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Yamamoto T, Mochida Y, Irie K, Altanbagana NU, Fuchida S, Aida J, Takeuchi K, Fujita M, Kondo K. Regional Inequalities in Oral Frailty and Social Capital. JDR Clin Trans Res 2024:23800844241238648. [PMID: 38654451 DOI: 10.1177/23800844241238648] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models. METHODS This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital (n = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density (n = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs). RESULTS The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11-1.23) (reference: metropolitan). CONCLUSION These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas. KNOWLEDGE TRANSFER STATEMENT The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas.
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Affiliation(s)
- T Yamamoto
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - Y Mochida
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - K Irie
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - N U Altanbagana
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - S Fuchida
- Department of Education Planning, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Takeuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - M Fujita
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - K Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Chiba, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Tanaka F, Irie K, Fukui N, Horii R, Imamura H, Hirabatake M, Ikesue H, Muroi N, Fukushima S, Sakai N, Hashida T. Pharmacokinetics of Temozolomide in a Patient With Glioblastoma Undergoing Hemodialysis: A Short Communication. Ther Drug Monit 2023; 45:823-826. [PMID: 37646650 PMCID: PMC10635330 DOI: 10.1097/ftd.0000000000001125] [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: 12/12/2022] [Accepted: 05/22/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Temozolomide (TMZ) is an alkylating agent used to treat glioblastoma. However, the pharmacokinetics of TMZ to establish a treatment strategy for patients undergoing hemodialysis (HD) remain unclear. In this case report, we evaluated the pharmacokinetics and HD removal rate of TMZ in a patient with glioblastoma undergoing HD to determine optimal dosing of TMZ. METHODS A 78-year-old man with glioblastoma who underwent HD 3 times a week was treated with TMZ concomitant with radiotherapy. One dose of TMZ was prescribed at 75 mg/m 2 on the day before HD and another dose of 37.5 mg/m 2 on the day before non-HD. Peak and trough concentrations (1 hour and 12 hours after dosing, respectively) were evaluated before HD and on non-HD days. HD removal rate of TMZ was calculated based on the predialyzer and postdialyzer plasma concentrations. Furthermore, the TMZ plasma concentrations were measured using liquid chromatography-tandem mass spectrometry. RESULTS The mean plasma peak and trough concentrations ± SD after 75 mg/m 2 TMZ were 2917 ± 914 and 108 ± 17.6 ng/mL, respectively. Those after 37.5 mg/m 2 TMZ dosage were 1305 ± 650 and 53.8 ± 11.8 ng/mL, respectively. The mean HD TMZ removal rate was 84.9 ± 1.9%. CONCLUSIONS TMZ was tolerable in patients undergoing HD. Based on the data from a single individual pharmacokinetic perspective, the pharmacokinetics of TMZ in this patient undergoing HD were comparable with those observed in patients with normal renal function. In addition, it may be reasonable to administer TMZ after HD because of the high HD removal rate.
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Affiliation(s)
- Fumiaki Tanaka
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kei Irie
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan; and
| | - Nobuyuki Fukui
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryo Horii
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hirotoshi Imamura
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masaki Hirabatake
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shoji Fukushima
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan; and
| | - Nobuyuki Sakai
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan; and
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Irie K, Yamamoto T. A Case of Pyoderma Gangrenosum-Like Ulcers Progressing into Neutrophilic Panniculitis in a Patient With Myelodysplastic Syndrome. Actas Dermosifiliogr 2023:S0001-7310(23)00926-2. [PMID: 38008246 DOI: 10.1016/j.ad.2023.02.034] [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: 01/05/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 11/28/2023] Open
Affiliation(s)
- K Irie
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan.
| | - T Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
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Yamaoka K, Irie K, Hiramoto N, Hirabatake M, Ikesue H, Hashida T, Shimizu T, Ishikawa T, Muroi N. Safety and blood levels of daratumumab after switching from intravenous to subcutaneous administration in patients with multiple myeloma. Invest New Drugs 2023; 41:761-767. [PMID: 37721661 PMCID: PMC10560139 DOI: 10.1007/s10637-023-01392-1] [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] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/08/2023] [Indexed: 09/19/2023]
Abstract
The intravenous administration (IV) of daratumumab sometimes causes an infusion reaction and needs a long infusion time. Recently, a subcutaneous formulation (SC) of daratumumab, which has fewer infusion reactions and shorter administration time, was approved. However, because SC has a fixed dose, overdosing is a concern for patients with low body weights. In this study, we investigated the safety and blood levels of daratumumab after switching from IV to SC in patients with multiple myeloma (MM). Patients who switched from IV to SC of daratumumab between June 2021 and May 2022 at Kobe City Medical Center General Hospital were included in the study. Blood daratumumab levels were measured using liquid chromatography-tandem mass spectrometry. Safety after switching from IV to SC was evaluated for six months and graded according to the Common Terminology Criteria for Adverse Events, version 5.0. The median body weight of ten patients included in the analysis was 57.4 kg (range: 45.0-74.4). Blood daratumumab levels were significantly increased after switching to SC (p = 0.002); median through concentration at the last IV dose was 403.6 μg/mL (range: 96.3-776.3) and that at the third SC dose was 557.1 μg/mL (range: 288.3-997.2). Grade 1-2 injection site reactions were observed in six patients (60.0%) after switching to SC. A new grade 3 adverse event was observed in only one patient (neutropenia). The blood levels of daratumumab were significantly increased after switching from IV to SC in patients with MM; however, the dosage was tolerable.
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Affiliation(s)
- Kenta Yamaoka
- Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
- School of Pharmacy, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan.
| | - Kei Irie
- Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
- Department of Clinical Pharmacy Research, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
- Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, 650-8586, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minami- machi, Chuo-ku, Kobe, 650-0047, Japan
| | - Masaki Hirabatake
- Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
- Department of Clinical Pharmacy Research, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
- Department of Clinical Pharmacy Research, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
- Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, 650-8586, Japan
| | - Tadashi Shimizu
- School of Pharmacy, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minami- machi, Chuo-ku, Kobe, 650-0047, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
- Department of Clinical Pharmacy Research, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
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Fuga M, Tanaka T, Tachi R, Yamana S, Irie K, Kajiwara I, Teshigawara A, Ishibashi T, Hasegawa Y, Murayama Y. Contrast Injection from an Intermediate Catheter Placed in an Intradural Artery is Associated with Contrast-Induced Encephalopathy following Neurointervention. AJNR Am J Neuroradiol 2023; 44:1057-1063. [PMID: 37536732 PMCID: PMC10494956 DOI: 10.3174/ajnr.a7944] [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: 03/22/2023] [Accepted: 06/22/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND PURPOSE Contrast-induced encephalopathy can result from neurotoxicity of contrast medium in the affected area. The development of intermediate catheters has allowed guidance of catheters to more distal arteries. This study focused on the association between contrast-induced encephalopathy and contrast injection from an intermediate catheter guided into a distal intradural artery during neurointervention for cerebral aneurysms. MATERIALS AND METHODS We retrospectively reviewed 420 consecutive aneurysms in 396 patients who underwent neurointervention for extracranial aneurysms and unruptured intracranial aneurysms at our institution from February 2012 to January 2023. Patients were divided into a group with contrast-induced encephalopathy and a group without. To identify risk factors for contrast-induced encephalopathy, we compared clinical, anatomic, and procedural factors between groups by multivariate logistic regression analysis and stepwise selection. RESULTS Among the 396 patients who underwent neurointervention for cerebral aneurysms, 14 (3.5%) developed contrast-induced encephalopathy. Compared with the group without contrast-induced encephalopathy, the group with contrast-induced encephalopathy showed significantly higher rates of patients on hemodialysis, previously treated aneurysms, intradural placement of a catheter for angiography, nonionic contrast medium, and flow-diversion procedures in univariate analyses. Stepwise multivariate logistic regression analysis revealed intradural placement of a catheter for angiography (OR = 40.4; 95% CI, 8.63-189) and previously treated aneurysms (OR = 8.20; 95% CI, 2.26-29.6) as independent predictors of contrast-induced encephalopathy. CONCLUSIONS Contrast injection from an intradural artery and retreatment of recurrent aneurysms were major risk factors for contrast-induced encephalopathy. Attention should be paid to the location of the intermediate catheter for angiography to avoid developing contrast-induced encephalopathy.
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Affiliation(s)
- M Fuga
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - T Tanaka
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
| | - R Tachi
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - S Yamana
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
| | - K Irie
- Department of Neurosurgery (K.I.), Japanese Red Cross Medical Center, Tokyo, Japan
| | - I Kajiwara
- Department of Neurosurgery (I.K.), National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
| | - A Teshigawara
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - T Ishibashi
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
| | - Y Hasegawa
- From the Department of Neurosurgery (M.F., T.T., R.T., S.Y., A.T., Y.H.), Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - Y Murayama
- Department of Neurosurgery (T.T., S.Y., T.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
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Irie K, Hiramoto N, Yamaoka K, Fuckushima S. Cerebrospinal fluid concentration of foscarnet in patients with HHV-6 encephalitis after haematopoietic stem cell transplantation. J Antimicrob Chemother 2023:7127733. [PMID: 37071595 DOI: 10.1093/jac/dkad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Affiliation(s)
- Kei Irie
- Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe 650-8586, Japan
- Department of Pharmacy, Kobe City Hospital Organisation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Nobuhiro Hiramoto
- Department of Haematology, Kobe City Hospital Organisation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Kenta Yamaoka
- Department of Pharmacy, Kobe City Hospital Organisation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Shoji Fuckushima
- Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe 650-8586, Japan
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Irie K. [Pharmacokinetic Study of Antiviral Drugs in Patients with COVID-19]. YAKUGAKU ZASSHI 2023; 143:239-241. [PMID: 36858556 DOI: 10.1248/yakushi.22-00169-1] [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] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The Faculty of Pharmaceutical Sciences, Kobe Gakuin University has collaborated in clinical research with Kobe City Medical Center General Hospital. In this university-medical institution collaboration, university faculty members discuss clinical problems with on-site pharmacists and doctors, and carry out clinical research to resolve these problems. During the coronavirus disease 2019 (COVID-19) pandemic, many patients with COVID-19 were treated at Kobe City Medical Center General Hospital. In February 2020, during the first increase in the number of patients with COVID-19 in Japan, treatment for COVID-19 was not established, and some existing anti-viral drugs, such as favipiravir, were experimentally used for COVID-19 treatment. However, since these drugs were not developed specifically for treating COVID-19, their pharmacokinetics have not been sufficiently studied. In particular, the pharmacokinetics of favipiravir in critically ill patients with COVID-19 was of concern, because critically ill patients have an urgent need for life-saving anti-viral drug treatment. Therefore, we conducted a collaborative clinical study to evaluate the pharmacokinetics of favipiravir in patients with COVID-19. The blood concentration of favipiravir in patients with COVID-19 at Kobe City Medical Center General Hospital was measured by lipid chromatography-tandem mass spectrometry at Kobe Gakuin University. Population pharmacokinetics analysis was then performed. In this symposium review, we introduce our pharmacokinetic study of antiviral drugs in patients with COVID-19, focusing on the university-medical institution collaboration. We believe collaborative clinical research will be useful for solving clinical issues and ensuring the effectiveness and safety of pharmacotherapies.
