ulcer healing, MMF was switched back to EVL for cardiac allograft vasculopathy prevention. Three weeks later, he was emergently admitted to a local hospital for life-threatening gastrointestinal bleeding from a recurrent terminal ileal ulcer, which required hemostatic forceps hemostasis. As EVL is suspected to be associated with recurrent ileal ulcers, EVL was again switched back to MMF. The ileal ulcers resolved, without recurrence in 3 months of clinical follow-up. This case demonstrates that cases of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers can mimic PTLD in a heart recipient treated with EVL.
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Affiliation(s)
- K Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - O Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - H Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Toda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - M Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - N Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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15
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Tsuchihashi K, Arita S, Fujiwara M, Iwasaki K, Hirano A, Yoshihiro T, Nio K, Koga Y, Esaki M, Ariyama H, Kusaba H, Moriyama T, Ohuchida K, Nagai E, Nakamura M, Oda Y, Akashi K, Baba E. Metastatic esophageal carcinosarcoma comprising neuroendocrine carcinoma, squamous cell carcinoma, and sarcoma: A case report. Medicine (Baltimore) 2018; 97:e12796. [PMID: 30313107 PMCID: PMC6203541 DOI: 10.1097/md.0000000000012796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
RATIONALE Esophageal carcinosarcoma generally comprises 2 histological components: squamous cell carcinoma (SqCC) and sarcoma. Esophageal carcinosarcoma comprising 3 components is extremely rare and no reports have described therapeutic effects for this disease with metastasis. PATIENT CONCERNS A 76-year-old man with dysphagia presented to a local clinic. Gastrointestinal endoscopy revealed a polypoid tumor in the middle esophagus and he was referred to our hospital. DIAGNOSIS AND INTERVENTIONS Thoracoscopic esophagectomy with super-extended (D3) nodal dissection and gastric tube reconstitution was performed, which resulted in carcinosarcoma comprising neuroendocrine carcinoma (NEC), SqCC, and sarcoma. Pathological stage was T1bN1M0 stage IIB according to the TNM Classification of Malignant Tumors-7th edition. The NEC component was observed in lymph node. At 47 days after surgery, lymph nodes, liver, and bone metastasis appeared, and tumor markers such as ProGRP and NSE were elevated. Combination chemotherapy with cisplatin and etoposide (EP) adapted to NEC was performed. OUTCOMES The patient showed complete response within 4 cycles of chemotherapy. However, the disease recurred 5.5 months after the final course of EP chemotherapy. LESSONS A therapeutic strategy based on assessment of which component caused metastasis might be important for metastatic carcinosarcoma comprising 3 components, although more accumulation of data about the efficacy of chemotherapy is necessary. Moreover, elucidation of the mechanisms underlying generation of carcinosarcoma is expected in the future.
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Affiliation(s)
- Kenji Tsuchihashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences
| | - Shuji Arita
- Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences
| | | | | | | | - Tomoyasu Yoshihiro
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences
| | - Kenta Nio
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences
| | | | | | - Hiroshi Ariyama
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences
| | - Hitoshi Kusaba
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences
| | - Taiki Moriyama
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenoki Ohuchida
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eishi Nagai
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences
| | - Eishi Baba
- Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences
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16
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Iwasaki K, Temin HM. Multiple sequence elements are involved in RNA 3' end formation in spleen necrosis virus. Gene Expr 2018; 2:7-18. [PMID: 1319783 PMCID: PMC6057358] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The function of the poly(A) signal in spleen necrosis virus (SNV) is dependent upon the distance between the cap site and the poly(A) site, while the function of the SV40 late poly(A) signal is independent of the distance. Deletions in the SNV poly(A) sequence do not alter the distance-dependent function. SNV/SV40 chimeric poly(A) signals show intermediate behavior between the SNV and SV40 poly(A) signals. These results indicate that multiple sequence elements are involved in the functions of either the SNV or SV40 poly(A) signals. This intermediate behavior is also observed with poly(A) signals from the mouse alpha-globin and herpes simplex virus thymidine kinase genes.
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Affiliation(s)
- K Iwasaki
- McArdle Laboratory for Cancer Research, University of Wisconsin, Madison 53706
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Malchesky P, Takahashi T, Iwasaki K, Harasaki H, Nosé Y. Conjugated Human Hemoglobin as a Physiological Oxygen Carrier - Pyridoxalated Hemoglobin Polyoxyethylene Conjugate (PHP). Int J Artif Organs 2018. [DOI: 10.1177/039139889001300711] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Problems associated with specific physiological properties of Hb-based blood substitutes, such as a low P50, short plasma half-life and nephrotoxicity are still major issues to be addressed. Extensive investigations aimed at overcoming these problems have resulted in the preparation of pyridoxalated-hemoglobin-polyoxyethylene conjugate (PHP). PHP was developed from human hemoglobin by two major chemical modifications; pyridoxylation for the purpose of lowering the oxygen affinity (P50 of 19.5 ± 1.2 mmHg), and coupling with polyoxyethylene (POE) to increase its molecular weight (to approximately 90 kdaltons). The circulating half-life of PHP is about 40 hours in dogs. Toxicologicai and physiological studies including renal function assessments have demonstrated that PHP does not have untoward effects on major organ functions. Its efficacy in transporting oxygen has been shown in ET and intracoronary perfusion, and in in vitro studies with sickle cells. Studies to date suggest that PHP is a promising candidate as a physiological oxygen carrier. In this paper the properties of PHP, its safety and efficacy aspects, and its potential as a clinical oxygen carrier are reviewed based on studies conducted in the Author's laboratory.
