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Hashimoto S, Fujita M, Aizawa T, Watanabe S, Tsugawa K, Tanaka H. Early add-on use of belimumab as induction therapy for patients with childhood-onset systemic lupus erythematosus. Lupus 2024; 33:543-544. [PMID: 38456833 DOI: 10.1177/09612033241238867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Shun Hashimoto
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Masashi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
- Niji-iro Children's Clinic, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon City, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
- Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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Tokutake H, Hashimoto S, Fujita M, Tsugawa K, Terui K, Kudo A, Tanaka H. Be aware of severe juvenile chronic iridocyclitis without evidence of arthritis: Juvenile chronic iridocyclitis revisited. Int J Rheum Dis 2024; 27:e14913. [PMID: 37706566 DOI: 10.1111/1756-185x.14913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Haruka Tokutake
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shun Hashimoto
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Masashi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Kiminori Terui
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Asaka Kudo
- Department of Ophthalmology, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
- Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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Karasawa T, Sato R, Imaizumi T, Fujita M, Aizawa T, Tsugawa K, Mattinzoli D, Kawaguchi S, Seya K, Terui K, Joh K, Tanaka H. Expression of interferon-stimulated gene 20 (ISG20), an antiviral effector protein, in glomerular endothelial cells: possible involvement of ISG20 in lupus nephritis. Ren Fail 2023; 45:2224890. [PMID: 37340981 DOI: 10.1080/0886022x.2023.2224890] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND In addition to regulating the antiviral response, increased expression of Toll-like receptor 3 (TLR3) in resident renal cells plays a role in developing some forms of glomerulonephritis. TLR3 activation leads to type I interferon (IFN) production, which induces the expression of IFN-stimulated genes (ISGs). However, the role of ISG20 expression in resident renal cells remains unclear. METHODS Cultured normal human glomerular endothelial cells (GECs) were treated with polyinosinic-polycytidylic acid (poly IC), Escherichia coli lipopolysaccharide (LPS), R848, and CpG (TLR3, TLR4, TLR7, and TLR9 agonists, respectively). The mRNA levels of ISG20, CX3CL1/fractalkine, and CXCL10/IP-10 were measured by quantitative reverse transcription-polymerase chain reaction. ISG20 protein expression was assessed by Western blotting. RNA interference was used to knockdown IFN-β and ISG20 expression. CX3CL1 protein levels were assessed by enzyme-linked immunosorbent assay. We performed immunofluorescence to examine endothelial ISG20 expression in biopsy specimens from patients with lupus nephritis (LN). RESULTS In GECs, the expression of ISG20 mRNA and protein was increased by polyIC, not by LPS, R848, or CpG treatment. Moreover, ISG20 knockdown prevented poly IC-induced CX3CL1 expression but had no effect on CXCL10 expression. Intense endothelial ISG20 immunoreactivity was observed in biopsy specimens obtained from patients with proliferative LN. CONCLUSION In GECs, ISG20 was regulated via TLR3 but not via TLR4, TLR7, or TLR9 signaling. Moreover, ISG20 was involved in regulating CX3CL1 production. In addition to regulating antiviral innate immunity, ISG20 may act as a mediator of CX3CL1 production, thereby inducing glomerular inflammation, particularly in patients with LN.
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Affiliation(s)
- Takao Karasawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Riko Sato
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Masashi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Deborah Mattinzoli
- Renal Research Laboratory, Fondazione D'Amico per la Ricerca sulle Malattie Renali & Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Shogo Kawaguchi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kiminori Terui
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Kensuke Joh
- Department of Pathology, The Jikei Medical University, Tokyo, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
- Department of School Health Science, Hirosaki University, Hirosaki, Aomori Japan
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Mattinzoli D, Li M, Castellano G, Ikehata M, Armelloni S, Elli FM, Molinari P, Tsugawa K, Alfieri CM, Messa P. Fibroblast growth factor 23 level modulates the hepatocyte's alpha-2-HS-glycoprotein transcription through the inflammatory pathway TNFα/NFκB. Front Med (Lausanne) 2022; 9:1038638. [PMID: 36569120 PMCID: PMC9769965 DOI: 10.3389/fmed.2022.1038638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction High serum levels of fibroblast growth factor 23 (FGF23) characterize chronic kidney disease (CKD) since its early stages and have been suggested to contribute to inflammation and cardiovascular disease. However, the mechanisms linking FGF23 with these pathological conditions remain still incompletely defined. The alpha-2-HS-glycoprotein (AHSG), a liver-produced anti-inflammatory cytokine, is highly modulated by inflammation itself, also through the TNFα/NFκB signaling pathway. In our previous study, we found that FGF23 modulates the production of AHSG in the liver in a bimodal way, with stimulation and inhibition at moderately and highly increased FGF23 concentrations, respectively. Methods The present study, aiming to gain further insights into this bimodal behavior, was performed in hepatocyte human cells line (HepG2), using the following methods: immunochemistry, western blot, chromatin immunoprecipitation, fluorescence in situ hybridization (FISH), qRT-PCR, and gene SANGER sequencing. Results We found that FGF23 at 400 pg/ml activates nuclear translocation of NFκB, possibly increasing AHSG transcription. At variance, at 1,200 pg/ml, FGF23 inactivates NFκB through the activation of two specific NFκB inhibitors (IκBα and NKIRAS2) and induces its detachment from the AHSG promoter, reducing AHSG transcription. Conclusion These results add another piece to the puzzle of FGF23 involvement in the multifold interactions between CKD, inflammation, and cardiovascular disease, suggesting the involvement of the NFκB pathway, which might represent a potential therapeutic target in CKD.
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Affiliation(s)
- Deborah Mattinzoli
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Renal Research Laboratory, Milan, Italy,*Correspondence: Deborah Mattinzoli,
| | - Min Li
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Renal Research Laboratory, Milan, Italy
| | - Giuseppe Castellano
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Unit of Nephrology, Dialysis and Renal Transplant, Milan, Italy,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Masami Ikehata
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Renal Research Laboratory, Milan, Italy
| | - Silvia Armelloni
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Renal Research Laboratory, Milan, Italy,Silvia Armelloni,
| | - Francesca Marta Elli
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Endocrinology Unit, Milan, Italy
| | - Paolo Molinari
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Unit of Nephrology, Dialysis and Renal Transplant, Milan, Italy
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Carlo Maria Alfieri
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Unit of Nephrology, Dialysis and Renal Transplant, Milan, Italy,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Piergiorgio Messa
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Unit of Nephrology, Dialysis and Renal Transplant, Milan, Italy,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Kurotaki K, Fujita M, Aizawa T, Tsugawa K, Tanaka H. Aseptic meningitis as initial presentation of subclinical Sjögren's syndrome: Could the cerebrospinal fluid anti-Ro/SSA and anti-La/SSB antibody system be the culprit? Mod Rheumatol Case Rep 2022; 6:217-219. [PMID: 35134231 DOI: 10.1093/mrcr/rxac011] [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: 12/03/2021] [Revised: 01/12/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Aseptic meningitis sometimes occurs as a consequence of central nervous system (CNS) involvement in patients with primary Sjögren's syndrome (SS), even in paediatric-onset cases. However, little information is available regarding the pathological role of CSF anti-Ro/SSA and anti-La/SSB antibodies in the CNS involvement in patients with primary SS. We experienced an 18-year-old adolescent female with a 7-year history of suspicion of subclinical SS who subsequently developed aseptic meningitis as an initial presentation of probable SS. Her CSF exhibited marked elevation of anti-Ro/SSA and anti-La/SSB antibodies. When compared to her CSF IgG/serum IgG ratio (0.0058), her CSF/serum ratios of anti-Ro/SSA and anti-La/SSB antibody titres were higher (0.448 and 0.068, respectively; these were 77.5 and 11.7 times higher than that of IgG, respectively), suggesting that regional production of these antibodies was attributable, at least partly, to the development of meningitis. After the initiation of prednisolone treatment, her clinical manifestations promptly subsided. Since the clinical and pathological roles of the Ro/SSA antibody system in several autoimmune conditions have been postulated, our clinical observation may add novel insight to this theory.