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Affiliation(s)
- Kei Irie
- Faculty of Pharmaceutical Science, Kobe Gakuin University
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Maeda A, Ando H, Irie K, Hashimoto N, Morishige JI, Fukushima S, Ebi H, Uchida K, Iwata H, Sawaki M. Effects of ABCB1 and ABCG2 Polymorphisms on the Pharmacokinetics of Abemaciclib Metabolites (M2, M20, M18). Anticancer Res 2023; 43:1283-1289. [PMID: 36854511 DOI: 10.21873/anticanres.16275] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/10/2022] [Revised: 11/04/2022] [Accepted: 11/16/2022] [Indexed: 03/02/2023]
Abstract
BACKGROUND/AIM Abemaciclib, an oral anticancer drug used in the treatment of breast cancer, is metabolised to its active forms - M2, M20 and M18; these forms have a potency similar to that of the parent drug. Abemaciclib and its active metabolites are reportedly transported by P-glycoprotein and breast cancer resistance protein (BCRP). We previously reported that the ABCB1 2677G>T/A homozygous type is associated with a higher abemaciclib concentration leading to treatment withdrawal and/or dose reduction. However, the pharmacokinetics of its metabolites have not been investigated. The purpose of the present study was to evaluate the effects of ABCB1 and ABCG2 polymorphisms on the pharmacokinetics of the abemaciclib metabolites M2, M20 and M18. PATIENTS AND METHODS We evaluated 40 patients with breast cancer who received 150 mg abemaciclib twice per day for 2 weeks at the Aichi Cancer Center Hospital, Japan. Peak areas (arbitrary unit) of abemaciclib metabolites were measured using liquid chromatography tandem with mass spectrometry and compared between ABCB1 1236T>C, 2677G>T/A, 3435C>T and ABCG2 421C>A gene polymorphisms. RESULTS For ABCB1 2677G>T/A polymorphisms, exposure doses for the abemaciclib metabolites M2 and M20 were higher in the homozygous (TT + AT) group than in the wild-type and heterozygous (GG + GA + GT) groups (p=0.09 and p=0.06, respectively). No significant association was observed between abemaciclib metabolites and ABCB1 1236T>C, ABCB1 3435C>T and ABCG2 421C>A polymorphisms. CONCLUSION The ABCB1 2677G>T/A polymorphism may influence tolerance to abemaciclib in breast cancer patients by affecting the pharmacokinetics of the agent and its active metabolites.
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Affiliation(s)
- Akimitsu Maeda
- Department of Pharmacy, Aichi Cancer Center Hospital, Nagoya, Japan;
| | - Hitoshi Ando
- Department of Cellular and Molecular Function Analysis, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kei Irie
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Naoya Hashimoto
- Department of Pharmacy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Jun-Ichi Morishige
- Department of Cellular and Molecular Function Analysis, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Shoji Fukushima
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Hiromichi Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Kosaku Uchida
- Department of Pharmacy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Tamura R, Irie K, Nakagawa A, Muroi H, Eto M, Ikesue H, Muroi N, Fukushima S, Tomii K, Hashida T. Population pharmacokinetics and exposure-clinical outcome relationship of remdesivir major metabolite GS-441524 in patients with moderate and severe COVID-19. CPT Pharmacometrics Syst Pharmacol 2023; 12:513-521. [PMID: 36798006 PMCID: PMC10088080 DOI: 10.1002/psp4.12936] [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: 08/22/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Although remdesivir, a prodrug of nucleoside analog (GS-441524), has demonstrated clinical benefits in coronavirus disease 2019 (COVID-19) treatment, its pharmacokinetics (PKs) in patients with COVID-19 remain poorly understood. Therefore, in this study, the PKs of remdesivir and its major metabolite, GS-441524, were evaluated using a population PK (PopPK) approach to understand the PK aspect and exposure-clinical outcome relationship. The serum concentrations of remdesivir and GS-441524 (102 points in 39 patients) were measured using liquid chromatography-tandem mass spectrometry. All patients received 200 mg remdesivir on the first day, followed by 100 mg on 2-5 days, except for one patient who discontinued remdesivir on day 4. The median (range) age, body surface area, and estimated glomerular filtration rate (eGFR) were 70 (42-85), 1.74 m2 (1.36-2.03), and 68 mL/min/1.73 m2 (33-113), respectively. A compartment model with first-order elimination combined with remdesivir and GS-441524 was used for nonlinear mixed-effects model analysis. Remdesivir was rapidly eliminated after infusion, whereas GS-441524 was eliminated relatively slowly (half-time = 17.1 h). The estimated apparent clearance (CL) and distribution volume of GS-441524 were 11.0 L/h (intersubject variability [ISV]% = 43.0%) and 271 L (ISV% = 58.1%), respectively. The CL of GS-441524 was significantly related to the eGFR (CL × [eGFR/68]0.745 ). The post hoc area under the curve of GS-441524 was unrelated to the recovery rate or aspartate aminotransferase/alanine aminotransferase elevation. Overall, PopPK analysis showed the rapid elimination of remdesivir in the blood, and GS-441524 accumulation depended on eGFR in patients with COVID-19. However, no relevance of exposure-clinical outcome was not suggestive of the dose adjustment of remdesivir.
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Affiliation(s)
- Ryo Tamura
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kei Irie
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan.,Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Atsushi Nakagawa
- Department of Respiratory Medicine, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hirohito Muroi
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masaaki Eto
- Department of Clinical Laboratory, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shoji Fukushima
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan.,Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan.,Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
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Hieda M, Futami S, Tanaka H, Moriyama S, Masui S, Kisanuki M, Hatakeyama K, Irie K, Yokoyama T, Fukata M, Arita T, Maruyama T, Nomura H, Akashi K. Natural history of severe aortic stenosis in elderly heart failure patients who declined transcatheter aortic valve implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2548] [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: 11/13/2022] Open
Abstract
Abstract
Background
Transcatheter aortic valve implantation (TAVI) is an established minimally invasive treatment for elderly patients with severe aortic stenosis (AS). Although it is a relatively minimally invasive procedure, many elderly patients cannot undergo TAVI due to advanced age, advanced dementia, significantly impaired ADL, or because the patient or family does not wish to undergo TAVI. In general, severe AS patients died 5 years after an angina attack, 3 years after syncope symptoms, and 2 years after heart failure symptoms. However, few studies have investigated the prognosis of elderly patients with severe AS who declined TAVI.
Purpose
This study aimed to comprehend the natural history of elderly severe AS patients who declined aortic valve intervention and identify risk factors for death in the TAVI era.
Methods
We retrospectively reviewed 2,786 echocardiographic data from our hospital between 2017 and 2021. We identified 504 patients with AS in the echocardiography database. The severe AS was defined by the following echocardiography parameters: peak aortic flow velocity ≥4.0 m/s, aortic valve mean gradient ≥40 mmHg, aortic valve area (AVA)<1.0 cm2, or AVA index<0.6 cm2/m2. Patients with mild and moderate AS and patients who underwent surgical or transcatheter aortic valve intervention were excluded. Eventually, 82 patients fulfilled the study criteria and were analyzed in this study. Clinical events were investigated, and Cox proportional hazards analysis was performed to elucidate risk factors for mortality.
Results
The mean age was 89±6 years, and 63 (77%) were women. AHA/ACC classification was Stage A/B/C/D: 0%/52.4%/39.0%/8.5%. As event occurrence, we detected 34 (41.5%) all-cause deaths, 41 (50.0%) major adverse cardiovascular events, 32 (39.0%) development of heart failure, 13 (15.9%) chest pain attacks, and 3 (3.7%) syncope. The time from diagnosis of severe AS to all-cause death was 227±273 days, and the 1-, 2-, and 3-year survival rates were 61.5%, 46.2%, and 36.9%, respectively. Of the heart failure-onset population, 16 (50.0%) were found to have severe AS on initial heart failure admission. The incidence of heart failure at 1, 2, and 3 years after diagnosis of severe AS was 60.1%, 56.7%, and 45.4%, respectively. The time from heart failure to death was 107±147 days. Cox proportional hazards analysis adjusted with age, sex, comorbidities revealed that dementia (HR 4.5, P=0.014) and Katz index <5 (HR7.8, P=0.009) were independent risk factors for mortality.