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Affiliation(s)
- P.S. Malchesky
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - T. Takahashi
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - K. Iwasaki
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - H. Harasaki
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - Y. Nosé
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
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18
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Iwasaki K, Kimura Y, Toda K, Kikuchi N, Kumai Y, Kuroda K, Seguchi O, Yanase M, Matsumoto Y, Fujita T, Kobayashi J, Fukushima N. Impact of Creatinine Excretion Rate, a Maker of Sarcopenia, on Prediction of Mortality and Neurological Events in Advanced Heart Failure Patients With Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.700] [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: 10/17/2022] Open
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19
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Iwasaki K, Uno Y, Utoh M, Yamazaki H. Importance of cynomolgus monkeys in development of monoclonal antibody drugs. Drug Metab Pharmacokinet 2018; 34:55-63. [PMID: 29655914 DOI: 10.1016/j.dmpk.2018.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 04/06/2017] [Revised: 11/29/2017] [Accepted: 02/06/2018] [Indexed: 01/30/2023]
Abstract
Animal species used in the preclinical studies for development of monoclonal antibody (mAb) drugs are surveyed in this review. Relevant animal species for preclinical studies of mAb candidates are those express desired epitope of mAb candidates. Cynomolgus monkeys cross-react with mAb drugs much higher than other animal species commonly used in preclinical studies such as absorption, distribution, metabolism and excretion (ADME), efficacy, and toxicity studies, for development of new drugs. Moreover, plasma exposure of the mAb drugs in humans is predicted well from the exposure in the monkeys, and the placental transfer of immunoglobulin G (IgG, all the mAb drugs contain IgG) from mother to fetus is similar between humans and the monkeys from a viewpoint of time course and plasma level of IgG transferred. These observed findings indicate that the monkeys are the most suitable animal species used in the ADME and toxicity studies for development of new mAb drugs.
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Affiliation(s)
- Kazuhide Iwasaki
- Pharmacokinetics and Bioanalysis Center, Shin Nippon Biomedical Laboratories, Ltd., 2-1-1 Fushimi-machi, Chuo-ku, Osaka 541-0044, Japan.
| | - Yasuhiro Uno
- Pharmacokinetics and Bioanalysis Center, Shin Nippon Biomedical Laboratories, Ltd., 16-1 Minami Akasaka, Kainan, Wakayama 642-0017, Japan
| | - Masahiro Utoh
- Pharmacokinetics and Bioanalysis Center, Shin Nippon Biomedical Laboratories, Ltd., 16-1 Minami Akasaka, Kainan, Wakayama 642-0017, Japan
| | - Hiroshi Yamazaki
- Showa Pharmaceutical University, 3-3165 Tamagawagakuen, Machida, Tokyo 194-8543, Japan
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Abstract
In a previous communication, we reported a leaflet fracture in a Jellyfish valve that was incorporated into a blood pump, after a 312-day animal implant duration. Subsequent finite element analysis revealed that the fracture location was consistent with an area of maximum strain concentration. Therefore, the aim of this study was to improve the durability in the light of these findings. Based on the engineering analysis results, a new valve seat having a concentric ring of 0.5mm width, located at a radius of 7.0 mm, was designed and fabricated. Accelerated fatigue tests, conducted under the conditions recommended by ISO 5840, demonstrated that the durability of this new prototype was extended by a factor of 10, as compared to the original valve. Moreover, further finite element analysis indicated that the maximum equivalent elastic strain of the proposed new valve was reduced by 52.3% as compared to the original valve. Accordingly, it has been confirmed that the modified Jellyfish valve is suitable for use in long-term artificial hearts.
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Affiliation(s)
- K. Iwasaki
- Department of Mechanical Engineering, Waseda University, Tokyo - Japan
| | - M. Umezu
- Department of Mechanical Engineering, Waseda University, Tokyo - Japan
| | - K. Imachi
- Department of Biomedical Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo - Japan
| | - K. Iijima
- Department of Mechanical Engineering, Waseda University, Tokyo - Japan
| | - T. Fujimoto
- Department of Mechanical Engineering, Shibaura Institute of Technology, Tokyo - Japan
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Murayama N, Yajima K, Hikawa M, Shimura K, Ishii Y, Takada M, Uno Y, Utoh M, Iwasaki K, Yamazaki H. Assessment of multiple cytochrome P450 activities in metabolically inactivated human liver microsomes and roles of P450 2C isoforms in reaction phenotyping studies. Biopharm Drug Dispos 2017; 39:116-121. [DOI: 10.1002/bdd.2115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/15/2017] [Accepted: 11/01/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Norie Murayama
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Kanako Yajima
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
- Pharmacokinetics and Bioanalysis Center; Shin Nippon Biomedical Laboratories, Ltd; Kainan Wakayama Japan
| | - Mikiko Hikawa
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Kanami Shimura
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Yu Ishii
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Masaki Takada
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Yasuhiro Uno
- Pharmacokinetics and Bioanalysis Center; Shin Nippon Biomedical Laboratories, Ltd; Kainan Wakayama Japan
| | - Masahiro Utoh
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
- Pharmacokinetics and Bioanalysis Center; Shin Nippon Biomedical Laboratories, Ltd; Kainan Wakayama Japan
| | - Kazuhide Iwasaki
- Pharmacokinetics and Bioanalysis Center; Shin Nippon Biomedical Laboratories, Ltd; Kainan Wakayama Japan
| | - Hiroshi Yamazaki
- Laboratory of Drug Metabolism and Pharmacokinetics; Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
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22
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Nagasue T, Kurahara K, Yaita H, Tanaka T, Oshiro Y, Kuno N, Harada A, Kameda M, Iwasaki K, Tsutsumi Y. Whipple's disease diagnosed using electron microscopy and polymerase chain reaction. Nihon Shokakibyo Gakkai Zasshi 2017; 113:1894-1900. [PMID: 27829601 DOI: 10.11405/nisshoshi.113.1894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 50-year-old man presented with bloody diarrhea and 25-kg weight loss over 3 months. Upper and lower endoscopy showed diffuse shaggy white villi in the duodenum and terminal ileum. In addition, capsule endoscopy and double-balloon enteroscopy revealed shaggy white villi in the entire small intestine. Histological examination of biopsy specimens found the lamina propria of the duodenal and intestinal mucosa to be densely infiltrated by rich foamy macrophages that were periodic acid-Schiff-positive. Electron microscopy showed numerous bacilli in the lamina propria. Tropheryma whipplei DNA was detected in the specimens by polymerase chain reaction. Based on these findings, the patient was diagnosed with Whipple's disease. He was treated with a 2-week course of ceftriaxone followed by trimethoprim-sulfamethoxazole. At the 2-month follow up, diffuse white shaggy villi improved dramatically.