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Affiliation(s)
- Keigo Kurotaki
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Masashi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
- Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Aomori, Japan
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Karasawa T, Sato R, Imaizumi T, Hashimoto S, Fujita M, Aizawa T, Tsugawa K, Kawaguchi S, Seya K, Terui K, Tanaka H. Glomerular endothelial expression of type I IFN-stimulated gene, DExD/H-Box helicase 60 via toll-like receptor 3 signaling: possible involvement in the pathogenesis of lupus nephritis. Ren Fail 2022; 44:137-145. [PMID: 35392757 PMCID: PMC9004514 DOI: 10.1080/0886022x.2022.2027249] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Sustained type I interferon (IFN) activation via Toll-like receptor (TLR) 3, 7 and 9 signaling has been reported to play a pivotal role in the development of lupus nephritis (LN). Although type I IFN activation has been shown to induce interferon-stimulated genes (ISGs) expression in systemic lupus erythematosus, the implication of ISGs expression in intrinsic glomerular cells remains largely unknown. Methods We treated cultured human glomerular endothelial cells (GECs) with polyinosinic-polycytidylic acid (poly IC), R848, and CpG (TLR3, TLR7, and TLR9 agonists, respectively) and analyzed the expression of DExD/H-Box Helicase 60 (DDX60), a representative ISG, using quantitative reverse transcription-polymerase chain reaction and western blotting. Additionally, RNA interference against IFN-β or DDX60 was performed. Furthermore, cleavage of caspase 9 and poly (ADP-ribose) polymerase (PARP), markers of cells undergoing apoptosis, was examined using western blotting. We conducted an immunofluorescence study to examine endothelial DDX60 expression in biopsy specimens from patients with LN. Results We observed that endothelial expression of DDX60 was induced by poly IC but not by R848 or CpG, and RNA interference against IFN-β inhibited poly IC-induced DDX60 expression. DDX60 knockdown induced cleavage of caspase 9 and PARP. Intense endothelial DDX60 expression was observed in biopsy specimens from patients with diffuse proliferative LN. Conclusion Glomerular endothelial DDX60 expression may prevent apoptosis, which is involved in the pathogenesis of LN. Modulating the upregulation of the regional innate immune system via TLR3 signaling may be a promising treatment target for LN.
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Affiliation(s)
- Takao Karasawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Riko Sato
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shun Hashimoto
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Masashi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shogo Kawaguchi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kiminori Terui
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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Hoshino A, Toyofuku E, Mitsuiki N, Yamashita M, Okamoto K, Yamamoto M, Kanda K, Yamato G, Keino D, Yoshimoto-Suzuki Y, Kamizono J, Onoe Y, Ichimura T, Nagao M, Yoshimura M, Tsugawa K, Igarashi T, Mitsui-Sekinaka K, Sekinaka Y, Doi T, Yasumi T, Nakazawa Y, Takagi M, Imai K, Nonoyama S, Morio T, Latour S, Kanegane H. Clinical Courses of IKAROS and CTLA4 Deficiencies: A Systematic Literature Review and Retrospective Longitudinal Study. Front Immunol 2022; 12:784901. [PMID: 35087518 PMCID: PMC8787285 DOI: 10.3389/fimmu.2021.784901] [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: 09/28/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
IKAROS and CTLA4 deficiencies are inborn errors of immunity and show similar clinical phenotypes, including hypogammaglobulinemia and autoimmune diseases (ADs). However, the differences in clinical features and pathogenesis of these are not fully understood. Therefore, we performed systematic literature reviews for IKAROS and CTLA4 deficiencies. The reviews suggested that patients with IKAROS deficiency develop AD earlier than hypogammaglobulinemia. However, no study assessed the detailed changes in clinical manifestations over time; this was likely due to the cross-sectional nature of the studies. Therefore, we conducted a retrospective longitudinal study on IKAROS and CTLA4 deficiencies in our cohort to evaluate the clinical course over time. In patients with IKAROS deficiency, AD and hypogammaglobulinemia often develop in that order, and AD often resolves before the onset of hypogammaglobulinemia; these observations were not found in patients with CTLA4 deficiency. Understanding this difference in the clinical course helps in the clinical management of both. Furthermore, our results suggest B- and T-cell-mediated ADs in patients with IKAROS and CTLA4 deficiencies, respectively.
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Affiliation(s)
- Akihiro Hoshino
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, INSERM UMR 1163, Imagine Institute, Paris, France
| | - Etsushi Toyofuku
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Mitsuiki
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motoi Yamashita
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keisuke Okamoto
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Michio Yamamoto
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Kenji Kanda
- Department of Pediatrics, Hikone Municipal Hospital, Hikone, Japan
| | - Genki Yamato
- Department of Hematology/Oncology, Gunma Children's Medical Center, Shibukawa, Japan
| | - Dai Keino
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yuri Yoshimoto-Suzuki
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Junji Kamizono
- Department of Pediatrics, Kitakyushu City Yahata Hospital, Kitakyushu, Japan
| | - Yasuhiro Onoe
- Department of Pediatrics, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Takuya Ichimura
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Mika Nagao
- Department of Pediatrics, Ohta Nishinouchi Hospital, Koriyama, Japan
| | - Masaru Yoshimura
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toru Igarashi
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | | | - Yujin Sekinaka
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Japan
| | - Takehiko Doi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Science, Hiroshima, Japan
| | - Takahiro Yasumi
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohsuke Imai
- Department of Community Pediatrics, Perinatal and Maternal Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shigeaki Nonoyama
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sylvain Latour
- Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, INSERM UMR 1163, Imagine Institute, Paris, France.,Université de Paris, Paris, France
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Fujita M, Aizawa T, Tsugawa K, Mattinzoli D, Nozu K, Joh K, Tanaka H. Underrecognized Frasier syndrome revisited: Paradoxical immunocomplex deposition. Pediatr Int 2022; 64:e15350. [PMID: 36421979 DOI: 10.1111/ped.15350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Masashi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Deborah Mattinzoli
- Department of Pediatrics, Renal Research Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kensuke Joh
- Department of Pathology, The Jikei Medical University, Tokyo, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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9
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Mori-Ishiguro M, Fujita M, Aizawa T, Tsugawa K, Mattinzoli D, Nozu K, Tanaka H. Be aware of underlying Dent disease in young boys with massive proteinuria. Pediatr Int 2022; 64:e15377. [PMID: 36197443 DOI: 10.1111/ped.15377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Minako Mori-Ishiguro
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of Neonatology, Saitama Children's Medical Center, Saitama, Japan
| | - Masashi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Deborah Mattinzoli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Renal Research Laboratory, Milan, Italy
| | - Kandai Nozu
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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10
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Sato R, Aizawa T, Imaizumi T, Tsugawa K, Kawaguchi S, Seya K, Terui K, Tanaka H. Effect of sera from lupus patients on the glomerular endothelial fibrinolysis system. Pediatr Int 2022; 64:e15099. [PMID: 35522716 DOI: 10.1111/ped.15099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/23/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dysregulation of the coagulation fibrinolysis system in resident glomerular cells is associated with the pathogenesis of lupus nephritis. However, the role of plasminogen activator inhibitor-1 (PAI-1) and tissue plasminogen activator (tPA) in resident glomerular cells remains undetermined. METHODS We examined the expression of PAI-1 and tPA mRNA in cultured normal human glomerular endothelial cells (GECs) treated with serum from patients with systemic lupus erythematosus (SLE) using quantitative reverse transcription polymerase chain reactions. We determined the relationship between PAI-1/tPA mRNA expression and several clinical/laboratory parameters. Serum from 16 patients (nine patients with new-onset SLE and seven patients with stable SLE) was used in the study. RESULTS Plasminogen activator inhibitor-1 and tPA mRNA expression was significantly higher in GECs treated with serum of patients with new-onset SLE than other groups. The PAI-1 and tPA mRNA levels were also significantly correlated in GECs treated with serum from patients with SLE. Interestingly, both PAI-1 and tPA mRNA levels in GECs were inversely correlated with serum C4 level and positively correlated with SLE disease activity. CONCLUSIONS These results suggest that serum from patients with SLE may activate the fibrinolysis system in glomerulus, which may be involved in the pathogenesis of lupus nephritis.