Conclusions
Compared to the comprehension of the natural history of AS patients, the prognosis in severe AS patients who declined TAVI was extremely poor. Although the elderly patients did not have a high rate of angina attacks or syncope symptoms, probably due to their reduced ADL, the results suggest that dementia prevention and maintenance of exercise tolerance are essential since dementia and reduced ADL (Katz<5) are independent risk factors for mortality.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Clinical Research Promotion Foundation Reiwa 2 Michinari Hieda
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Affiliation(s)
- M Hieda
- Kyushu University Hospital , Fukuoka , Japan
| | - S Futami
- Kyushu University Hospital , Fukuoka , Japan
| | - H Tanaka
- Kyushu University Hospital , Fukuoka , Japan
| | - S Moriyama
- Kyushu University Hospital , Fukuoka , Japan
| | - S Masui
- Kyushu University Hospital , Fukuoka , Japan
| | - M Kisanuki
- Kyushu University Hospital , Fukuoka , Japan
| | | | - K Irie
- Kyushu University Hospital , Fukuoka , Japan
| | - T Yokoyama
- Kyushu University Hospital , Fukuoka , Japan
| | - M Fukata
- Kyushu University Hospital , Fukuoka , Japan
| | - T Arita
- Fukuoka Wajiro Hospital , Fukuoka , Japan
| | - T Maruyama
- Kyushu University Hospital , Fukuoka , Japan
| | - H Nomura
- Haradoi Hospital , Fukuoka , Japan
| | - K Akashi
- Kyushu University Hospital , Fukuoka , Japan
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Shalehin N, Seki Y, Takebe H, Fujii S, Mizoguchi T, Nakamura H, Yoshiba N, Yoshiba K, Iijima M, Shimo T, Irie K, Hosoya A. Gli1 +-PDL Cells Contribute to Alveolar Bone Homeostasis and Regeneration. J Dent Res 2022; 101:1537-1543. [PMID: 35786034 DOI: 10.1177/00220345221106921] [Citation(s) in RCA: 1] [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] [Indexed: 01/09/2023] Open
Abstract
The periodontal ligament (PDL) contains mesenchymal stem cells (MSCs) that can differentiate into osteoblasts, cementoblasts, and fibroblasts. Nevertheless, the distribution and characteristics of these cells remain uncertain. Gli1, an essential hedgehog signaling transcription factor, functions in undifferentiated cells during embryogenesis. Therefore, in the present study, the differentiation ability of Gli1+ cells was examined using Gli1-CreERT2/ROSA26-loxP-stop-loxP-tdTomato (iGli1/Tomato) mice. In 4-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were only slightly detected in the PDL, around endomucin-expressing blood vessels. These cells had proliferated over time, localizing in the PDL as well as on the bone and cementum surfaces at day 28. However, in 8-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were quiescent, as most cells were not immunoreactive for Ki-67. These cells in 8-wk-old mice exhibited high colony-forming unit fibroblast activity and were capable of osteogenic, chondrogenic, and adipogenic differentiation in vitro. In addition, after transplantation of teeth of iGli1/Tomato mice into the hypodermis of wild-type mice, Tomato fluorescence indicating the progeny of Gli1+ cells was detected in the osteoblasts and osteocytes of the regenerated bone. These results demonstrate that Gli1+ cells in the PDL were MSCs and could contribute to the alveolar bone regeneration.
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Affiliation(s)
- N Shalehin
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - Y Seki
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan.,Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - H Takebe
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - S Fujii
- Division of Oral Surgery, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - T Mizoguchi
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - H Nakamura
- Department of Oral Anatomy, Matsumoto Dental University, Nagano, Japan
| | - N Yoshiba
- Division of Cariology, Department of Oral Health Science, Operative Dentistry and Endodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Yoshiba
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - M Iijima
- Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - T Shimo
- Division of Oral Surgery, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - K Irie
- Division of Anatomy, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - A Hosoya
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
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Fukudome Y, Hieda M, Masui S, Yokoyama T, Futami S, Moriyama S, Irie K, Fukata M, Ushijima T, Shiose A, Akashi K. Case Report: Bronchogenic Cyst in the Right Atrium of a Young Woman. Front Cardiovasc Med 2022; 9:915876. [PMID: 35711360 PMCID: PMC9197382 DOI: 10.3389/fcvm.2022.915876] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/02/2022] [Indexed: 12/03/2022] Open
Abstract
A 31-year-old woman was referred to our hospital for evaluation of a cardiac mass in the right atrium. Cardiac magnetic resonance imaging indicated a cystic mass filled with fluid accumulation in the right atrium. The mass was identified as a cardiac cyst and was surgically removed. Pathological examination revealed an extremely rare bronchogenic cyst. Bronchogenic cysts are benign congenital abnormalities of primitive foregut origins that form in the mediastinum during embryonic development. There is unusual clinical dilemmas surrounding the treatment plan for cardiac surgery or biopsy of cardiac masses, especially in patients with rare cardiac cysts. The anatomical location of the cyst can be related to various clinical symptoms and complications. In cases of indeterminate cardiac cysts, direct cyst removal without prior biopsy is of utmost importance.
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Affiliation(s)
- Yuya Fukudome
- Heart Center, Kyushu University Hospital, Fukuoka, Japan
| | - Michinari Hieda
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
- *Correspondence: Michinari Hieda,
| | - Shiho Masui
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Taku Yokoyama
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shutaro Futami
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shohei Moriyama
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kei Irie
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Mitsuhiro Fukata
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Tomoki Ushijima
- Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Akira Shiose
- Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
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Hirabatake M, Ikesue H, Iwama Y, Irie K, Yoshino S, Yamasaki T, Hashida T, Kawakita M, Muroi N. Pharmacist-Urologist Collaborative Management Improves Clinical Outcomes in Patients With Castration-Resistant Prostate Cancer Receiving Enzalutamide. Front Pharmacol 2022; 13:901099. [PMID: 35662711 PMCID: PMC9162505 DOI: 10.3389/fphar.2022.901099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Enzalutamide is useful for the treatment of castration-resistant prostate cancer (CRPC). Despite its usefulness, adverse events (AEs) sometimes force patients to discontinue treatment. To maximize patient care, we developed an ambulatory care pharmacy practice that allows collaboration between a pharmacist and urologist to manage patients with CRPC receiving enzalutamide. In this study, we investigated the efficacy of this collaborative management. Methods: A retrospective chart review of 103 patients with CRPC receiving enzalutamide in our hospital between May 2014 and December 2020 was performed. Our collaborative management was implemented in October 2016. Before being examined by urologists, patients visited the oncology pharmacy consultation room for a face-to-face consultation, wherein the oncology pharmacists assessed factors such as adherence to enzalutamide, any AEs and their grades, and provided their suggestions to the urologists. The time to enzalutamide discontinuation and prostate-specific antigen progression were compared between patients who started enzalutamide before (n = 41) and after (n = 62) the implementation of the collaborative management. A multivariate Cox regression analysis was performed to analyze the factors associated with enzalutamide discontinuation. Results: After implementing collaborative management, the pharmacists had 881 patient consultations. Among the 476 suggestions from pharmacists, 345 were accepted by urologists. The most frequent suggestion was supportive care in enzalutamide treatment (224 suggestions). Multivariate analysis showed that collaborative management [hazard ratio (HR) 0.53, 95% confidence interval (CI) 0.31–0.89, p = 0.017] and higher prostate-specific antigen (PSA; HR 2.41, 95% CI 1.36–4.28, p = 0.003) were significantly associated with enzalutamide discontinuation. The median time to discontinuation (18.9 vs. 7.6 months, p = 0.012), time to discontinuation due to AEs (not reached in both groups, p = 0.001), and time to PSA progression (13.3 vs. 5.8 months, p = 0.002) were all significantly longer in the after group. Conclusions: We implemented a pharmacist-urologist collaborative management program for outpatients with CRPC receiving enzalutamide. The results revealed that collaborative management was useful for prolonging the time to enzalutamide discontinuation.
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Affiliation(s)
- Masaki Hirabatake
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
- *Correspondence: Hiroaki Ikesue,
| | - Yuna Iwama
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kei Irie
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Shintaro Yoshino
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshinari Yamasaki
- Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Mutsushi Kawakita
- Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
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Maeda A, Ando H, Irie K, Hashimoto N, Morishige JI, Fukushima S, Okada A, Ebi H, Matsuzaki M, Iwata H, Sawaki M. Effects of ABCB1 and ABCG2 polymorphisms on the pharmacokinetics of abemaciclib. Eur J Clin Pharmacol 2022; 78:1239-1247. [PMID: 35527301 DOI: 10.1007/s00228-022-03331-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/17/2022] [Accepted: 05/02/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Adverse events after the use of the CDK4/6 inhibitor abemaciclib are dose-dependent. However, its pharmacokinetics varies among individuals. Abemaciclib is reportedly transported by P-glycoprotein and breast cancer resistance protein. Therefore, we evaluated whether ABCB1 and ABCG2 polymorphisms are pharmacokinetic predictive factors of abemaciclib. METHODS A total of 45 patients with breast cancer taking abemaciclib (150 mg twice per day) for 2 weeks were evaluated to determine the associations among abemaciclib concentration; adverse events; and ABCB1 1236 T > C, 2677G > T/A, 3435C > T, and ABCG2 421C > A gene polymorphisms. RESULTS The trough concentration of abemaciclib was significantly higher in the group with grade 2 or greater neutropenia and thrombocytopenia than in those with grades 0 or 1. For ABCB1 2677G > T/A polymorphisms, the concentration of abemaciclib tended to be higher in the homozygous group (TT + AT) than in the wild-type + heterozygous group (GG + GA + GT) (median [range], 222.8 [80.5-295.8] ng/mL vs. 113.5 [23.6-355.2] ng/mL, P = 0.09), Moreover, the ABCB1 2677G > T/A homozygous group had a higher tendency of abemaciclib withdrawal or dose reduction within 4 weeks than the wild-type + heterozygous group (odds ratio, 4.22; 95% confidence interval, 0.86-20.7; P = 0.08). No significant association was observed among abemaciclib concentration; adverse reactions; and ABCB1 1236 T > C, 3435C > T, and ABCG2 421C > A polymorphisms. CONCLUSION ABCB1 2677G > T/A polymorphism might be a predictor of the pharmacokinetics and tolerability of abemaciclib.