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Iwasaki K, Kitsugi Y, Ikeda K, Yoshikawa T, Hosaka S, Uehara S, Uno Y, Utoh M, Yamazaki H. In vivo individual variations in pharmacokinetics of efavirenz in cynomolgus monkeys genotyped for cytochrome P450 2C9. Biopharm Drug Dispos 2017; 37:379-83. [PMID: 27417918 DOI: 10.1002/bdd.2021] [Citation(s) in RCA: 9] [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: 05/16/2016] [Revised: 06/14/2016] [Accepted: 07/05/2016] [Indexed: 11/10/2022]
Abstract
Cynomolgus monkeys are used frequently in preclinical studies for new drug development due to their evolutionary closeness to humans. An antiretroviral drug, efavirenz, is a typical probe substrate for human cytochrome P450 (P450) 2B6, but is mainly metabolized by cynomolgus monkey P450 2C9. In this study, plasma concentrations of efavirenz were assessed in six cynomolgus monkeys genotyped for P450 2C9 c.334 A > C (I112L) (three wild-type, one heterozygote and two homozygotes) by high performance liquid chromatography with tandem mass spectrometry. After intravenous administration at a dose of 1.0 mg/kg, biphasic plasma elimination curves of efavirenz were seen in these cynomolgus monkeys. The mean plasma concentration of the primary metabolite 8-hydroxyefavirenz (1 h after treatment, with hydrolysis by β-glucuronidase) in the wild-type group was significantly higher (4.0-fold) than the combined heterozygous and homozygous group mean. The area under the plasma concentration-time curve value of efavirenz in the homozygous group after oral administration at a dose of 2.0 mg/kg was significantly higher (2.0-fold) than the combined wild-type and heterozygous group. These results collectively indicated that P450 2C9 c.334 A > C (I112L) variation was associated with efavirenz metabolic clearance in vivo. Cynomolgus P450 2C9 polymorphism might account for interindividual variations of efavirenz metabolism in cynomolgus monkeys. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Kazuhide Iwasaki
- Shin Nippon Biomedical Laboratories, Ltd, Kainan, Wakayama, 642-0017, Japan
| | - Yusuke Kitsugi
- Shin Nippon Biomedical Laboratories, Ltd, Kainan, Wakayama, 642-0017, Japan
| | - Kanami Ikeda
- Shin Nippon Biomedical Laboratories, Ltd, Kainan, Wakayama, 642-0017, Japan
| | - Takahiro Yoshikawa
- Shin Nippon Biomedical Laboratories, Ltd, Kainan, Wakayama, 642-0017, Japan
| | - Shinya Hosaka
- Showa Pharmaceutical University, Machida Tokyo, 194-8543, Japan
| | - Shotaro Uehara
- Showa Pharmaceutical University, Machida Tokyo, 194-8543, Japan
| | - Yasuhiro Uno
- Shin Nippon Biomedical Laboratories, Ltd, Kainan, Wakayama, 642-0017, Japan
| | - Masahiro Utoh
- Shin Nippon Biomedical Laboratories, Ltd, Kainan, Wakayama, 642-0017, Japan
| | - Hiroshi Yamazaki
- Showa Pharmaceutical University, Machida Tokyo, 194-8543, Japan.
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24
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Iwasaki K, Kitsugi Y, Ikeda K, Yoshikawa T, Uehara S, Uno Y, Utoh M, Yamazaki H. Effect of CYP2C9 genotype for pharmacokinetics of efavirenz in vivo in cynomolgus monkeys. Drug Metab Pharmacokinet 2017. [DOI: 10.1016/j.dmpk.2016.10.168] [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: 11/28/2022]
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25
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Hosaka S, Murayama N, Satsukawa M, Uehara S, Shimizu M, Iwasaki K, Iwano S, Uno Y, Yamazaki H. Identification of putative substrates for cynomolgus monkey cytochrome P450 2C8 by substrate depletion assays with 22 human P450 substrates and inhibitors. Biopharm Drug Dispos 2016; 37:310-3. [DOI: 10.1002/bdd.1998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 10/30/2015] [Accepted: 11/06/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Shinya Hosaka
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
- Kaken Pharmaceutical Co.; Ltd; Shizuoka 426-8646 Japan
| | - Norie Murayama
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | | | - Shotaro Uehara
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Makiko Shimizu
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Kazuhide Iwasaki
- Shin Nippon Biomedical Laboratories; Ltd; Kainan Wakayama 642-0017 Japan
| | - Shunsuke Iwano
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
- Novartis Pharma K.K.; Tokyo 106-8618 Japan
| | - Yasuhiro Uno
- Shin Nippon Biomedical Laboratories; Ltd; Kainan Wakayama 642-0017 Japan
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26
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Matsuo K, Takazawa Y, Ross MS, Elishaev E, Podzielinski I, Yunokawa M, Sheridan TB, Bush SH, Klobocista MM, Blake EA, Takano T, Matsuzaki S, Baba T, Satoh S, Shida M, Nishikawa T, Ikeda Y, Adachi S, Yokoyama T, Takekuma M, Fujiwara K, Hazama Y, Kadogami D, Moffitt MN, Takeuchi S, Nishimura M, Iwasaki K, Ushioda N, Johnson MS, Yoshida M, Hakam A, Li SW, Richmond AM, Machida H, Mhawech-Fauceglia P, Ueda Y, Yoshino K, Yamaguchi K, Oishi T, Kajiwara H, Hasegawa K, Yasuda M, Kawana K, Suda K, Miyake TM, Moriya T, Yuba Y, Morgan T, Fukagawa T, Wakatsuki A, Sugiyama T, Pejovic T, Nagano T, Shimoya K, Andoh M, Shiki Y, Enomoto T, Sasaki T, Fujiwara K, Mikami M, Shimada M, Konishi I, Kimura T, Post MD, Shahzad MM, Im DD, Yoshida H, Omatsu K, Ueland FR, Kelley JL, Karabakhtsian RG, Roman LD. Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma. Ann Oncol 2016; 27:1257-66. [PMID: 27052653 DOI: 10.1093/annonc/mdw161] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 12/07/2015] [Accepted: 03/29/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To examine the effect of the histology of carcinoma and sarcoma components on survival outcome of uterine carcinosarcoma. PATIENTS AND METHODS A multicenter retrospective study was conducted to examine uterine carcinosarcoma cases that underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating to clinico-pathological demographics and outcomes. RESULTS Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma) with high-grade/homologous (40.8%) being the most common type followed by high-grade/heterologous (30.9%), low-grade/homologous (18.0%), and low-grade/heterologous (10.3%). On multivariate analysis, high-grade/heterologous (5-year rate, 34.0%, P = 0.024) and high-grade/homologous (45.8%, P = 0.017) but not low-grade/heterologous (50.6%, P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3%). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrial invasion, lymphovascular space invasion, and advanced-stage disease were independently associated with decreased PFS (all, P < 0.01). Both postoperative chemotherapy (5-year rates, 48.6% versus 39.0%, P < 0.001) and radiotherapy (50.1% versus 44.1%, P = 0.007) were significantly associated with improved PFS in univariate analysis. However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improved PFS [hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.27-0.43, P < 0.001]. On univariate analysis, significant treatment benefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0% versus 49.8%, P = 0.001), platinum for high-grade carcinoma (46.9% versus 32.4%, P = 0.034) and homologous sarcoma (53.1% versus 38.2%, P = 0.017), and anthracycline for heterologous sarcoma (66.2% versus 39.3%, P = 0.005). Conversely, platinum, taxane, and anthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared with non-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95% CI 0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95% CI 0.22-0.60, P < 0.001), and anthracycline for high-grade/heterologous (HR 0.30, 95% CI 0.14-0.62, P = 0.001) remained independent predictors for improved PFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, while sarcoma components tended to spread loco-regionally (P < 0.001). CONCLUSION Characterization of histologic pattern provides valuable information in the management of uterine carcinosarcoma.
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Affiliation(s)
- K Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
| | - Y Takazawa
- Department of Pathology, Cancer Institute Hospital, Tokyo, Japan
| | - M S Ross
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
| | - E Elishaev
- Department of Pathology, MaGee-Womens Hospital, University of Pittsburgh, Pittsburgh
| | - I Podzielinski
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - M Yunokawa
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T B Sheridan
- Department of Pathology, Mercy Medical Center, Baltimore
| | - S H Bush
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida, Tampa
| | - M M Klobocista
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bronx
| | - E A Blake
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology; University of Colorado, Boulder, USA
| | - T Takano
- Department of Obstetrics and Gynecology, Tohoku University, Miyagi
| | - S Matsuzaki
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - T Baba
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - S Satoh
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - M Shida
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa
| | - T Nishikawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - Y Ikeda
- Departments of Obstetrics and Gynecology, The University of Tokyo, Tokyo
| | - S Adachi
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T Yokoyama
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka
| | - M Takekuma
- Department of Obstetrics and Gynecology, Shizuoka Cancer Center, Shizuoka
| | - K Fujiwara
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama
| | - Y Hazama
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - D Kadogami
- Department of Obstetrics and Gynecology; Kitano Hospital, Osaka, Japan
| | - M N Moffitt
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Portland, USA
| | - S Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka
| | - M Nishimura
- Department of Obstetrics and Gynecology, Tokushima University, Tokushima
| | - K Iwasaki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi
| | - N Ushioda
- Department of Gynecology, Cancer Institute Hospital, Tokyo
| | - M S Johnson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - M Yoshida
- Departments of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - A Hakam
- Department of Pathology, Moffitt Cancer Center, University of South Florida, Tampa
| | - S W Li
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bronx
| | - A M Richmond
- Department of Pathology, University of Colorado, Boulder
| | - H Machida
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
| | - P Mhawech-Fauceglia
- Department of Pathology, University of Southern California, Los Angeles, USA
| | - Y Ueda
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - K Yoshino
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - K Yamaguchi
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - T Oishi
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - H Kajiwara
- Department of Pathology, Tokai University, Kanagawa
| | - K Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - M Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - K Kawana
- Departments of Obstetrics and Gynecology, The University of Tokyo, Tokyo
| | - K Suda
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T M Miyake
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - T Moriya
- Department of Pathology, Kawasaki Medical School, Okayama
| | - Y Yuba
- Department of Pathology, Kitano Hospital, Osaka, Japan
| | - T Morgan
- Department of Pathology, Oregon Health & Science University, Portland, USA
| | - T Fukagawa
- Department of Pathology, Iwate Medical University, Morioka
| | - A Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi
| | - T Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka
| | - T Pejovic
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Portland, USA
| | - T Nagano
- Department of Obstetrics and Gynecology; Kitano Hospital, Osaka, Japan
| | - K Shimoya
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - M Andoh
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama
| | - Y Shiki
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka
| | - T Enomoto
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T Sasaki
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - K Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - M Mikami
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa
| | - M Shimada
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - I Konishi
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - T Kimura
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - M D Post
- Department of Pathology, University of Colorado, Boulder
| | - M M Shahzad
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida, Tampa
| | - D D Im
- Department of Gynecology, Mercy Medical Center, Baltimore
| | - H Yoshida