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Affiliation(s)
- Riko Sato
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shogo Kawaguchi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kiminori Terui
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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Watanabe S, Hidenori U, Hashimoto S, Riko S, Aizawa T, Tsugawa K, Imaizumi T, Tanaka H. Sphingomyelin Phosphodiesterase Acid-Like 3b is Essential for Toll-Like Receptor 3 Signaling in Human Podocytes. J Membr Biol 2021; 255:117-122. [PMID: 34739556 DOI: 10.1007/s00232-021-00206-w] [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: 08/10/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022]
Abstract
Recent studies have revealed the importance of cell membrane stability in normal cell function. Sphingomyelin phosphodiesterase acid-like 3b (SMPDL3b), a lipid modifying enzyme that converts sphingomyelin to ceramide in the cell membrane, is expressed in macrophages and regulates Toll-like receptor (TLR) 4 signaling by altering cell membrane fluidity. SMPDL3b is also expressed in human podocytes, which are involved in the pathogenesis of several glomerular diseases such as diabetic kidney disease, focal segmental glomerulosclerosis, and idiopathic nephrotic syndrome in children; however, the role of SMPDL3b in podocyte innate immunity is unclear. As podocytes are equipped with innate immune systems including TLR3, and viral infections often exacerbate proteinuria in children with idiopathic nephrotic syndrome, we hypothesized that changes in SMPDL3b expression levels could affect anti-viral responses via TLR3 signaling in podocytes, consequently impairing normal podocyte function. To examine the role of SMPDL3b in TLR3 signaling in podocytes, we treated conditionally immortalized human podocytes with polyinosinic-polycytidylic acid (poly IC), to activate TLR3 signaling. The cells were then transfected with small interfering RNA against SMPDL3b. Poly IC activated the TLR3 pathway, whereas knockdown of SMPDL3b attenuated poly IC-induced interferon-β/chemokine C-X-C ligand 10 expression in podocytes. To our knowledge, this is the first report demonstrating SMPDL3b involvement in podocyte innate immunity; these results suggest that SMPDL3b is essential for adequate anti-viral responses in podocytes, possibly by modulating lipid metabolism in the cell membrane.
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Affiliation(s)
- Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan. .,Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, 7910295, Japan.
| | - Umetsu Hidenori
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shun Hashimoto
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Sato Riko
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, Japan
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12
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Tsuji Y, Yamamura T, Nagano C, Horinouchi T, Sakakibara N, Ishiko S, Aoto Y, Rossanti R, Okada E, Tanaka E, Tsugawa K, Okamoto T, Sawai T, Araki Y, Shima Y, Nakanishi K, Nagase H, Matsuo M, Iijima K, Nozu K. Systematic Review of Genotype-Phenotype Correlations in Frasier Syndrome. Kidney Int Rep 2021; 6:2585-2593. [PMID: 34622098 PMCID: PMC8484119 DOI: 10.1016/j.ekir.2021.07.010] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction Frasier syndrome (FS) is a rare inherited kidney disease caused by intron 9 splicing variants of WT1. For wild-type WT1, 2 active splice donor sites in intron 9 cause a mixture of 2 essential transcripts (with or without lysine-threonine-serine [+/KTS or −KTS]), and imbalance of the +KTS/−KTS ratio results in the development of FS. To date, 6 causative intron 9 variants have been identified; however, detailed transcript analysis has not yet been conducted and the genotype-phenotype correlation also remains to be elucidated. Methods We conducted an in vitro minigene splicing assay for 6 reported causative variants and in vivo RNA sequencing to determine the +KTS/−KTS ratio using patients’ samples. We also performed a systematic review of reported FS cases with a description of the renal phenotype. Results The in vitro assay revealed that although all mutant alleles produced −KTS transcripts only, the wild-type allele produced both +KTS and −KTS transcripts at a 1:1 ratio. In vivo RNA sequencing showed that patients’ samples with all heterozygous variants produced similar ratios of +KTS to −KTS (1:3.2−1:3.5) and wild-type kidney showed almost a 1:1 ratio (1:0.85). A systematic review of 126 cases clarified that the median age of developing ESKD was 16 years in all FS patients, and there were no statistically significant differences between the genotypes or sex chromosome karyotypes in terms of the renal survival period. Conclusion Our study suggested no differences in splicing pattern or renal survival period among reported intron 9 variants causative of FS.
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Affiliation(s)
- Yurika Tsuji
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohiko Yamamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoko Horinouchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nana Sakakibara
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Ishiko
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuya Aoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rini Rossanti
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Eri Okada
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Eriko Tanaka
- Department of Pediatrics, Kyorin University School of Medicine, Mitaka, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Graduate School of Meidicine, Sapporo, Japan
| | - Toshihiro Sawai
- Department of Pediatrics, Shiga University of Medical Science, Shiga, Japan
| | - Yoshinori Araki
- Department of Pediatrics, Hokkaido Medical Center, Sapporo, Japan
| | - Yuko Shima
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Koichi Nakanishi
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroaki Nagase
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masafumi Matsuo
- Locomotion Biology Research Center, Kobe Gakuin University, Kobe, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
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13
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Hashimoto S, Imaizumi T, Watanabe S, Aizawa T, Tsugawa K, Kawaguchi S, Seya K, Matsumiya T, Tanaka H. Expression of IFN-induced transmembrane protein 1 in glomerular endothelial cells. Pediatr Int 2021; 63:1075-1081. [PMID: 33332692 DOI: 10.1111/ped.14579] [Citation(s) in RCA: 3] [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: 09/02/2020] [Revised: 11/29/2020] [Accepted: 12/08/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Glomerular endothelial cells (GECs) are directly exposed to circulating viral particles in the glomerulus. Although viral infections may trigger the development of acute kidney injury or the worsening of pre-existing chronic kidney disease, the specific molecular mechanisms underlying antiviral reactions via the activation of endothelial Toll-like receptor 3 signaling in the kidney remain to be determined. Interferon (IFN)-induced transmembrane protein 1 (IFITM1), a member of interferon-stimulated gene protein family, is involved in the prevention of viral entry into cerebral vascular endothelial cells, respiratory epithelial cells, and endometrium. However, as far as we are aware, the implication of IFITM1 associated with viral infections in GECs has not been investigated to date. METHODS Cultured, normal human GECs were treated with polyinosinic-polycytidylic acid (poly IC), a synthesized viral double-stranded RNA, then the expression of IFITM1 was examined by quantitative real-time reverse transcription-polymerase chain reaction and western blotting. To further elucidate the poly IC-induced signaling pathway, the cells were applied to RNA interference against IFN-β, nuclear factor-κB p65, and IFN regulatory factor 3. We also conducted an immunofluorescence study to examine endothelial IFITM1 expression in biopsy specimens from patients with chronic kidney disease. RESULTS We found that the activation of Toll-like receptor 3 induced endothelial expression of IFITM1, and that this involved IFN regulatory factor 3 and IFN-β, but not nuclear factor-κB. Intense endothelial IFITM1 immunoreactivity was observed in biopsy specimens from patients with lupus nephritis. CONCLUSIONS Antiviral reaction-related endothelial expression of IFITM1 may be involved, at least in part, in the development of particularly in lupus nephritis. Further detailed studies of the implication of interferon stimulated genes, including IFITM1 in GECs are needed.