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Affiliation(s)
- Akimitsu Maeda
- Department of Pharmacy, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
| | - Hitoshi Ando
- Department of Cellular and Molecular Function Analysis, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kei Irie
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, 650-8586, Japan
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minami-machi, Chuo-ku, Kobe, 650-0047, Japan
| | - Naoya Hashimoto
- Department of Pharmacy, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Jun-Ichi Morishige
- Department of Cellular and Molecular Function Analysis, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Shoji Fukushima
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, 650-8586, Japan
| | - Akira Okada
- Department of Regulatory Science, Faculty of Pharmacy, Musashino University, 1-1-20 Shinmachi , Nishitokyo City, 202-8585, Japan
| | - Hiromichi Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Masahide Matsuzaki
- Department of Pharmacy, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
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15
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Irie K, Hiramoto N, Ishikawa T, Fukushima S. Use of liquid chromatography-tandem mass spectrometry for foscarnet quantification in human serum and cerebrospinal fluid. Rapid Commun Mass Spectrom 2022; 36:e9255. [PMID: 35001441 DOI: 10.1002/rcm.9255] [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] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
RATIONALE Foscarnet (FCV) is used to treat cytomegalovirus, human herpesvirus, and human immunodeficiency virus infections. It is a low-molecular-weight compound containing carboxylate and phosphate groups. There are no reports on the use of liquid chromatography-tandem mass spectrometry (LC/MS/MS) to analyze FCV via bioanalysis. In the present study, we developed the ion-pair LC/MS/MS method to analyze FCV in human serum and cerebrospinal fluid (CSF). METHODS FCV was extracted from human serum and CSF by weak anion exchange (WAX) solid-phase extraction. The LC/MS/MS systems were coated with 0.1% phosphoric acid in methanol to avoid nonspecific absorption. FCV was detected using ion-pair LC/MS/MS with dibutylammonium acetate. Selected reaction monitoring transition of FCV in the negative ion mode was selected at m/z 125.1 → 62.9. RESULTS FCV was selectively detected in human serum and CSF, and the liner range was 5-1000 μM (R2 = 0.99). The intraday and interday accuracy and precision were within ±15%. FCV was constantly extracted from human serum and CSF by WAX solid-phase extraction (recovery ratio = 76.0-77.9%). No matrix effect was observed. CONCLUSIONS A robust LC/MS/MS method to analyze FCV was successfully developed. FCV was selectively measured using LC/MS/MS in very low extract volumes (20 μL). The method will be useful in evaluating the FCV level in human serum and CSF.
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Affiliation(s)
- Kei Irie
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shoji Fukushima
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
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Mukaiyama K, Irie K, Takeda M, Yamashita R, Uemura S, Kanazawa S, Nagai-Tanima M, Aoyama T. Load distribution and forearm muscle activity during cylinder grip at various grip strength values. Hand Surgery and Rehabilitation 2022; 41:176-182. [DOI: 10.1016/j.hansur.2021.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 10/19/2022]
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17
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Minamii T, Shimizu H, Irie K, Nishioka H. Encephalopathy induced by high levels of ceftriaxone in the blood and cerebrospinal fluid. IDCases 2022; 29:e01581. [PMID: 35938149 PMCID: PMC9352448 DOI: 10.1016/j.idcr.2022.e01581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Ceftriaxone is commonly used to treat bacterial infections. Encephalopathy is a rare adverse effect of ceftriaxone therapy, and most cases have been diagnosed based on medical history. We report a case of a 73-year-old woman with ceftriaxone-associated encephalopathy, which was confirmed by measuring the ceftriaxone levels in the blood and cerebrospinal fluid. She regularly underwent hemodialysis. She received intravenous ceftriaxone at a dose of 1 g/day for 4 days for enteritis, and mental status began to be disturbed during the therapy. Six days after ceftriaxone discontinuation, her consciousness level rapidly improved. Thus, ceftriaxone-associated encephalopathy was suspected. High ceftriaxone levels in the blood and cerebrospinal fluid were observed while the patient had disturbed consciousness. This case indicated that high ceftriaxone levels in the blood and cerebrospinal fluid were related to development of encephalopathy. The estimation of ceftriaxone levels may be useful for an accurate diagnosis.
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18
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Irie K, Nakagawa A, Fujita H, Tamura R, Eto M, Ikesue H, Muroi N, Fukushima S, Tomii K, Hashida T. Population pharmacokinetics of favipiravir in patients with COVID-19. CPT Pharmacometrics Syst Pharmacol 2021; 10:1161-1170. [PMID: 34292670 PMCID: PMC8420316 DOI: 10.1002/psp4.12685] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/17/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
The antiretroviral drug favipiravir (FPV) inhibits RNA‐dependent RNA polymerase. It has been developed for the treatment of the novel coronavirus (severe acute respiratory syndrome coronavirus 2) infection disease, coronavirus disease 2019 (COVID‐19). However, its pharmacokinetics in patients with COVID‐19 is poorly understood. In this study, we measured FPV serum concentration by liquid chromatography–tandem mass spectrometry and conducted population pharmacokinetic analysis. A total of 39 patients were enrolled in the study: 33 were administered FPV 1600 mg twice daily (b.i.d.) on the first day followed by 600 mg b.i.d., and 6 were administered FPV 1800 mg b.i.d. on the first day followed by 800 mg or 600 mg b.i.d. The median age was 68 years (range, 27–89 years), 31 (79.5%) patients were men, median body surface area (BSA) was 1.72 m2 (range, 1.11–2.2 m2), and 10 (25.6%) patients required invasive mechanical ventilation (IMV) at the start of FPV. A total of 204 serum concentrations were available for pharmacokinetic analysis. A one‐compartment model with first‐order elimination was used to describe the pharmacokinetics. The estimated mean clearance/bioavailability (CL/F) and distribution volume/bioavailability (V/F) were 5.11 L/h and 41.6 L, respectively. Covariate analysis revealed that CL/F was significantly related to dosage, IMV use, and BSA. A simulation study showed that the 1600 mg/600 mg b.i.d. regimen was insufficient for the treatment of COVID‐19 targeting the 50% effective concentration (9.7 µg/mL), especially in patients with larger BSA and/or IMV. A higher FPV dosage is required for COVID‐19, but dose‐dependent nonlinear pharmacokinetics may cause an unexpected significant pharmacokinetic change and drug toxicity. Further studies are warranted to explore the optimal FPV regimen.
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Affiliation(s)
- Kei Irie
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan.,Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Atsushi Nakagawa
- Department of Respiratory Medicine, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hirotoshi Fujita
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryo Tamura
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masaaki Eto
- Department of Clinical Laboratory, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shoji Fukushima
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
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Irie K, Okada A, Fukushima S, Takase N, Katakami N. Pharmacokinetics and clinical outcomes of nivolumab administered every 4 weeks in patients with advanced non-small-cell lung cancer: A four-case pilot study. Respir Investig 2021; 59:545-549. [PMID: 33781720 DOI: 10.1016/j.resinv.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/19/2020] [Revised: 01/13/2021] [Accepted: 02/02/2021] [Indexed: 11/15/2022]
Abstract
This pilot study evaluated the pharmacokinetics and clinical outcome of nivolumab, administered every 4 weeks to patients with advanced non-small-cell lung cancer. The interval of nivolumab administration was changed from 2 to 4 weeks in four patients in whom tumor growth had been controlled for more than 6 months. Pharmacokinetics and clinical outcomes of nivolumab were prospectively investigated. The estimated steady-state nivolumab mean plasma concentration (±standard deviation) of each interval in the four patients was 53.1 (±15.0) at 4 weeks and 105.2 (±29.5) μg/mL at 2 weeks. No disease progression was observed in three patients for at least 1 year after the interval change; however, one patient developed interstitial lung disease within 5.6 months after the change. In conclusion, the pharmacological effects of nivolumab continued with doses administered less frequently than the standard schedule. Nevertheless, further research on nivolumab administration intervals is necessary.
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Affiliation(s)
- Kei Irie
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima Chuo-ku Kobe City 650-8586, Japan; Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi Chuo-ku Kobe City 650-0047, Japan
| | - Akira Okada
- Department of Regulatory Science, Faculty of Pharmacy, Musashino University, 1-1-20 Shinmachi Nishitokyo City 202-8585, Japan
| | - Shoji Fukushima
- Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi Chuo-ku Kobe City 650-0047, Japan
| | - Naoto Takase
- Department of Medical Oncology, Takarazuka City Hospital, 4-5-1 Kohama Takarazuka City 655-0827, Japan
| | - Nobuyuki Katakami
- Department of Medical Oncology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi Chuo-ku Kobe City 650-0047, Japan; Department of Medical Oncology, Takarazuka City Hospital, 4-5-1 Kohama Takarazuka City 655-0827, Japan.
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Ninomaru T, Okada H, Fujishima M, Irie K, Fukushima S, Hata A. Lazarus Response to Tepotinib for Leptomeningeal Metastases in a Patient With MET Exon 14 Skipping Mutation-Positive Lung Adenocarcinoma: Case Report. JTO Clin Res Rep 2021; 2:100145. [PMID: 34590003 PMCID: PMC8474417 DOI: 10.1016/j.jtocrr.2021.100145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/29/2022] Open
Abstract
The spread of next-generation sequencing enables clinicians to identify rare oncogene alterations, including MET exon 14 skipping mutation, in clinical practice for NSCLC. Several tyrosine kinase inhibitors for MET exon 14 skipping mutation such as capmatinib and tepotinib have elucidated their effectiveness. Only a few reports have suggested their efficacy against central nervous system lesions, especially leptomeningeal metastases. We here report a case of a patient with NSCLC with MET exon 14 skipping mutation and poor performance status salvaged by marked leptomeningeal metastases response to tepotinib. We further provide measures of plasma/cerebrospinal fluid concentrations of tepotinib and its cerebrospinal fluid penetration rate.