- Departments of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - K Omatsu
- Department of Gynecology, Cancer Institute Hospital, Tokyo
| | - F R Ueland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - J L Kelley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
| | - R G Karabakhtsian
- Department of Pathology, University of Kentucky, Lexington Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, USA
| | - L D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
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Hosaka S, Murayama N, Satsukawa M, Uehara S, Shimizu M, Iwasaki K, Iwano S, Uno Y, Yamazaki H. Similar substrate specificity of cynomolgus monkey cytochrome P450 2C19 to reported human P450 2C counterpart enzymes by evaluation of 89 drug clearances. Biopharm Drug Dispos 2015; 36:636-43. [DOI: 10.1002/bdd.1991] [Citation(s) in RCA: 7] [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] [Received: 07/25/2015] [Revised: 08/22/2015] [Accepted: 08/30/2015] [Indexed: 01/19/2023]
Affiliation(s)
- Shinya Hosaka
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
- Kaken Pharmaceutical Co., LTD.; Shizuoka 426-8646 Japan
| | - Norie Murayama
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | | | - Shotaro Uehara
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Makiko Shimizu
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
| | - Kazuhide Iwasaki
- Shin Nippon Biomedical Laboratories, Ltd; Kainan Wakayama 642-0017 Japan
| | - Shunsuke Iwano
- Showa Pharmaceutical University; Machida Tokyo 194-8543 Japan
- Novartis Pharma K.K.; Tokyo 106-8618 Japan
| | - Yasuhiro Uno
- Shin Nippon Biomedical Laboratories, Ltd; Kainan Wakayama 642-0017 Japan
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Hosaka S, Murayama N, Satsukawa M, Uehara S, Shimizu M, Iwasaki K, Iwano S, Uno Y, Yamazaki H. Comprehensive Evaluation for Substrate Selectivity of Cynomolgus Monkey Cytochrome P450 2C9, a New Efavirenz Oxidase. Drug Metab Dispos 2015; 43:1119-22. [DOI: 10.1124/dmd.115.063925] [Citation(s) in RCA: 12] [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: 02/20/2015] [Accepted: 05/06/2015] [Indexed: 11/22/2022] Open
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29
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Utoh M, Yoshikawa T, Hayashi Y, Shimizu M, Iwasaki K, Uno Y, Yamazaki H. Slow R-warfarin 7-hydroxylation mediated by P450 2C19 genetic variants in cynomolgus monkeys in vivo. Biochem Pharmacol 2015; 95:110-4. [DOI: 10.1016/j.bcp.2015.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/12/2015] [Indexed: 12/23/2022]
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30
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Ishizaki H, Umemura K, Mineta H, Nozue M, Matsuoka I, Iwasaki K, Nishida Y. The examination of body sway in normal subjects and patients with Ménière's disease or cerebellar dysfunction. Adv Otorhinolaryngol 2015; 41:166-72. [PMID: 3265001 DOI: 10.1159/000416051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- H Ishizaki
- Department of Otorhinolaryngology, Hamamatsu University School of Medicine, Japan
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31
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Iwasaki K, Kogo N, Dei M. Example Of Analysis Utilizing Real World Data: Medical Cost Reduction By Advising Untreated-Diabetes Patients To Visit Doctors. Value Health 2014; 17:A744. [PMID: 27202686 DOI: 10.1016/j.jval.2014.08.158] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - N Kogo
- Milliman Inc., Tokyo, Japan
| | - M Dei
- Milliman Inc., Tokyo, Japan
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32
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Iwasaki K, Kogo N, Dei M. Example of Analysis Utilizing Real World Data: Medical Cost Reduction of Combination Drugs. Value Health 2014; 17:A720-A721. [PMID: 27202550 DOI: 10.1016/j.jval.2014.08.016] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - N Kogo
- Milliman Inc., Tokyo, Japan
| | - M Dei
- Milliman Inc., Tokyo, Japan
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33
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Iwasaki K, Kogo N, Dei M. Example of Analysis Utilizing Real World Data: Medical Cost Reduction by Advising Untreated-Hypertension Patients to Visit Doctors. Value Health 2014; 17:A760. [PMID: 27202778 DOI: 10.1016/j.jval.2014.08.252] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - N Kogo
- Milliman Inc., Tokyo, Japan
| | - M Dei
- Milliman Inc., Tokyo, Japan
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34
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Hosaka S, Murayama N, Satsukawa M, Shimizu M, Uehara S, Fujino H, Iwasaki K, Iwano S, Uno Y, Yamazaki H. Evaluation of 89 Compounds for Identification of Substrates for Cynomolgus Monkey CYP2C76, a New Bupropion/Nifedipine Oxidase. Drug Metab Dispos 2014; 43:27-33. [DOI: 10.1124/dmd.114.061275] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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35
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Abstract
Neonatal Fc receptor (FcRn), a heterodimer of MHC class I-like protein and β2-microglobulin, encoded by FCGRT and B2M, respectively, is important for recycling immunoglobulin G (IgG) antibodies by binding with the Fc region of IgG. Cynomolgus macaques are important animal species used in the evaluation of therapeutic antibodies, largely due to sequence similarities of target proteins to those of humans. Because the function of FcRn could be modified by mutations in FCGRT or B2M, 71 cynomolgus and 24 rhesus macaques were analyzed in the present study. A total of 21 variants were identified, of which 4 were non-synonymous in FCGRT. Fifteen variants were unique to cynomolgus macaques, of which 3, 2, and 5 were unique to cynomolgus macaques bred in China (MacfaCHN), Cambodia (MacfaCAM), and Indonesia (MacfaIDN), respectively. Five variants were shared by MacfaCHN and MacfaCAM, but not by MacfaIDN. In B2M, only 5 variants were found, including 2 non-synonymous variants. Tissue expression analysis showed that cynomolgus FCGRT and B2M were widely expressed in the 10 tissue types analyzed. None of the non-synonymous variants of FCGRT or B2M found changes in the amino acid residues known to be important for FcRn function, suggesting that substantial inter-animal variability of FcRn is not expected for the cynomolgus macaques analyzed.