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Affiliation(s)
- Shun Hashimoto
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shogo Kawaguchi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoh Matsumiya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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14
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Aizawa T, Watanabe S, Tsugawa K, Joh K, Tanaka H. Membranous nephropathy associated with Mycoplasma pneumoniae infection. Pediatr Int 2021; 63:853-855. [PMID: 33961316 DOI: 10.1111/ped.14517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/26/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Kensuke Joh
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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15
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Umetsu H, Watanabe S, Imaizumi T, Aizawa T, Tsugawa K, Kawaguchi S, Seya K, Matsumiya T, Tanaka H. Interleukin-6 via Toll-Like Receptor 3 Signaling Attenuates the Expression of Proinflammatory Chemokines in Human Podocytes. Kidney Blood Press Res 2021; 46:207-218. [PMID: 33827102 DOI: 10.1159/000514589] [Citation(s) in RCA: 3] [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: 09/23/2020] [Accepted: 01/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although toll-like receptor 3 (TLR3) signaling is involved in the development of certain chronic kidney diseases, the specific molecular mechanisms underlying inflammatory reactions via activation of TLR3 signaling in human podocytes remain unclear. Interleukin (IL)-6 is a pleiotropic cytokine associated with innate and adaptive immune responses; however, little is known about the implication of IL-6 via the activation of regional TLR3 signaling in the inflammatory reactions in human podocytes. METHODS We treated immortalized human podocytes with polyinosinic-polycytidylic acid (poly IC), an authentic viral double-stranded RNA, and assessed the expression of IL-6, monocyte chemoattractant protein-1 (MCP-1), and C-C motif chemokine ligand 5 (CCL5) using quantitative real-time reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay. To further elucidate the poly IC-induced signaling pathway, we subjected the cells to RNA interference against IFN-β and IL-6. RESULTS We found that the activation of TLR3 induced expression of IL-6, MCP-1, CCL5, and IFN-β in human podocytes. RNA interference experiments revealed that IFN-β was involved in the poly IC-induced expression of IL-6, MCP-1, and CCL5. Interestingly, IL-6 knockdown markedly increased the poly IC-induced expression of MCP-1 and CCL5. Further, treatment of cells with IL-6 attenuated the expression of CCL5 and MCP-1 mRNA and proteins. CONCLUSION IL-6 induced by TLR3 signaling negatively regulates the expression of representative TLR3 signaling-dependent proinflammatory chemokines in human podocytes.
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Affiliation(s)
- Hidenori Umetsu
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shogo Kawaguchi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoh Matsumiya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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16
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Sato R, Imaizumi T, Aizawa T, Watanabe S, Tsugawa K, Kawaguchi S, Seya K, Matsumiya T, Tanaka H. Inhibitory effect of anti-malarial agents on the expression of proinflammatory chemokines via Toll-like receptor 3 signaling in human glomerular endothelial cells. Ren Fail 2021; 43:643-650. [PMID: 33820486 PMCID: PMC8032345 DOI: 10.1080/0886022x.2021.1908901] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Although anti-malarial agents, chloroquine (CQ) and hydroxychloroquine (HCQ) are currently used for the treatment of systemic lupus erythematosus, their efficacy for lupus nephritis (LN) remains unclear. Given that upregulation of glomerular Toll-like receptor 3 (TLR3) signaling plays a pivotal role in the pathogenesis of LN, we examined whether CQ and HCQ affect the expression of the TLR3 signaling-induced representative proinflammatory chemokines, monocyte chemoattractant protein-1 (MCP-1), and C–C motif chemokine ligand 5 (CCL5) in cultured human glomerular endothelial cells (GECs). Methods We examined the effect of polyinosinic-polycytidylic acid (poly IC), an agonist of TLR3, on MCP-1, CCL5 and interferon (IFN)-β expression in GECs. We then analyzed whether pretreatment with CQ, HCQ, or dexamethasone (DEX) inhibits poly IC-induced expression of these chemokines using real-time quantitative reverse transcriptase PCR and ELISA. Phosphorylation of signal transducers and activator of transcription protein 1 (STAT1) was examined using western blotting. Results Poly IC increased MCP-1 and CCL5 expression in a time- and concentration-dependent manner in GECs. Pretreating cells with CQ, but not DEX, attenuated poly IC-induced MCP-1 and CCL5 expression; however, HCQ pretreatment attenuated poly IC-induced CCL5, but not MCP-1. HCQ did not affect the expression of IFN-β and phosphorylation of STAT-1. Conclusion Considering that TLR3 signaling is implicated, at least in part, in LN pathogenesis, our results suggest that anti-malarial agents exert a protective effect against the development of inflammation in GECs, as postulated in LN. Interestingly, CQ is a rather powerful inhibitor compared with HCQ on TLR3 signaling-induced chemokine expression in GECs. In turn, these findings may further support the theory that the use of HCQ is safer than CQ in a clinical setting. However, further detailed studies are needed to confirm our preliminary findings.