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Affiliation(s)
- Taira Ninomaru
- Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Hideaki Okada
- Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Mika Fujishima
- Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Kei Irie
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Shoji Fukushima
- Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Akito Hata
- Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
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21
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Yoshida S, Fujimoto A, Fukushima K, Ando M, Irie K, Hirano T, Miyasaka M, Shimomura Y, Ishikawa T, Ikesue H, Muroi N, Hashida T, Sugioka N. Population pharmacokinetics of tacrolimus in umbilical cord blood transplant patients focusing on the variation in red blood cell counts. J Clin Pharm Ther 2020; 46:190-197. [PMID: 33090593 DOI: 10.1111/jcpt.13279] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/22/2020] [Accepted: 09/07/2020] [Indexed: 01/28/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE The distribution of tacrolimus (TAC), an immunosuppressant used during cord blood transplantation (CBT)-one of the haematopoietic stem cell transplantations, to red blood cell (RBC) is approximately 90% in whole blood. In CBT patients, the total RBC count shows dramatic fluctuation due to conditioning before transplantation, including anticancer agents and total body irradiation, as well as RBC transfusions during the treatment period. Therefore, the amount of TAC in whole blood may show wide variation. However, therapeutic drug monitoring (TDM) of TAC has been performed based on the whole blood concentration. In this study, to contribute to TDM of TAC in CBT, we performed the population pharmacokinetic (PPK) analysis of TAC in 56 CBT patients and investigated the factors that affected the concentration of TAC, focusing the variation of RBC count. METHOD A one-compartment model was applied to the observed whole blood TAC concentrations, and a PPK analysis was conducted with a non-linear mixed effect model. RESULTS AND DISCUSSION Our final PPK model indicated good robustness and accuracy. In addition, haemoglobin (Hb) level was an influential covariate on Vd, which was expressed as Vd(L) = 91.4 × (Hb/8.2)(-1.07) . WHAT IS NEW AND CONCLUSION In this study, our results showed the necessity for the Hb level monitoring during TDM of TAC in CBT patients and provided useful information for improving TDM strategy of TAC.
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Affiliation(s)
- Saki Yoshida
- Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan.,Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ayumi Fujimoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan.,Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan
| | - Keizo Fukushima
- Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Motozumi Ando
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.,Department of Medical Cooperation, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Kei Irie
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.,Department of Medical Cooperation, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Tatsuya Hirano
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Moena Miyasaka
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Sugioka
- Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
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22
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Maeda A, Irie K, Hashimoto N, Fukushima S, Ando H, Okada A, Ebi H, Kajita M, Iwata H, Sawaki M. Serum concentration of the CKD4/6 inhibitor abemaciclib, but not of creatinine, strongly predicts hematological adverse events in patients with breast cancer: a preliminary report. Invest New Drugs 2020; 39:272-277. [PMID: 32856274 DOI: 10.1007/s10637-020-00994-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023]
Abstract
Purpose The CKD4/6 inhibitor abemaciclib is related to adverse events such as hematological toxicity and increase in serum creatinine levels associated with abemaciclib pharmacokinetics. Increase in serum creatinine levels is considered a result of competition with abemaciclib via organic cation transporter 2 and multidrug and toxic compound extrusion. Therefore, we evaluated the association among serum creatinine levels, serum abemaciclib concentrations, and adverse events and whether increase in serum creatinine levels is a useful indicator for predicting the onset of the adverse events of abemaciclib. Methods In total, the data of 12 patients with breast cancer who were treated with abemaciclib (150 mg twice daily) were evaluated to determine the association between increased serum creatinine levels and abemaciclib concentrations and hematological toxicity. Results Grade 3 neutropenia, thrombocytopenia, and anemia were observed at 4 weeks in four (33%), two (17%), and one (8%) patients, respectively. A significant association was observed between steady-state abemaciclib concentrations and the rate of decrease in neutrophil and platelet counts (r = - 0.80, P = 0.003 and r = - 0.70, P = 0.016, respectively). Compared with baseline levels (0.61 [0.53-0.82] mg/mL), serum creatinine levels significantly increased and reached a steady state in at least 2 weeks (0.84 [0.61-1.02] mg/mL, P = 0.01). However, we did not find a significant association between increase in serum creatinine levels and abemaciclib concentrations and hematological toxicity. Conclusions Abemaciclib concentrations are associated with neutropenia and thrombocytopenia. However, increase in serum creatinine levels may not be a useful predictor for estimating abemaciclib pharmacokinetics and hematological toxicity.
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Affiliation(s)
- Akimitsu Maeda
- Department of Pharmacy, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Aichi, Nagoya, 464-8681, Japan.
| | - Kei Irie
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Kobe, Chuo-ku, 650-8586, Japan.,Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minami-machi, Kobe, Chuo-ku, 650-0047, Japan
| | - Naoya Hashimoto
- Department of Pharmacy, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Aichi, Nagoya, 464-8681, Japan
| | - Shoji Fukushima
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Kobe, Chuo-ku, 650-8586, Japan
| | - Hitoshi Ando
- Department of Cellular and Molecular Function Analysis, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Akira Okada
- Department of Regulatory Science, Faculty of Pharmacy, Musashino University, 1-1-20 Shinmachi , Nishitokyo City, 202-8585, Japan
| | - Hiromichi Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, 464-8681, Nagoya, Aichi, Japan
| | - Masaki Kajita
- Department of Pharmacy, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Aichi, Nagoya, 464-8681, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
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23
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Irie K, Nakagawa A, Fujita H, Tamura R, Eto M, Ikesue H, Muroi N, Tomii K, Hashida T. Pharmacokinetics of Favipiravir in Critically Ill Patients With COVID-19. Clin Transl Sci 2020; 13:880-885. [PMID: 32475019 PMCID: PMC7300626 DOI: 10.1111/cts.12827] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 12/22/2022] Open
Abstract
Since December 2019, a novel coronavirus (severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2)) infection has been rapidly spreading worldwide and causing the respiratory illness, coronavirus disease 2019 (COVID‐19). The antiretroviral drug favipiravir (FPV) has been experimentally used for COVID‐19 treatment since March 2020 in Japan. However, the pharmacokinetics of FPV in critically ill patients is unknown. We measured the serum concentration of FPV using high‐performance liquid chromatography in patients with severe COVID‐19 who were admitted to the intensive care unit and placed on mechanical ventilation. The patients were administered 1,600 mg of FPV twice daily on day 1, followed by 600 mg twice daily from day 2 to day 5 (or more if needed). Suspensions of FPV tablets were administered through a nasogastric tube. Seven patients were enrolled in this study. Forty‐nine blood samples were obtained from the eligible patients to evaluate FPV concentration. The FPV trough (after 8–12 hours) concentrations of most samples were lower than the lower limit of quantification (1 µg/mL) and half‐maximal effective concentration (9.7 µg/mL) against SARS‐CoV‐2 previously tested in vitro. FPV trough concentration in critically ill patients was much lower than that of healthy subjects in a previous clinical trial, which is a cause for great concern. Further study is required to determine the optimal strategy for treatment of patients with severe COVID‐19.
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Affiliation(s)
- Kei Irie
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan.,Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Atsushi Nakagawa
- Department of Respiratory Medicine, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hirotoshi Fujita
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryo Tamura
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masaaki Eto
- Department of Clinical Laboratory, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
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24
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Kishimoto K, Hasegawa D, Irie K, Okada A, Nakamura S, Tamura A, Yamamoto N, Kozaki A, Saito A, Ishida T, Fukushima S, Kosaka Y. Pharmacokinetic analysis for model-supported therapeutic drug monitoring of busulfan in Japanese pediatric hematopoietic stem cell transplantation recipients. Pediatr Transplant 2020; 24:e13696. [PMID: 32196880 DOI: 10.1111/petr.13696] [Citation(s) in RCA: 4] [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] [Received: 11/18/2019] [Revised: 02/09/2020] [Accepted: 02/21/2020] [Indexed: 12/22/2022]
Abstract
This prospective observational study analyzed the pharmacokinetics of busulfan in Japanese children and evaluated the predicting accuracy of previous pediatric PPK models of busulfan. This study enrolled five patients (aged 2-12 years, BW 14-48 kg) receiving a busulfan-based conditioning regimen for hematopoietic stem cell transplantation at our hospital between January 2017 and December 2018. All patients received a 2-hour intravenous busulfan infusion four times daily for a total of 16 doses. After the infusions, 51 plasma samples were collected with the plasma busulfan concentration measured by liquid chromatography-tandem mass spectrometry. PPK model fitting was analyzed using the (%MPE) and the (%MAPE). Limited sampling strategies for estimating busulfan AUC were also evaluated. High interpatient variability was observed in the PK parameters. The most suitable PPK model that reflected our data was McCune's two-compartment model (%MPE -8.7, %MAPE 19.3). A combination sampling method using the busulfan concentration at 2 and 6 hours after the start of the first busulfan dose was found to be able to estimate AUC4 day . These results provide useful information on busulfan therapeutic drug monitoring in the Japanese pediatric population.