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Affiliation(s)
- Yasuhiro Uno
- Pharmacokinetics and Bioanalysis Center, Shin Nippon Biomedical Laboratories, Ltd
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36
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Muroi C, Fujioka M, Mishima K, Irie K, Fujimura Y, Nakano T, Fandino J, Keller E, Iwasaki K, Fujiwara M. Effect of ADAMTS-13 on cerebrovascular microthrombosis and neuronal injury after experimental subarachnoid hemorrhage. J Thromb Haemost 2014; 12:505-14. [PMID: 24476338 DOI: 10.1111/jth.12511] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 09/08/2013] [Accepted: 12/17/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Microthrombosis and reactive inflammation contribute to neuronal injury after subarachnoid hemorrhage (SAH). ADAMTS-13 cleaves von Willebrand factor multimers, and inhibits thrombus formation and, seemingly, inflammatory reactions. OBJECTIVE To investigate the effect of ADAMTS-13 in experimental SAH. METHODS A total of 100 male C57/BL6 mice were randomly assigned to four groups: sham (n = 15), SAH (n = 27), vehicle (n = 25), and ADAMTS-13 (n = 23; 100 μL per 10 g of body weight of 100 μg of ADAMTS-13 per 1 mL of 0.9% NaCl; 20 min after SAH). Neurologic performance was assessed on days 1 and 2 after SAH. Animals were killed on day 2. The amounts of subarachnoid blood, microthrombi, apoptosis and degenerative neurons were compared. The degree of neuronal inflammation and vasospasm was also compared. In five mice each (SAH and ADAMTS-13 groups), bleeding time was assessed 2 h after SAH. RESULTS Systemic administration of ADAMTS-13 achieved significant amelioration of microthrombosis and improvement in neurologic performance. ADAMTS-13 reduced the amount of apoptotic and degenerative neurons. A tendency for decreased neuronal inflammation was observed. ADAMTS-13 did not show any significant effect on vasospasm. The degree of systemic inflammation was not changed by ADAMTS-13 administration. ADAMTS-13 neither increased the amount of subarachnoid blood nor prolonged the bleeding time. CONCLUSIONS ADAMTS-13 may reduce neuronal injury after SAH by reducing microthrombosis formation and neuronal inflammation, thereby providing a new option for mitigating the severity of neuronal injury after SAH.
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Affiliation(s)
- C Muroi
- Department of Neuropharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan; Institute of Aging and Brain Sciences, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan; Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland; Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
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37
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Norimura D, Isomoto H, Fukuda E, Yamao T, Ozawa E, Iwasaki K, Ohnita K, Takeshima F, Shikuwa S, Nakao K. Cowden's disease manifested by esophageal polyposis with characteristic appearance on magnifying endoscopy using narrow band imaging. Endoscopy 2014; 45 Suppl 2 UCTN:E298. [PMID: 24008475 DOI: 10.1055/s-0032-1310022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/10/2022]
Affiliation(s)
- D Norimura
- Department of Gastroenterology and Hepatology, Sasebo Municipal General Hospital, Sasebo, Japan.
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38
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Yajima K, Uno Y, Murayama N, Uehara S, Shimizu M, Nakamura C, Iwasaki K, Utoh M, Yamazaki H. Evaluation of 23 Lots of Commercially Available Cryopreserved Hepatocytes for Induction Assays of Human Cytochromes P450. Drug Metab Dispos 2014; 42:867-71. [DOI: 10.1124/dmd.113.056804] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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39
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Utoh M, Murayama N, Uno Y, Onose Y, Hosaka S, Fujino H, Shimizu M, Iwasaki K, Yamazaki H. Monkey liver cytochrome P450 2C9 is involved in caffeine 7-N-demethylation to form theophylline. Xenobiotica 2013; 43:1037-42. [PMID: 23679834 DOI: 10.3109/00498254.2013.793874] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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]
Abstract
Caffeine (1,3,7-trimethylxanthine) is a phenotyping substrate for human cytochrome P450 1A2. 3-N-Demethylation of caffeine is the main human metabolic pathway, whereas monkeys extensively mediate the 7-N-demethylation of caffeine to form pharmacological active theophylline. Roles of monkey P450 enzymes in theophylline formation from caffeine were investigated using individual monkey liver microsomes and 14 recombinantly expressed monkey P450 enzymes, and the results were compared with those for human P450 enzymes. Caffeine 7-N-demethylation activity in microsomes from 20 monkey livers was not strongly inhibited by α-naphthoflavone, quinidine or ketoconazole, and was roughly correlated with diclofenac 4'-hydroxylation activities. Monkey P450 2C9 had the highest activity for caffeine 7-N-demethylation. Kinetic analysis revealed that monkey P450 2C9 had a high Vmax/Km value for caffeine 7-N-demethylation, comparable to low Km value for monkey liver microsomes. Caffeine could dock favorably with monkey P450 2C9 modeled for 7-N-demethylation and with human P450 1A2 for 3-N-demethylation. The primary metabolite theophylline was oxidized to 8-hydroxytheophylline in similar ways by liver microsomes and by recombinant P450s in both humans and monkeys. These results collectively suggest a high activity for monkey liver P450 2C9 toward caffeine 7-N-demethylation, whereas, in humans, P450 1A2-mediated caffeine 3-N-demethylation is dominant.
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Affiliation(s)
- Masahiro Utoh
- Shin Nippon Biomedical Laboratories, Ltd., Pharmacokinetics and Bioanalysis Center , Kainan , Japan
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40
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Nakanishi Y, Yamashita H, Yoshikawa T, Tominaga T, Nojiri K, Sunaga Y, Muneoka A, Iwasaki K, Utoh M, Nakamura C, Yamazaki H, Uno Y. Cytochrome P450 metabolic activities in the small intestine of cynomolgus macaques bred in Cambodia, China, and Indonesia. Drug Metab Pharmacokinet 2013; 28:510-3. [PMID: 23648676 DOI: 10.2133/dmpk.dmpk-13-nt-031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cynomolgus macaques, used in drug metabolism studies due to their evolutionary closeness to humans, are mainly bred in Asian countries, including Cambodia, China, and Indonesia. Cytochromes P450 (P450s) are important drug-metabolizing enzymes, present in the liver and small intestine, major drug metabolizing organs. Previously, our investigation did not find statistically significant differences in hepatic P450 metabolic activities measured in cynomolgus macaques bred in Cambodia (MacfaCAM) and China (MacfaCHN). In the present study, P450 metabolic activity was investigated in the small intestine of MacfaCAM and MacfaCHN, and cynomolgus macaques bred in Indonesia (MacfaIDN) using P450 substrates, including 7-ethoxyresorufin, coumarin, bupropion, paclitaxel, diclofenac, S-mephenytoin, bufuralol, chlorzoxazone, and testosterone. The results indicated that P450 metabolic activity of the small intestine was not statistically significantly different (<2.0-fold) in MacfaCAM, MacfaCHN, and MacfaIDN. In addition, statistically significant sex differences were not observed (<2.0-fold) in any P450 metabolic activity in MacfaCAM as supported by mRNA expression results. These results suggest that P450 metabolic activity of the small intestine does not significantly differ statistically among MacfaCAM, MacfaCHN, and MacfaIDN.