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Affiliation(s)
- Riko Sato
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shogo Kawaguchi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoh Matsumiya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Faculty of Education, Department of School Health Science, Hirosaki University, Hirosaki, Japan
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17
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Sugita A, Hashimoto S, Sato R, Fujita M, Watanabe S, Aizawa T, Tsugawa K, Tanaka H. Takayasu's arteritis in a girl with steroid-dependent nephrotic syndrome: Could rituximab be the culprit? Nephrology (Carlton) 2021; 26:693-694. [PMID: 33723913 DOI: 10.1111/nep.13870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Azusa Sugita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shun Hashimoto
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Riko Sato
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Masahi Fujita
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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18
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Furuya Y, Goto Y, Tsugawa K, Kanemaki Y. Evaluation of synthesized 2D mammography visibility with same pixel pitch as full-field digital mammography. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30793-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Watanabe S, Hirono K, Aizawa T, Tsugawa K, Joh K, Imaizumi T, Tanaka H. Podocyte sphingomyelin phosphodiesterase acid-like 3b decreases among children with idiopathic nephrotic syndrome. Clin Exp Nephrol 2020; 25:44-51. [PMID: 32946006 DOI: 10.1007/s10157-020-01970-0] [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: 09/12/2019] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
AIM Sphingomyelin phosphodiesterase acid-like 3b (SMPDL-3b), a regulator of the cytoskeleton, is expressed on podocytes. Recent reports present evidence that it is directly targeted by rituximab in the treatment of intractable nephrotic syndrome. However, the implications of SMPDL-3b for treatment of paediatric-onset idiopathic nephrotic syndrome (INS) remain unclear. This study aimed to investigate the level of expression of SMPDL-3b in urine, serum, and biopsy specimens and explore its implications in treatment of patients with INS. METHODS Levels of urinary SMPDL-3b among 31 patients (20 in remission and 11 in relapse) with INS were analysed by dot blotting. For reference of precise quantitative analysis, we examined urinary excretion of SMPDL-3b from 10 patients with INS by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in both remitted and relapsed status. The levels of serum SMPDL-3b among 20 patients (13 in remission and 7 in relapse or onset) with INS were also measured using enzyme-linked immunosorbent assay. Further, the immunoreactivity of SMPDL-3b in the biopsy specimens obtained from patients with INS was compared with those from patients with proteinuric IgA nephropathy, lupus nephritis, and non-proteinuric controls. RESULTS Urinary excretion of SMPDL-3b in patients with INS was significantly decreased in relapse cases compared with cases of remission and other types of proteinuric glomerular disease or controls by both dot blotting and LC-MS/MS method. On the other hand, serum SMPDL-3b level in INS was not different between cases of remission and relapse. Glomerular immunoreactivity of SMPDL-3b in patient with INS in remission was almost the same level to that of control. CONCLUSION The expression of SMPDL-3b on podocytes is specifically decreased in paediatric-onset INS and its urinary excretion level reflects such conditions.
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Affiliation(s)
- Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, 51 Hon-cho, Hirosaki, 036-8563, Japan.
| | - Koji Hirono
- Department of Pediatrics, Hirosaki University Hospital, 51 Hon-cho, Hirosaki, 036-8563, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, 51 Hon-cho, Hirosaki, 036-8563, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, 51 Hon-cho, Hirosaki, 036-8563, Japan
| | - Kensuke Joh
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, 51 Hon-cho, Hirosaki, 036-8563, Japan.,Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, Japan
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20
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Watanabe S, Hirono K, Aizawa T, Tsugawa K, Tanaka H. P1800RITUXIMAB ENHANCES THE EXPRESSION OF INTERLEUKIN-6 VIA TOLL-LIKE RECEPTOR 3 SIGNALING IN HUMAN PODOCYTE. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa144.p1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
The etiology of idiopathic nephrotic syndrome (INS) in children remains unclear, but it is well known that viral infections often cause relapses of INS. Since toll-like receptor 3 (TLR3), a ligand of viral dsRNA exists in podocytes, dysregulation of TLR3 signaling in podocytes may be involved in the pathogenesis of INS. Recently, rituximab (RTX) a specific antibody to human CD20, has been successfully used to treat children with intractable nephrotic syndrome (frequent relapse nephrotic syndrome, FRNS, and steroid dependent nephrotic syndrome, SDNS). It has been reported that depletion of B cell is main mechanism of RTX treatment. However, some patients experienced recurrence before peripheral blood B cell recovery, whereas selected patients have sustained remission even after peripheral blood B cell recovery. Considering that dramatic effects of RTX in the treatment of INS, it is speculated that some B cell-independent mechanisms of RTX exist. In this context, some recent studies have reported a direct effect of RTX on podocyte, targeting sphingomyelinase phosphodiesterase acid-like 3b (SMPDL3b), but detailed mechanisms remain to be determined. In this study, we examined whether RTX influences TLR3 signaling in cultured human podocyte.
Method
Immortalized human podocytes in culture were treated with polyinosinic-polycytidylic acid (poly IC), a synthetic analogue of viral dsRNA. RTX were added before or after the treatment of poly IC. Then, expression of interleukin (IL)-6 were measured using real time RT-PCR and ELISA. Direct binding of RTX to podocyte were confirmed by immunofluorescence.
Results
Poly IC induced the expression of IL-6 in cultured human podocyte in a concentration and time-dependent manner. IL-6 expression induced by poly IC were enhanced in both mRNA and protein level by pretreatment of RTX. RTX itself were apparently stained on podocyte by immunofluorescence.
Conclusion
RTX binds directly to cultured human podocyte and enhances the IL-6 expression induced by poly IC. Since IL-6 from podocyte was reported to be engaged in regulating glomerular inflammation by cross-talk with endothelial cells, exploring the role of enhanced IL-6 from podocyte by RTX, at least in a part, suggests a direct mechanism of RTX in treating intractable nephrotic syndrome in children.
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Affiliation(s)
- Shojiro Watanabe
- Hirosaki University Hospital, Department of Pediatrics, Hirosaki, Japan
| | - Koji Hirono
- Hirosaki University Hospital, Department of Pediatrics, Hirosaki, Japan
| | - Tomomi Aizawa
- Hirosaki University Hospital, Department of Pediatrics, Hirosaki, Japan
| | - Koji Tsugawa
- Hirosaki University Hospital, Department of Pediatrics, Hirosaki, Japan
| | - Hiroshi Tanaka
- Hirosaki University Hospital, Department of Pediatrics, Hirosaki, Japan
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21
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Tsugawa K, Tanaka H. Septicemia probably due to bacterial translocation in immunoglobulin A vasculitis: Is it a rare complication? Pediatr Int 2020; 62:512-513. [PMID: 32342651 DOI: 10.1111/ped.14130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/25/2019] [Accepted: 12/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Koji Tsugawa
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki University, Hirosaki, Japan
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Hashimoto S, Aizawa T, Watanabe S, Tsugawa K, Tanaka H. Osteomyelitis-related glomerulonephritis with myeloperoxidase-antineutrophil cytoplasmic antibody positivity. Pediatr Int 2020; 62:236-238. [PMID: 32067324 DOI: 10.1111/ped.14080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/21/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Shun Hashimoto
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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23
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Hirono K, Imaizumi T, Aizawa T, Watanabe S, Tsugawa K, Shiratori T, Kawaguchi S, Seya K, Matsumiya T, Ito E, Tanaka H. Endothelial expression of fractalkine (CX3CL1) is induced by Toll-like receptor 3 signaling in cultured human glomerular endothelial cells. Mod Rheumatol 2019; 30:1074-1081. [PMID: 31625434 DOI: 10.1080/14397595.2019.1682768] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 02/08/2023]
Abstract
Background: Endothelial expression of membrane-bound fractalkine/CX3CL1 (Fkn) reportedly acts as a strong mediator of inflammation. Toll-like receptor 3 (TLR3) axes are thought to play some roles in the development of chronic glomerulonephritis (CGN) including lupus nephritis (LN). However, detailed mechanism of TLR3-mediated Fkn expression in glomerular endothelial cells (GECs) remains to be elucidated.Methods: We examined the effect of polyinosinic-polycytidylic acid (poly IC) on Fkn expression in cultured human GECs. Fkn mRNA and protein levels were quantified by real-time PCR and enzyme-linked immunosorbent assay, respectively. To further elucidate the effects of poly IC on this signaling pathway, we used small-interfering RNA (siRNA) to knockdown expression of TLR3, nuclear factor (NF)-κB p65, interferon (IFN)-β, and IFN regulatory factor 3 (IRF3). We then analyzed whether pretreatment of chloroquine or dexamethasone (DEX) inhibits poly IC-induced Fkn expression.Results: We found that poly IC-induced Fkn expression in GECs, and that this involved NF-κB, IFN-β, and IRF3. Pretreating cells with chloroquine, but not DEX attenuated poly IC-induced Fkn expression in GECs.Conclusion: Since the activation of TLR3/NF-κB/IFN-β/Fkn and TLR3/IRF3/Fkn axes is involved in inflammatory reactions in GECs, intervention of glomerular TLR3 signaling may be a suitable therapeutic strategy for treating CGN especially LN.