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Affiliation(s)
- Kenji Kishimoto
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Kei Irie
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan.,Department of Pharmacy, Kobe City Hospital Organization Kobe City Medical Center General Hospital, Kobe, Japan
| | - Akira Okada
- Department of Regulatory Science, Faculty of Pharmacy, Musashino University, Tokyo, Japan
| | - Sayaka Nakamura
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Akihiro Tamura
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Nobuyuki Yamamoto
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Shoji Fukushima
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
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25
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Kuramoto K, Beppu T, Irie K, Kinoshita K, Sato N, Akahoshi S, Yoshida Y, Yuki H, Hamada Y. Hepatobiliary and Pancreatic: Intra-ductal biliary schwannoma. J Gastroenterol Hepatol 2019; 34:1674. [PMID: 31210364 DOI: 10.1111/jgh.14679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 03/09/2019] [Accepted: 03/30/2019] [Indexed: 12/09/2022]
Affiliation(s)
- K Kuramoto
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - T Beppu
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - K Irie
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - K Kinoshita
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - N Sato
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - S Akahoshi
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - Y Yoshida
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - H Yuki
- Department of Radiology, Yamaga City Medical Center, Yamaga, Japan
| | - Y Hamada
- Department of Pathology, Fukuoka University, Fukuoka, Japan
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26
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Moriyama S, Yokoyama T, Irie K, Ito M, Tsuchihashi K, Fukata M, Kusaba H, Maruyama T, Akashi K. Atrial fibrillation observed in a patient with esophageal cancer treated with fluorouracil. J Cardiol Cases 2019; 20:183-186. [PMID: 31719941 PMCID: PMC6834961 DOI: 10.1016/j.jccase.2019.08.005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/18/2019] [Accepted: 07/30/2019] [Indexed: 11/20/2022] Open
Abstract
Fluorouracil (5-FU), a commonly used anticancer agent, has potent cardiotoxicity that is mediated by vascular endothelial injury and vasospasm. Here, we report a patient demonstrating atrial fibrillation (AF), which was most likely induced by vasospasm mediated by 5-FU. A 69-year-old man presented with dysphagia and was diagnosed with advanced esophageal cancer. Frequent paroxysms of atrial fibrillation (AF) were observed during combination chemotherapy including 5-FU. AF was refractory to disopyramide, but was sensitive to antianginal agents (nicorandil and nitroglycerin transdermal patch). Coronary angiography performed within the chemotherapeutic period demonstrated moderate stenosis in the right coronary artery (RCA). Severe spasm at the proximal portion of the atrial branch in RCA was induced by provocation test using acetylcholine. Our case indicated that 5-FU predisposed vasospasm in RCA and the subsequent atrial ischemia may lead to AF. <Learning objective: Fluorouracil (5-FU), a commonly used anticancer agent, induces cardiac ischemic events and sometimes leads to the paroxysms of atrial fibrillation (AF). Coronary-dilating agents should be considered for the treatment of AF which occurs after the administration of 5-FU and is refractory to antiarrhythmic agents.>
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Affiliation(s)
- Shohei Moriyama
- Corresponding author at: Department of Hematology/Oncology/Cardiovascular Medicine, Kyushu University Hospital, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8586, Japan.
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27
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Irie K, Okada A, Yamasaki Y, Kokan C, Hata A, Kaji R, Fukushima K, Sugioka N, Okada Y, Katakami N, Fukushima S. An LC-MS/MS Method for Absolute Quantification of Nivolumab in Human Plasma: Application to Clinical Therapeutic Drug Monitoring. Ther Drug Monit 2018; 40:716-724. [DOI: 10.1097/ftd.0000000000000558] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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28
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Sato N, Tasaki T, Noguchi H, Irie K, Nakayama T. Pulmonary tumor thrombotic microangiopathy (PTTM): 24 case series and its criteria for pathological diagnosis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy304.039] [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: 11/13/2022] Open
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29
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Masago K, Irie K, Fujita S, Imamichi F, Okada Y, Katakami N, Fukushima S, Yatabe Y. Relationship between Paronychia and Drug Concentrations of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors. Oncology 2018; 95:251-256. [DOI: 10.1159/000490177] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/18/2018] [Indexed: 11/19/2022]
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30
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Okada A, Kariya M, Irie K, Okada Y, Hiramoto N, Hashimoto H, Kajioka R, Maruyama C, Kasai H, Hamori M, Nishimura A, Shibata N, Fukushima K, Sugioka N. Population Pharmacokinetics of Vancomycin in Patients Undergoing Allogeneic Hematopoietic Stem-Cell Transplantation. J Clin Pharmacol 2018; 58:1140-1149. [DOI: 10.1002/jcph.1106] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/25/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Akira Okada
- Department of Clinical Pharmacokinetics; Faculty of Pharmaceutical Sciences; Kobe Gakuin University; Chuo-ku Kobe Japan
| | - Misato Kariya
- Department of Hospital Pharmacy; Kobe Minimally Invasive Cancer Center; Chuo-ku; Kobe Japan
- Department of Hospital Pharmacy; Institute of Biomedical Research and Innovation Hospital; Chuo-ku; Kobe Japan
| | - Kei Irie
- Department of Hospital Pharmacy; Institute of Biomedical Research and Innovation Hospital; Chuo-ku; Kobe Japan
| | - Yutaka Okada
- Department of Hospital Pharmacy; Institute of Biomedical Research and Innovation Hospital; Chuo-ku; Kobe Japan
| | - Nobuhiro Hiramoto
- Department of Cell Therapy; Institute of Biomedical Research and Innovation Hospital; Chuo-ku; Kobe Japan
| | - Hisako Hashimoto
- Department of Cell Therapy; Institute of Biomedical Research and Innovation Hospital; Chuo-ku; Kobe Japan
| | - Ryosuke Kajioka
- Department of Clinical Pharmacokinetics; Faculty of Pharmaceutical Sciences; Kobe Gakuin University; Chuo-ku Kobe Japan
| | - Chika Maruyama
- Department of Clinical Pharmacokinetics; Faculty of Pharmaceutical Sciences; Kobe Gakuin University; Chuo-ku Kobe Japan
| | | | - Mami Hamori
- Depertment of Biopharmaceutics; Faculty of Pharmaceutical Science; Doshisha Women's College of Liberal Arts; Kyo-tanabe Kyoto Japan
| | - Asako Nishimura
- Depertment of Biopharmaceutics; Faculty of Pharmaceutical Science; Doshisha Women's College of Liberal Arts; Kyo-tanabe Kyoto Japan
| | - Nobuhito Shibata
- Depertment of Biopharmaceutics; Faculty of Pharmaceutical Science; Doshisha Women's College of Liberal Arts; Kyo-tanabe Kyoto Japan
| | - Keizo Fukushima
- Department of Clinical Pharmacokinetics; Faculty of Pharmaceutical Sciences; Kobe Gakuin University; Chuo-ku Kobe Japan
| | - Nobuyuki Sugioka
- Department of Clinical Pharmacokinetics; Faculty of Pharmaceutical Sciences; Kobe Gakuin University; Chuo-ku Kobe Japan
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31
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Irie K, Okada A, Masuda Y, Fukushima K, Sugioka N, Okuda C, Hata A, Kaji R, Okada Y, Katakami N, Fukushima S. Assessment of exposure risk of irinotecan and its active metabolite, SN-38, through perspiration during chemotherapy. J Oncol Pharm Pract 2018; 25:865-868. [PMID: 29651916 DOI: 10.1177/1078155218769136] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Irinotecan (CPT-11) is the key drug used in chemotherapy for many malignant tumors. CPT-11 has cholinergic activity and induces perspiration during intravenous administration. In this study, concentrations of CPT-11 and its active metabolite, SN-38, released during perspiration were measured and risk of exposure of these drugs was assessed. METHOD Beads of sweat were collected using a dropper from four patients undergoing a chemotherapy regimen involving intravenous administration of CPT-11. The concentrations of CPT-11 and SN-38 in sweat were measured using liquid chromatography tandem mass spectrometry. RESULT Chemotherapy regimens were capecitabine and irinotecan plus bevacizumab (n = 1), CPT-11 monotherapy (n = 1), and oxaliplatin-irinotecan-leucovorin-5-fluorouracil (n = 2). Uridine diphosphate-glucuronosyltransferase 1A1 phenotypes were *6 homo-type (n = 1), *6 hetero-type (n = 1), and wild type (n = 2). CPT-11 dose was 292.3 ± 75.5 mg/body weight (mean ± standard deviation). CPT-11 was detected in sweat secreted by all the four patients, and its mean (±standard deviation) concentration was 252.6 (±111.9) ng/ml. SN-38 was detected in only one of the patients who received oxaliplatin-irinotecan-leucovorin-5-fluorouracil treatment and who had the wild-type uridine diphosphate-glucuronosyltransferase 1A1 phenotype at a concentration of 74.37 ng/ml. CONCLUSION CPT-11 and SN-38 are detected in sweat released during intravenous CPT-11 administration. Beads of sweat or linen clothes that absorb the sweat might be the source of CPT-11 and SN-38 exposure.
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Affiliation(s)
- Kei Irie
- 1 Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan.,2 Division of Pharmacy, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan
| | - Akira Okada
- 3 Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Yoshio Masuda
- 1 Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Keizo Fukushima
- 3 Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Nobuyuki Sugioka
- 3 Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
| | - Chiyuki Okuda
- 4 Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan
| | - Akito Hata
- 4 Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan
| | - Reiko Kaji
- 4 Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan
| | - Yutaka Okada
- 2 Division of Pharmacy, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan
| | - Nobuyuki Katakami
- 4 Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan
| | - Shoji Fukushima
- 1 Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe, Japan
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Irie K, Shobu S, Hiratsuji S, Yamasaki Y, Nanjo S, Kokan C, Hata A, Kaji R, Masago K, Fujita S, Okada Y, Katakami N, Fukushima S. Development and validation of a method for gefitinib quantification in dried blood spots using liquid chromatography-tandem mass spectrometry: Application to finger-prick clinical blood samples of patients with non-small cell lung cancer. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1087-1088:1-5. [PMID: 29689441 DOI: 10.1016/j.jchromb.2018.04.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 01/27/2018] [Revised: 04/09/2018] [Accepted: 04/12/2018] [Indexed: 11/19/2022]
Abstract
A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the quantification of gefitinib in dried blood spots (DBSs). Gefitinib was extracted with methanol from DBS of 3 mm in diameter and detected using a triple quadrupole mass spectrometer. The method was validated by evaluating its precision, accuracy, selectivity, carryover, matrix effect, recovery, and stability. For clinical validation, paired finger-prick DBS and plasma concentrations were compared for 10 patients with non-small cell lung cancer (NSCLC) taking gefitinib. The calibration linear range was 37.5-2400 ng/mL (coefficient of determination [R2] = 0.99), encompassing the therapeutic concentrations of gefitinib. The accuracy and precision were within 15% of the quality control (QC) concentrations of 80, 200, and 2000 ng/mL. The lower limit of quantification was determined to be 40 ng/mL. Gefitinib was stable in DBSs for up to 5 months at room temperature and -20 °C, and at 40 °C for 24 h. A good correlation was observed between the gefitinib levels measured by the DBS method and plasma concentrations (R2 = 0.99). This method provides a simple, fast, and accurate approach to the quantitative analysis of gefitinib in finger-prick DBSs. The method would be useful for minimally invasive evaluation of the clinical gefitinib blood concentration.