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Affiliation(s)
- Yasuharu Nakanishi
- Pharmacokinetics and Bioanalysis Center, Shin Nippon Biomedical Laboratories, Ltd
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41
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Ieiri I, Doi Y, Maeda K, Sasaki T, Kimura M, Hirota T, Chiyoda T, Miyagawa M, Irie S, Iwasaki K, Sugiyama Y. Microdosing Clinical Study: Pharmacokinetic, Pharmacogenomic (SLCO2B1), and Interaction (Grapefruit Juice) Profiles of Celiprolol Following the Oral Microdose and Therapeutic Dose. J Clin Pharmacol 2013; 52:1078-89. [DOI: 10.1177/0091270011408612] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Tokumine J, Lefor AT, Yonei A, Kagaya A, Iwasaki K, Fukuda Y. Three-step method for ultrasound-guided central vein catheterization. Br J Anaesth 2013; 110:368-73. [PMID: 23131458 DOI: 10.1093/bja/aes381] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The long-axis view and in-plane needle approach (LAX-IP) for ultrasound-guided central vein catheterization is considered ideal because of the quality of real-time imaging. We describe a novel technique, using a step-by-step procedure, to overcome the pitfalls associated with the LAX-IP. This study was undertaken to demonstrate the clinical utility of this approach. METHODS All operators underwent training before participation in this study. One hundred patients were enrolled in this study and underwent central venous catheterization using this method. Using a portable ultrasound and vein catheterization kit, patients were appropriately positioned and a straight portion of the vein identified (Step 1). A needle guide was used (Step 2) and the vein imaged in real time in two directions (Step 3), to identify the true long axis and prevent damage to surrounding tissues. RESULTS The overall success rate for catheterization was 100% with a median of one puncture for each patient. All catheterizations were performed within three punctures. Problems with the first puncture included difficult insertion of the guide-wire due to coiling, difficult anterior wall puncture, less experience with the procedure, and other reasons. There were no complications associated with the procedure. CONCLUSIONS This three-step method is not dependent on an operator's ability to proceed based on spatial awareness, but rather depends on logic. This method can prevent difficulties associated with a two-dimensional ultrasound view, and may be a safer technique compared with others. Further clinical trials are needed to establish the safety of this technique.
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Affiliation(s)
- J Tokumine
- Department of Anesthesia, Seikei-kai Chiba Medical Center, 1-11-12, Minami-cho, Chuo-ku, Chiba-shi 260-0842, Japan.
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Emoto C, Yoda N, Uno Y, Iwasaki K, Umehara K, Kashiyama E, Yamazaki H. Comparison of p450 enzymes between cynomolgus monkeys and humans: p450 identities, protein contents, kinetic parameters, and potential for inhibitory profiles. Curr Drug Metab 2013; 14:239-252. [PMID: 22963393] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 06/05/2012] [Accepted: 08/15/2012] [Indexed: 06/01/2023]
Abstract
Cynomolgus monkeys are used to predict human pharmacokinetic and/or toxic profiles in the drug developmental stage. Cynomolgus P450s exhibit a high degree of identity (more than 90%) in both cDNA and amino acid sequences with corresponding human P450s. CYP3A protein predominantly exists in cynomolgus monkey liver microsomes, followed by CYP2A, CYP2C, CYP2B6, CYP2E1, and CYP2D. There are many similarities of metabolic properties in cytochrome P450s between cynomolgus monkeys and humans, but the species differences between cynomolgus monkey and human P450s are clearly present in substrate specificity and inhibitor selectivity. Diclofenac 4'-hydroxylation (DFOH) in monkey liver and intestinal microsomes shows much lower activities compared with those in human liver and intestinal microsomes. Sulfaphenazole strongly inhibits DFOH in human liver microsomes, but does not effectively inhibit DFOH in monkey liver and intestinal microsomes. Cynomolgus CYP2C19 exhibits higher activity for DFOH than cynomolgus CYP2C9 although this reaction is a marker reaction of human CYP2C9. On the other hand, cynomolgus CYP2C76 orthologue is not expressed in humans and shows 70-72% identity in amino acid sequences of human CYP2C subfamilies. Cynomolgus CYP2C76 metabolizes non-CYP2C substrates, 7-ethoxyresorufin (human CYP1A substrate) and bufuralol (human CYP2D6 substrate). In addition, cynomolgus CYP3A4 and CYP3A5 also exhibits wider substrate selectivity toward human CYP2D6 and CYP2E1 substrates. These enzymes may be responsible for species difference in drug metabolism between cynomolgus monkeys and humans. The comparative data presented here can be helpful for designing in vivo metabolic assays using cynomolgus monkeys in terms of substrate specificity and inhibitor selectivity.