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Affiliation(s)
- Koji Hirono
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | | | - Shogo Kawaguchi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoh Matsumiya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Etsuro Ito
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, Japan
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24
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Liu Q, Imaizumi T, Aizawa T, Hirono K, Kawaguchi S, Watanabe S, Tsugawa K, Matsumiya T, Seya K, Yoshida H, Tanaka H. Cytosolic Sensors of Viral RNA Are Involved in the Production of Interleukin-6 via Toll-Like Receptor 3 Signaling in Human Glomerular Endothelial Cells. Kidney Blood Press Res 2019; 44:62-71. [PMID: 30808838 DOI: 10.1159/000498837] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Accepted: 02/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Dysregulation of interleukin-6 (IL-6) production in residual renal cells may play a pivotal role in the development of glomerulonephritis (GN). Given that Toll-like receptor 3 (TLR3) signaling has been implicated in the pathogenesis of some forms of GN, we examined activated TLR3-mediated IL-6 signaling in cultured normal human glomerular endothelial cells (GECs). METHODS We treated GECs with polyinosinic-polycytidylic acid (poly IC), an authentic double-stranded RNA, and analyzed the expression of IL-6 and the cytosolic viral RNA sensors retinoic acid-inducible gene-I (RIG-I) and melanoma differentiation associated gene 5 (MDA5) using reverse transcription quantitative real-time polymerase chain reaction, western blotting, and enzyme-linked immunosorbent assays. To further elucidate the effects of poly IC on this signaling pathway, we subjected the cells to small interfering RNA (siRNA) against TLR3, interferon (IFN)-β, RIG-I, and MDA5. RESULTS We found that poly IC induced the expression of RIG-I, MDA5 and IL-6 via TLR3/IFN-β signaling in GECs. siRNA experiments revealed that both MDA5 and RIG-I were involved in the poly IC-induced expression of IL-6, with MDA5 being upstream of RIG-I. CONCLUSION Interestingly, cytosolic sensors of viral RNA were found to be involved in IL-6 production via TLR3 signaling in GECs. Regional activation of TLR3/IFN-β/ MDA5/RIG-I/IL-6 axis due to viral and "pseudoviral" infections is involved in innate immunity and inflammatory reactions in GECs. We believe this signaling pathway also plays a pivotal role in the development of some forms of GN.
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Affiliation(s)
- Qiang Liu
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Nephrology, the First Hospital of China Medical University, Shenyang, China
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Hirono
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shogo Kawaguchi
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomoh Matsumiya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hidemi Yoshida
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan,
- Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan,
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25
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Mattinzoli D, Ikehata M, Tsugawa K, Alfieri CM, Barilani M, Lazzari L, Andreetta P, Elli FM, Mantovani G, Messa P. FGF23 and Fetuin-A Interaction and Mesenchymal Osteogenic Transformation. Int J Mol Sci 2019; 20:ijms20040915. [PMID: 30791553 PMCID: PMC6412477 DOI: 10.3390/ijms20040915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/08/2019] [Accepted: 02/13/2019] [Indexed: 12/14/2022] Open
Abstract
Recently, we found a strict bone association between Fibroblast growth factor 23 (FGF23) and Fetuin-A, both involved in cardiovascular and mineral bone disorders. In this study, an uninvestigated bone marrow positivity for both was found. Though the role of exogenous FGF23 on mesenchymal cells (MSCs) was reported, no information is as yet available on the possible production of this hormone by MSCs. To further analyze these uninvestigated aspects, we studied human primary cells and mouse and human cell lines by means of immunostaining, qRT-PCR, enzyme linked immunosorbent assays, chromatin immunoprecipitation, transfection, and a streamlined approach for the FGF23⁻Fetuin-A interaction called Duolink proximity ligation assay. Mesenchymal cells produce but do not secrete FGF23 and its expression increases during osteo-differentiation. Fibroblast growth factor 23 is also involved in the regulation of Fetuin-A by binding directly to the Fetuin-A promoter and then activating its transcription. Both FGF23 overexpression and addition induced an upregulation of Fetuin-A in the absence of osteo-inducer factors. Fibroblast growth factor 23 and Fetuin-A promoter were increased by osteo-inducer factors with this effect being abolished after FGF23 silencing. In conclusion, both FGF23 and Fetuin-A are present and strictly linked to each other in MSCs with FGF23 driving Fetuin-A production. This mechanism suggests a role for these two proteins in the osteoblast differentiation.
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Affiliation(s)
- Deborah Mattinzoli
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Masami Ikehata
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Koji Tsugawa
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Carlo M Alfieri
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
- Unit of Nephrology, Dialysis and Renal transplant Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Mario Barilani
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
- Department of Transfusion Medicine and Hematology, Cell Factory, Regenerative medicine laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Lorenza Lazzari
- Department of Transfusion Medicine and Hematology, Cell Factory, Regenerative medicine laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Paola Andreetta
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Francesca M Elli
- Department of Clinical Sciences and Community Health, Endocrinology Unit, University of Milan, 20122 Milan, Italy.
- Unit of Endocrinology and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Giovanna Mantovani
- Department of Clinical Sciences and Community Health, Endocrinology Unit, University of Milan, 20122 Milan, Italy.
- Unit of Endocrinology and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Piergiorgio Messa
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
- Unit of Nephrology, Dialysis and Renal transplant Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
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26
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Watanabe S, Aizawa T, Tsukaguchi H, Tsugawa K, Tsuruga K, Shono A, Nozu K, Iijima K, Joh K, Tanaka H. Long-term clinicopathologic observation in a case of steroid-resistant nephrotic syndrome caused by a novel Crumbs homolog 2 mutation. Nephrology (Carlton) 2018; 23:697-702. [PMID: 29473663 DOI: 10.1111/nep.13244] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2018] [Indexed: 01/14/2023]
Abstract
Recent advances in high-throughput sequencing for clinical genetic testing have revealed novel disease-causing genes, such as Crumbs homolog 2 (CRB2) for early-onset steroid-resistant nephrotic syndrome (SRNS). We report the long-term clinicopathologic observation of a Japanese female patient with SRNS caused by a newly identified compound heterozygous mutation of CRB2 (p.Arg628Cys and p.Gly839Trp located in the 10th and 11th epidermal growth factor-like domains, respectively). She was initially examined during a mass urinary screening for 3.5-year-old children in Japan. Although she developed long-standing SRNS without any extrarenal clinical signs thereafter, her renal function was well-preserved over the next 17 years. In total, six sequential renal biopsy specimens revealed histologic alterations ranging from minor glomerular abnormalities to advanced focal segmental glomerulosclerosis (FSGS). A genetic analysis for SRNS performed at 19 years of age revealed a newly identified compound heterozygous mutation in CRB2. Glomerular CRB2 immunoreactivity in biopsy specimens from the patient was scanty, whereas intense expression was observed in those from patients with idiopathic FSGS or in controls. To our knowledge, this is the first report regarding a long-term outcome in a case of SRNS due to an identified CRB2 mutation. Although the phenotype of CRB2 mutation-related syndrome is now expanding, we believe that this case might provide a novel clinicopathologic aspect of this syndrome.