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Affiliation(s)
- Kei Irie
- Division of Pharmacy, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan; Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe 650-8586, Japan.
| | - Saori Shobu
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe 650-8586, Japan
| | - Seika Hiratsuji
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe 650-8586, Japan
| | - Yuta Yamasaki
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe 650-8586, Japan
| | - Shigeki Nanjo
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Chiyuki Kokan
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Akito Hata
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Reiko Kaji
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Katsuhiro Masago
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Shiro Fujita
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Yutaka Okada
- Division of Pharmacy, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Nobuyuki Katakami
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe 650-0047, Japan
| | - Shoji Fukushima
- Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe 650-8586, Japan
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Kisanuki M, Fujita K, Moriyama S, Irie K, Yosida C, Fukata M, Arita T, Yokoyama T, Odashiro K, Maruyama T, Akashi K. Complex regional pain syndrome induced by pacemaker implantation for sick sinus syndrome. J Arrhythm 2017; 33:643-645. [PMID: 29255517 PMCID: PMC5729003 DOI: 10.1016/j.joa.2017.08.005] [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: 07/07/2017] [Revised: 07/29/2017] [Accepted: 08/23/2017] [Indexed: 11/18/2022] Open
Abstract
A 53-year-old woman reported burning pain, muscle weakness, and dysesthesia of the left arm 2 months after permanent pacemaker insertion in the ipsilateral side for the treatment of sick sinus syndrome. Complex regional pain syndrome (CRPS) induced by pacemaker implantation was diagnosed. In 2017, her pulse generator became exhausted and was exchanged carefully to avoid exacerbation of CRPS, under the application of local anesthesia and premedication. Six months later, the patient's grip strength in her left hand remained lower relative to that in her right hand. Although rare, the presence of CRPS following device implantation should be remembered.
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Affiliation(s)
- Megumi Kisanuki
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Kazumasa Fujita
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Shohei Moriyama
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Kei Irie
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Chiharu Yosida
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Mitsuhiro Fukata
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Takeshi Arita
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Taku Yokoyama
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Keita Odashiro
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
| | - Toru Maruyama
- Faculty of Arts and Science, Kyushu University, Kasuga Kohen 6-1, Kasuga 816-8580, Japan
- Correspondence to: Faculty of Arts and Science, Kasuga-Kohen 3-1, Kasuga City, Fukuoka 816-8580, Japan. Fax: +81 92 592 2866.Faculty of Arts and ScienceKasuga-Kohen 3-1Kasuga CityFukuoka816-8580Japan
| | - Koichi Akashi
- Heart Center, Kyushu University Hospital, Maidashi 3-1-1, Fukuoka 812-8582, Japan
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Irie K, Fukata M, Fujita K, Noda H, Moriyama S, Yokoyama T, Arita T, Odashiro K, Akashi K, Maruyama TORU. P839The Association between atrial fibrillation-related traits and low skeletal muscles. Europace 2017. [DOI: 10.1093/ehjci/eux151.021] [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: 11/13/2022] Open
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Fukata M, Mukai Y, Fujita K, Irie K, Kawai S, Inoue S, Tsutusi H, Akashi K. P1402An effective therapeutic technique of hot balloon ablation in atrial fibrillation regarding contact force concept. Europace 2017. [DOI: 10.1093/ehjci/eux158.030] [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: 11/12/2022] Open
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Abstract
Elastic system fibers are load-bearing proteins found in periodontal tissue. There are three types—oxytalan, elaunin, and elastic fibers—which differ in their relative microfibril and elastin contents. Oxytalan fibers are known to be distributed in the periodontal ligaments and gingiva, whereas elaunin and elastic fibers are present only in the gingiva. We examined gene expression and accumulation of tropoelastin in the cell-matrix layers of human gingival fibroblasts (HGF) and periodontal ligament fibroblasts (HPLF) in vitro. HGF and HPLF were cultured in MEM containing 10% newborn calf serum for 8 wks. Northern blotting and RT-PCR analyses showed that only HGF expressed mRNA encoding tropoelastin. Western blotting analysis demonstrated 77-kDa protropoelastin and 68-kDa tropoelastin only in the cell-matrix layer of HGF cultured for 8 wks. These results suggest that the different tropoelastin expression patterns reflect the difference between HGF and HPLF phenotypes.
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Affiliation(s)
- E. Tsuruga
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
| | - K. Irie
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
| | - Y. Sakakura
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
| | - T. Yajima
- Department of Oral Anatomy, School of Dentistry, Health Sciences
University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293,
Japan
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Hata A, Nanjo S, Okuda C, Kaji R, Masago K, Fujita S, Irie K, Okada H, Okada H, Okada H, Fukushima S, Katakami N. 451PD Osimertinib at 80 mg for refractory leptomeningeal metastases in T790M-positive EGFR-mutant non-small cell lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw594.015] [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: 11/12/2022] Open
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Hata A, Nanjo S, Okuda C, Kaji R, Masago K, Fujita S, Irie K, Okada H, Okada H, Okada H, Fukushima S, Katakami N. 451PD Osimertinibat 80mg for refractoryleptomeningeal metastases in T790M-positive EGFR-mutant non-small cell lung cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00609-8] [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: 10/22/2022] Open
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Abstract
Elastic system fibers, comprised of microfibrils and tropoelastin, are extracellular components of periodontal tissue. During development, the microfibrils act as a template on which tropoelastin is deposited. However, the process of elastic system fiber remodeling is not fully understood. Therefore, we examined whether matrix metalloproteinases (MMPs) are involved in the remodeling of fibrillins (major components of microfibrils) by human gingival fibroblasts and periodontal ligament (PDL) fibroblasts. Gingival and PDL fibroblasts were cultured for 6 weeks. In some cultures, MMP inhibitor or tissue inhibitor of matrix metalloproteinsase-2 (TIMP-2) was added to the medium for an additional 2 weeks. Active MMP-2 (62 kDa) appeared as cell-membrane-associated or in extracellular matrix only in PDL fibroblast cell layers. The addition of MMP inhibitor or TIMP-2 significantly increased fibrillin-2 accumulation in PDL fibroblast cell layers, and decreased the amount of fibrillin-2 fragments, suggesting that active MMP-2 may degrade fibrillin-2, and that MMPs may play a role in the remodeling of elastic system fibers in PDL.
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Affiliation(s)
- E Tsuruga
- Department of Oral Anatomy, School of Dentistry, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293, Japan.
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Okada Y, Sadoshima S, Saku Y, Kitazono T, Irie K, Ogasawara T, Utsunomiya H, Fujishima M. Influence of haemorrhagic transformation on the outcome of thrombolytic therapy for patients with acute brain embolism. Neurol Res 2016; 14:167-70. [PMID: 1355879 DOI: 10.1080/01616412.1992.11740042] [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: 10/21/2022]
Affiliation(s)
- Y Okada
- Department of Cerebrovascular Disease, St. Mary's Hospital, Kurume, Japan
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Greer A, Irie K, Hashim A, Leroux BG, Chang AM, Curtis MA, Darveau RP. Site-Specific Neutrophil Migration and CXCL2 Expression in Periodontal Tissue. J Dent Res 2016; 95:946-52. [PMID: 27013641 DOI: 10.1177/0022034516641036] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The oral microbial community is the best-characterized bacterial ecosystem in the human host. It has been shown in the mouse that oral commensal bacteria significantly contribute to clinically healthy periodontal homeostasis by influencing the number of neutrophils that migrate from the vasculature to the junctional epithelium. Furthermore, in clinically healthy tissue, the neutrophil response to oral commensal bacteria is associated with the select expression of the neutrophil chemokine CXCL2 but not CXCL1. This preliminary study examined the contribution of commensal bacteria on neutrophil location across the tooth/gingival interface. Tissue sections from the root associated mesial (anterior) of the second molar to the root associated distal (posterior) of the second molar were examined for neutrophils and the expression of the neutrophil chemokine ligands CXCL1 and CXCL2. It was found that both the number of neutrophils as well as the expression of CXCL2 but not CXCL1 was significantly increased in tissue sections close to the interdental region, consistent with the notion of select tissue expression patterns for neutrophil chemokine expression and subsequent neutrophil location. Furthermore, mice gavaged with either oral Streptococcus or Lactobacillus sp. bacteria induced a location pattern of neutrophils and CXCL2 expression similar to the normal oral flora. These data indicate for the first time select neutrophil location and chemokine expression patterns associated with clinically healthy tissue. The results reveal an increased inflammatory load upon approaching the interproximal region, which is consistent with the observation that the interproximal region often reveals early clinical signs of periodontal disease.