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Affiliation(s)
- Chie Emoto
- Department of Drug Metabolism, Tokushima Research Institute, Otsuka Pharmaceutical Co. Ltd., 463-10 Kagasuno, Tokushima, Japan
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Emoto C, Yoda N, Uno Y, Iwasaki K, Umehara K, Kashiyama E, Yamazaki H. Comparison of P450 Enzymes Between Cynomolgus Monkeys and Humans: P450 Identities, Protein Contents, Kinetic Parameters, and Potential for Inhibitory Profiles. Curr Drug Metab 2013. [DOI: 10.2174/138920013804870664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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45
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Emoto C, Yoda N, Uno Y, Iwasaki K, Umehara K, Kashiyama E, Yamazaki H. Comparison of P450 Enzymes Between Cynomolgus Monkeys and Humans: P450 Identities, Protein Contents, Kinetic Parameters, and Potential for Inhibitory Profiles. Curr Drug Metab 2013. [DOI: 10.2174/1389200211314020012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Iwasaki K, Obara W, Kato Y, Takata R, Tanji S, Fujioka T. Neoadjuvant Gemcitabine Plus Carboplatin for Locally Advanced Bladder Cancer. Jpn J Clin Oncol 2012; 43:193-9. [DOI: 10.1093/jjco/hys213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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47
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Hosoi Y, Uno Y, Murayama N, Fujino H, Shukuya M, Iwasaki K, Shimizu M, Utoh M, Yamazaki H. Monkey liver cytochrome P450 2C19 is involved in R- and S-warfarin 7-hydroxylation. Biochem Pharmacol 2012; 84:1691-5. [PMID: 23041648 DOI: 10.1016/j.bcp.2012.09.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 09/25/2012] [Accepted: 09/25/2012] [Indexed: 02/06/2023]
Abstract
Cynomolgus monkeys are widely used as primate models in preclinical studies. However, some differences are occasionally seen between monkeys and humans in the activities of cytochrome P450 enzymes. R- and S-warfarin are model substrates for stereoselective oxidation in humans. In this current research, the activities of monkey liver microsomes and 14 recombinantly expressed monkey cytochrome P450 enzymes were analyzed with respect to R- and S-warfarin 6- and 7-hydroxylation. Monkey liver microsomes efficiently mediated both R- and S-warfarin 7-hydroxylation, in contrast to human liver microsomes, which preferentially catalyzed S-warfarin 7-hydroxylation. R-Warfarin 7-hydroxylation activities in monkey liver microsomes were not inhibited by α-naphthoflavone or ketoconazole, and were roughly correlated with P450 2C19 levels and flurbiprofen 4-hydroxylation activities in microsomes from 20 monkey livers. In contrast, S-warfarin 7-hydroxylation activities were not correlated with the four marker drug oxidation activities used. Among the 14 recombinantly expressed monkey P450 enzymes tested, P450 2C19 had the highest activities for R- and S-warfarin 7-hydroxylations. Monkey P450 3A4 and 3A5 slowly mediated R- and S-warfarin 6-hydroxylations. Kinetic analysis revealed that monkey P450 2C19 had high V(max) and low K(m) values for R-warfarin 7-hydroxylation, comparable to those for monkey liver microsomes. Monkey P450 2C19 also mediated S-warfarin 7-hydroxylation with V(max) and V(max)/K(m) values comparable to those for recombinant human P450 2C9. R-warfarin could dock favorably into monkey P450 2C19 modeled. These results collectively suggest high activities for monkey liver P450 2C19 toward R- and S-warfarin 6- and 7-hydroxylation in contrast to the saturation kinetics of human P450 2C9-mediated S-warfarin 7-hydroxylation.
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Affiliation(s)
- Yoshio Hosoi
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, Machida, Tokyo 194-8543, Japan
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Bhakta JN, Ohnishi K, Munekage Y, Iwasaki K, Wei MQ. Characterization of lactic acid bacteria-based probiotics as potential heavy metal sorbents. J Appl Microbiol 2012; 112:1193-206. [PMID: 22404232 DOI: 10.1111/j.1365-2672.2012.05284.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To isolate and characterize lactic acid bacteria (LAB) and determine whether they could potentially be used as heavy metal (cadmium and lead) absorbing probiotics. METHODS AND RESULTS The study used 53 environmental (mud and sludge) samples to isolate cadmium- and lead-resistant LAB, by following spared plate technique. A total of 255 cadmium- and lead-resistant LAB were isolated from these samples. The survival of 26 of the LAB was found after passing through sequential probiotic characterizations. These 26 probiotic LAB exhibited remarkable variations in their metal-resistant and metal-removal abilities. Of 26, seven (Cd54-2, Cd61-7, Cd69-12, Cd70-13, Pb82-8, Pb96-19 and Cd109-16) and four (Pb71-1, Pb73-2, Pb85-9 and Pb96-19) strains displayed relatively elevated cadmium- and lead-removal efficiencies from water, respectively, compare with that of the remaining strains. Strains Cd70-13 and Pb71-1 showed the highest cadmium (25%) and lead (59%) removal capacity from MRS (De Man, Rogosa and Sharpe) culture medium, respectively, amongst the selected strains and showed a good adhesive ability on fish mucus. A phylogenetic analysis of their 16S rDNA sequences revealed that the strains Cd70-13 and Pb71-1 belong to Lactobacillus reuteri. CONCLUSION Excellent probiotic, metal sorption and adhesive characteristics of newly identified Lact. reuteri strains Cd70-13 and Pb71-1 were isolated, which indicated their high potential abilities to survive in the intestinal milieu and to uptake the tested metals from the environment. SIGNIFICANCE AND IMPACT OF THE STUDY To our knowledge, this is the first study that has aimed to isolate, characterize and identify metal-resistant LAB strains that have potential to be a probiotic candidate for food and in vivo challenge studies in the intestinal milieu of fish for the uptake and control of heavy metal bioaccumulation.
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Affiliation(s)
- J N Bhakta
- Research Institute of Molecular Genetics, Faculty of Agriculture, Kochi University, Monobe, Nankoku, Kochi, Japan
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Iwasaki K, Kikuchi A, Takeda A, Satoh T, Sawada JI, Konno H, Takahashi T, Takayama S, Tobita M, Yaegashi N. 1.257 A CROSSOVER STUDY OF A TRADITIONAL ASIAN HERBAL MEDICINE FOR HUNTINGTON'S DISEASE. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70315-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Sawabe M, Aoki A, Komaki M, Iwasaki K, Ogita M, Izumi Y. Gingival healing following Er:YAG laser ablation Vs electrosurgery in rats. Med Oral Patol Oral Cir Bucal 2012. [DOI: 10.4317/medoral.17643734] [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: 11/05/2022] Open
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