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Affiliation(s)
- Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | | | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Kazushi Tsuruga
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Akemi Shono
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kensuke Joh
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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27
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Liu Q, Imaizumi T, Kawaguchi S, Aizawa T, Matsumiya T, Watanabe S, Tsugawa K, Yoshida H, Tsuruga K, Joh K, Kijima H, Tanaka H. Toll-Like Receptor 3 Signaling Contributes to Regional Neutrophil Recruitment in Cultured Human Glomerular Endothelial Cells. Nephron Clin Pract 2018; 139:349-358. [PMID: 29791907 DOI: 10.1159/000489507] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/20/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Given the importance of neutrophil recruitment in the pathogenesis of glomerulonephritis (GN), the representative neutrophil chemoattractant C-X-C motif chemokine 1 (CXCL1)/GROα and the adhesion molecule E-selectin in glomerular endothelial cells (GECs) play a pivotal role in the development of GN. Endothelial Toll-like receptor 3 (TLR3) is thought to be involved in the inflammatory response via innate immunity. However, the role of endothelial TLR3 signaling in the expression of neutrophil chemoattractants and adhesion molecules remains to be elucidated. Thus, we aimed to examine this issue. METHODS We treated normal human GECs with polyinosinic-polycytidylic acid (poly IC), an authentic double-stranded RNA, and analyzed the expressions of CXCL1 and E-selectin using quantitative real-time reverse transcription-polymerase chain reaction, western blotting, and enzyme-linked immunosorbent assay. To further elucidate the poly IC-induced signaling pathway, we subjected the cells to RNA interference against TLR3, interferon (IFN)-β, nuclear factor (NF)-κB p65, and IFN regulatory factor (IRF) 3. We also used immunofluorescence to examine the endothelial expression of CXCL1 in biopsy specimens from patients with crescentic and non-crescentic purpura nephritis (PN). RESULTS We found that the activation of TLR3 induced the endothelial expression of CXCL1 and E-selectin, and that this involved TLR3, -NF-κB, IRF3, and IFN-β. Intense endothelial CXCL1 expression was observed in biopsy specimens from patients with crescentic PN. CONCLUSION These findings support a role for glomerular antiviral innate immunity in the pathogenesis of GN. Intervention of glomerular TLR3 signaling may therefore be a suitable therapeutic strategy for treating GN in the future.
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Affiliation(s)
- Qiang Liu
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Nephrology, The First Hospital of China Medical University, Shenyang, China
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shogo Kawaguchi
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomoh Matsumiya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hidemi Yoshida
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazushi Tsuruga
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Kensuke Joh
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of School Health Science, Hirosaki University Faculty of Education, Hirosaki, Japan
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28
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Watanabe S, Aizawa T, Tsugawa K, Tsuruga K, Ito E, Tanaka H. FP764URINARY EXCRETION AND GLOMERULAR EXPRESSION OF SPHINGOMYELINASE PHOSPHODIESTERASE ACID-LIKE 3B IN PEDIATRIC ONSET NEPHROTIC SYNDROME. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Tomomi Aizawa
- Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | | | - Etsuro Ito
- Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
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29
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Mattinzoli D, Ikehata M, Tsugawa K, Alfieri CM, Dongiovanni P, Trombetta E, Valenti L, Puliti A, Lazzari L, Messa P. FGF23 and Fetuin-A Interaction in the Liver and in the Circulation. Int J Biol Sci 2018; 14:586-598. [PMID: 29904273 PMCID: PMC6001652 DOI: 10.7150/ijbs.23256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/02/2018] [Indexed: 12/24/2022] Open
Abstract
Recently it has been demonstrated that Fetuin-A, an anti-inflammatory protein synthesized by the liver, is produced also in bone by an FGF23-regulated pathway. FGF23 has been also demonstrated to induce inflammatory cytokine production in the liver. This study aimed to explore if FGF23 plays a role in the Fetuin-A production in the liver cells too and the possible relationships with FGF23 pro-inflammatory effects. FGF23 and Fetuin-A were studied in liver, kidney and in plasma with immunochemistry, immunoprecipitation, western blot, chromatin immunoprecipitation, duolink, ELISA, qrtPCR methodology. FGF23 is produced, but not secreted by the liver cells. In hepatocytes and circulation, FGF23 was present only strictly linked to Fetuin-A, while Fetuin-A was found also in unbounded form. No link was observed in the kidney. FGF23 up to 600 pg/ml stimulates, while, at higher concentrations, reduces Fetuin-A expression. Notably, overall the range of concentrations, FGF23 stimulates Fetuin-A promoter, TNFα and IL6 expression. In the nucleus, FGF23 seems to act as a direct transcription factor of Fetuin-A promoter. These results suggest that FGF23 played a direct regulatory role in Fetuin-A expression in liver cells with a biphasic effect: Fetuin-A progressively increases when FGF23 increases up to 400-600 pg/mL, and declines at higher FGF23 concentrations. These results lead us to hypothesize: a) a possible epigenetic post-transcriptional regulation; b) a possible counter-regulatory effect of FGF23 induced inflammatory cytokines (TNFα/ NF-κB mechanism). This study could add an additional key for the interpretation of the possible mechanisms linking FGF23, Fetuin-A and inflammation in CKD patients and suggests a role for FGF23 as transcription factor.
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Affiliation(s)
- Deborah Mattinzoli
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Masami Ikehata
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Koji Tsugawa
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Carlo M Alfieri
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.,Unit of Nephrology, Dialysis and Renal transplant Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Dongiovanni
- Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Trombetta
- Flow Cytometry and Experimental Hepatology Service, Clinical Chemistry and Microbiology Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Valenti
- Department of pathophysiology and transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Università degli Studi di Milano, Italy
| | - Aldamaria Puliti
- DiNOGMI, University of Genoa, Italy.,Medical Genetics Unit, Istituto Giannina Gaslini, Italy
| | - Lorenza Lazzari
- Cell Factory Unit of Cell Therapy and Cryobiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Piergiorgio Messa
- Renal Research Laboratory Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.,Unit of Nephrology, Dialysis and Renal transplant Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Università degli Studi di Milano, Italy
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30
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Toyama T, Jeong J, Srimuninnimit V, Sriuranpong V, Noh W, Tsugawa K, Takahashi M, Iwase H, Arce C, Ridolfi A, Lin C, Royce M, Cardoso F. Everolimus (EVE) + letrozole (LET) in Asian patients with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2−) advanced breast cancer (ABC): Results of a subgroup analysis from the BOLERO-4 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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31
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Watanabe S, Tsugawa K, Tsuruga K, Imaizumi T, Tanaka H. Urinary excretion of sphingomyelinase phosphodiesterase acid-like 3b in children with intractable nephrotic syndrome. Pediatr Int 2017; 59:1112-1115. [PMID: 29081073 DOI: 10.1111/ped.13355] [Citation(s) in RCA: 7] [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: 02/08/2017] [Revised: 06/04/2017] [Accepted: 06/06/2017] [Indexed: 12/14/2022]
Abstract
Rituximab (RTX), a specific antibody to human CD20, has been successfully used to treat intractable nephrotic syndrome (NS). Recent studies have suggested a direct effect of RTX on podocytes by targeting sphingomyelinase phosphodiesterase acid-like 3b (SMPDL-3b). Thus, we examined the urinary excretion of SMPDL-3b as well as its immunoreactivity in biopsy specimens from children with intractable NS. Urine samples from six patients (five with minimal-change NS and one with focal segmental glomerulosclerosis) and from four healthy adults were examined. Glomerular immunoreactivity and urinary excretion of SMPDL3b in proteinuric NS patients decreased compared with controls. Interestingly, urine samples obtained from the same patients at the remission stage after RTX treatment showed an increase in urinary SMPDL-3b excretion compared with the proteinuric stage. Urinary excretion level of SMPDL-3b could thus be used to predict the clinical efficacy of RTX treatment in NS patients.