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Affiliation(s)
- A Greer
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - K Irie
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - A Hashim
- Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - B G Leroux
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - A M Chang
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - M A Curtis
- Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - R P Darveau
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
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Kobayashi S, Ueno M, Irie K, Goda Y, Moriya S, Tedzuka S, Ohkawa S, Morimoto M. 2378 Prognostic significance of a new proteomic profile in patients with advanced pancreatic adenocarcinoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31294-1] [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: 11/16/2022]
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Takao H, Ishibashi T, Yuki I, Kaku S, Kan I, Nishimura K, Mori R, Watanabe M, Kanbayashi Y, Yeh Y, Irie K, Sakano T, Arita H, Oobatake T, Murayama Y. E-035 new app to support decision making during stroke emergencies: ‘join’. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.110] [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: 11/03/2022]
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Ishibashi T, Murayama Y, Yuki I, Ebara M, Arakawa H, Irie K, Takao H, Kaku S, Kan I, Nishimura K, Suzuki T, Watanabe M, Sakamoto H. E-100 comparison of the clinical outcomes among 3 coiling generations in unruptured aneurysms. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.175] [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: 11/04/2022]
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Irie K, Novince CM, Darveau RP. Impact of the Oral Commensal Flora on Alveolar Bone Homeostasis. J Dent Res 2014; 93:801-6. [PMID: 24935067 DOI: 10.1177/0022034514540173] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/28/2014] [Indexed: 12/21/2022] Open
Abstract
Homeostasis of healthy periodontal tissues is affected by innate and adaptive immunosurveillance mechanisms in response to the normal oral flora. Recent comparisons of germ-free (GF) and normal specific-pathogen-free (SPF) mice have revealed the impact of host immunosurveillance mechanisms in response to the normal oral flora on alveolar bone height. Prior reports that alveolar bone height is significantly less in normal SPF mice compared with their age- and strain-matched GF counterparts suggest that naturally occurring alveolar bone loss is a normal component of healthy periodontal tissue homeostasis. In this report, histomorphometric analyses confirmed increased alveolar bone loss and revealed increased numbers of TRAP+ osteoclastic cells lining the alveolar bone surface in SPF compared with GF mice. Increased numbers of RANKL+ cells and IL17+ cells in the periodontium of SPF mice demonstrate possible molecular mechanisms mediating the up-regulated osteoclastogenesis and alveolar bone loss in SPF mice compared with GF mice. Increased numbers of T-lymphocytic cells and T-helper cells in the junctional epithelium of SPF mice compared with GF mice suggest that the adaptive immune response contributes to physiologic alveolar bone loss in the healthy periodontium. This GF animal model study notably begins to elucidate the impact of host immunosurveillance mechanisms in response to the normal oral flora, mediating catabolic alveolar bone homeostasis in the healthy periodontium.
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Affiliation(s)
- K Irie
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195, USA Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya, Aichi, 464-8650, Japan Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - C M Novince
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195, USA
| | - R P Darveau
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195, USA
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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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Kobayashi N, Murayama Y, Yuki I, Ishibashi T, Ebara M, Arakawa H, Irie K, Takao H, Kajiwara I, Nishimura K, Karagiozov K, Urashima M. Natural course of dissecting vertebrobasilar artery aneurysms without stroke. AJNR Am J Neuroradiol 2014; 35:1371-5. [PMID: 24610902 DOI: 10.3174/ajnr.a3873] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The natural history and therapeutic management of dissecting vertebrobasilar aneurysms without ischemic or hemorrhagic stroke (nonstroke dissecting vertebrobasilar aneurysms) are not well-established. We conservatively followed patients with nonstroke dissecting vertebrobasilar aneurysms and evaluated the factors related to clinical and morphologic deterioration. MATERIALS AND METHODS One hundred thirteen patients were enrolled and divided by clinical presentation at diagnosis: asymptomatic (group 1, n = 52), pain only (group 2, n = 56), and mass effect (group 3, n = 5). Patients were conservatively managed without intervention and antithrombotic therapy. Clinical outcomes and morphologic changes were analyzed. RESULTS A total of 113 patients who were diagnosed with nonstroke dissecting vertebrobasilar aneurysm had a mean follow-up of 2.9 years (range, 27 days to 8 years). Throughout that period, 1 patient in group 1 (1.9%) and 1 patient in group 2 (1.8%) showed clinical deterioration due to mass effect, and 1 patient in group 3 (20%) developed ischemic stroke followed by subarachnoid hemorrhage. Most patients (97.3%) were clinically unchanged. Three patients who had clinical deterioration showed aneurysm enlargement (P < .001). Aneurysms remained morphologically unchanged in 91 patients (80.5%). Aneurysm enlargement was seen in 5 patients (4.4%); risk of enlargement was significantly associated with either maximum diameter (hazard ratio = 1.30; 95% CI, 1.11-11.52; P = .001) or aneurysm ≥10 mm (hazard ratio = 18.0; 95% CI, 1.95-167; P = .011). CONCLUSIONS The natural course of these lesions suggests that acute intervention is not always required and close follow-up without antithrombotic therapy is reasonable. Patients with symptoms due to mass effect or aneurysms of >10 mm may require treatment.
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Affiliation(s)
- N Kobayashi
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - Y Murayama
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - I Yuki
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - T Ishibashi
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - M Ebara
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - H Arakawa
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - K Irie
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - H Takao
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - I Kajiwara
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - K Nishimura
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - K Karagiozov
- From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.)
| | - M Urashima
- Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan
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Takao H, Ishibashi T, Saguchi T, Arakawa H, Ebara M, Irie K, Murayama Y. Validation and initial application of a semiautomatic aneurysm measurement software: a tool for assessing volumetric packing attenuation. AJNR Am J Neuroradiol 2013; 35:721-6. [PMID: 24231852 DOI: 10.3174/ajnr.a3777] [Citation(s) in RCA: 17] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Precise aneurysm measurements and volume embolization ratios are essential for long-term durability of endovascular coil embolization. We evaluated the accuracy of newly developed semiautomatic cerebral aneurysm measurement software, NeuroVision, and explored the value of volume embolization ratio in the prediction of re-treatment. MATERIALS AND METHODS We compared software-derived volume measurements of 4 silicone aneurysm models with those calculated with an approximation formula and ground truth values (validation study). We used NeuroVision to retrospectively evaluate outcomes of 100 unruptured aneurysms (97 patients) treated with embolization (clinical study). Aneurysm size (height, width, and neck), volume, and volume embolization ratios were calculated for 3 groups (stable, recanalization, and re-treatment) and were compared. RESULTS This validation study illustrated higher accuracy of NeuroVision in computing aneurysm volume compared with an approximation formula: percentage absolute errors were 4.50% ± 3.18% and 23.07% ± 17.60%, with maximal percentage absolute errors of 8.99% and 45.63%, respectively. Of 100 unruptured aneurysms, 20 recanalized and 12 were re-treated. Average volume embolization ratios of stable and re-treated aneurysms were 24.88% ± 5.91% and 20.50% ± 4.06%, respectively (P ≤ .01). The optimal volume embolization ratio cutoff point for re-treatment was < 19.15%, at which the Youden index was 0.50 (sensitivity, 58.33%; specificity, 87.50%; area under the receiver operating characteristic curve, 0.74). CONCLUSIONS The NeuroVision software provided accurate aneurysm volume measurements and may be a useful standardized tool to measure aneurysm size and volume, especially for multicenter clinical studies. Volume embolization ratio may be a valuable predictor of aneurysm occlusion changes.
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Affiliation(s)
- H Takao
- From the Division of Endovascular Neurosurgery and Neurosurgery (H.T., T.I., H.A., M.E., K.I., Y.M.), Jikei University School of Medicine, Tokyo, Japan
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Ibayashi S, Irie K, Kitayama J, Nagao T, Kitazono T, Fujishima M. Ischemic brain metabolism in patients with chronic cerebrovascular disease: Increased oxygen extraction fraction and cerebrospinal fluid lactate. J Stroke Cerebrovasc Dis 2013; 9:166-71. [PMID: 24192022 DOI: 10.1053/jscd.2000.7219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/1999] [Accepted: 01/07/2000] [Indexed: 11/11/2022] Open
Abstract
The aim of the present study is to elucidate the existence of chronically ischemic metabolism concomitant with misery perfusion of the brain in patients with chronic cerebrovascular disease. For this purpose, we measured cerebral blood flow (CBF) and oxygen metabolism by positron emission tomography (PET) and also determined cerebrospinal fluid (CSF) lactate as an indicator of the ischemic brain metabolism. Twenty-eight patients with chronic ischemic stroke and transient ischemic attack (TIA), who had angiographically occlusive (n = 11), stenotic (n = 10), and nonstenotic changes (n = 7) of the carotid artery and/or the intracranial major artery, were selected for this study. CBF, oxygen extraction fraction (OEF), cerebral metabolic rate for oxygen (CMRO2), and cerebral blood volume (CBV) were determined by PET, and CSF lactate and pyruvate were determined by enzymatic method in the patients with various grades of stenotic changes of the carotid artery. There were no significant differences in PET parameters and CSF variables among the groups of the occlusive, stenotic, and nonstenotic carotid artery. However, CSF lactate was correlated negatively with mean bilateral hemispheric (m)CBF (R(2) = 0.229, P<.01), positively with mOEF (R(2) = 0.278, P<.005) and more highly with mCMRO2/CBF (absolute extraction of oxygen content to the brain) (R(2) = 0.473, P<.0001) in all patients. There was no correlation between CSF lactate and mCMRO2 or mCBV. None of the cases in the nonstenotic group showed mOEF greater than 0.45, or mCMRO2/CBF greater than 7.9 vol%, while 80% of the cases in the stenotic group and 82% of the cases in the occlusive group showed mOEF and mCMRO2/CBF exceeding the above-mentioned values, respectively. The present findings, that increased mOEF and mCMRO2/CBF were significantly correlated with increased CSF lactate, indicate the brain to be in a metabolically ischemic state or increased anaerobic glycolysis with oxygen metabolism maintained in patients with chronic ischemic stroke.
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Affiliation(s)
- S Ibayashi
- Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Higashi-ku, Fukuoka, Japan
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Kobayashi S, Ueno M, Ohkawa S, Gouda Y, Irie K, Morimoto M. Second-Line Therapy of S-1 for Patients with Advanced Biliary Tract Cancer After Failure to Cisplatin Plus Gemcitabine. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt459.13] [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: 11/14/2022] Open
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