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Affiliation(s)
- Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Kazushi Tsuruga
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, Japan
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32
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Saeki T, Mukai H, Ro J, Lin YC, Fujiwara Y, Nagai S, Lee K, Watanabe J, Ohtani S, Kim S, Kuroi K, Tsugawa K, Tokuda Y, Iwata H, Park Y, Yang Y, Nambu Y. A global phase III clinical study comparing NK105 and paclitaxel in metastatic or recurrent breast cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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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33
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Maeda I, Oana Y, Tsugawa K, Takagi M. Availability of immunocytochemistry using cocktail antibody targeting p63/cytokeratin14 for the differential diagnosis of fibroadenoma and ductal carcinoma in situ in fine needle aspiration cytology of the breast. Cytopathology 2017; 28:378-384. [DOI: 10.1111/cyt.12434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/28/2022]
Affiliation(s)
- I. Maeda
- Department of Pathology; St. Marianna University School of Medicine; Kawasaki Japan
| | - Y. Oana
- Department of Clinical Pathology; St. Marianna University Hospital; Kawasaki Japan
| | - K. Tsugawa
- Department of Breast and Endocrine Surgery; St. Marianna University School of Medicine; Kawasaki Japan
| | - M. Takagi
- Department of Pathology; St. Marianna University School of Medicine; Kawasaki Japan
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Narui K, Ishikawa T, Shimizu D, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. Abstract P5-16-04: A randomized phase II neoadjuvant study comparing docetaxel and cyclophosphamide (TC) with 5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel (FEC-D) for hormone receptor-negative breast cancer: The Kanagawa breast oncology group (KBOG) 1101 study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: This study aimed to evaluate response to neoadjuvant chemotherapy (NAC) for patients with hormone receptor-negative (HR-negative) breast cancer (BC) to identify subtypes that require anthracycline treatment.
Methods: In total, 103 patients with operable HR-negative BC were registered. They were randomely assigned to administration of 6 cycles of docetaxel (75mg/m2) and cyclophosphamide (600 mg/m2) (TC6) or 3 cycles of 5-fluorouracil (500 mg/m2), epirubicin (100mg/m2), and cyclophosphamide (500mg/m2) followed by 3 cycles of docetaxel (100mg/m2) (FEC-D). Cytokeratin (CK) 5/6 and EGFR expression were used to identify basal and non-basal triple-negative (TN) BC. The primary endpoint was pathological complete response (pCR); secondary endpoints were safety, breast-conserving surgery, disease-free survival, and overall survival. Predictive factors of pCR for each regimen were also evaluated.
Results:
The pCR rate was 36% for FEC-D and 25.5% for TC6, which did not differ significantly (P=0.265). When TN BC was subdivided into basal and non-basal subtypes, the pCR rate in the basal subtype was significantly lower for TC6 (13.6%) than for FEC-D (42.9%) (P=0.033), but did not significantly differ in the non-basal (TC6, 36.4%; FEC-D, 25.0%) and HER2-positive (TC6, 41.7%; FEC-D, 35.7%) cases.
The relative dose intensities of epirubicin and docetaxel in FEC-D and docetaxel in TC6 were 96.3±13.0%, 93.5±14.6%, and 93.9±16.3% (mean±SD), respectively. Occurrence of grade ≥2 adverse events was significant in FEC-D-treated patients. Poor appetite (P<0.001), nausea (P<0.001), vomiting (P<0.001), dysgeusia (P=0.03), and fatigue (P=0.05) were significantly more common for FEC-D than TC6. Patients treated with FEC-D experienced significantly more febrile neutropenia and anemia (P=0.016 and 0.017, respectively).
The rates of breast-conserving surgery were 68.0 and 72.3% for FEC-D and TC6, respectively (P=0.641).
Patients achieved pCR had better DFS (log rank test, P = 0.287) and OS (log rank test, P = 0.069), though not significant. Patients treated with FEC-D had better DFS (log rank test, P = 0.107) and OS (log rank test, P = 0.159), though not significant. Among patients with TN BC, those treated with FEC-D had significantly better DFS (log rank test, P = 0.016) and OS (log rank test, P = 0.034) than treated with TC6.
Low ALDH1 expression and high topo IIα protein expression were strongly correlated with pCR in FEC-D, with odds ratios (ORs) of 4.33 [95% CI, 1.02–18.38] and 4.08 [0.97–17.2], respectively. ALDH1 was also associated with pCR in TC, OR=3.50 [0.84–14.6]. Other factors, including age, tumor size, nodal status, tumor grade, Ki67, p53, and TOP 2A status were not associated with pCR in either regimen.
Conclusions:We found that TC6 was less effective than FEC-D for treating HR-negative BC because it was insufficient for TNBC, particularly for basal BC. This suggests that anthracycline is more important than taxane for basal BC. Additionally, ALDH1 could be a marker for resistance to conventional chemotherapy.
Citation Format: Narui K, Ishikawa T, Shimizu D, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. A randomized phase II neoadjuvant study comparing docetaxel and cyclophosphamide (TC) with 5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel (FEC-D) for hormone receptor-negative breast cancer: The Kanagawa breast oncology group (KBOG) 1101 study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-04.
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Affiliation(s)
- K Narui
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Ishikawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - D Shimizu
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Tanabe
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Sasaki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - MS Oba
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - S Morita
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - S Nawata
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - K Kida
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Mogaki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Doi
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - K Tsugawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - H Ogata
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Ota
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Kosaka
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - N Sengoku
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Kuranami
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Saito
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Suzuki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - A Suto
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - H Arioka
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Chishima
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Ichikawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - I Endo
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Tokuda
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
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Villanueva C, Tsugawa K, Toyama T, Noh W, Jeong J, Cardoso F, Sriuranpong V, Srimuninnimit V, Ozguroglu M, Kendall S, Falkson C, Cianfrocca M, Manlius C, Lin JCJ, Ringeisen F, Ridolfi A, Royce M. Abstract P2-11-08: Stomatitis in patients treated with first-line everolimus (EVE) plus letrozole (LET): Results from BOLERO-4 trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-11-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Stomatitis is the most frequent adverse event reported in trials of mTOR-inhibitors, including EVE. In the pivotal phase 3 BOLERO-2 study, stomatitis incidence in the EVE + exemestane (EXE) arm was 59%. The BOLERO-4 study (NCT01698918) evaluated the efficacy and safety of first-line EVE + LET in postmenopausal pts with HR+, HER2− metastatic or locally advanced breast cancer (ABC). BOLERO-4 also assessed the effectiveness of an alcohol-free dexamethasone (0.5 mg/ 5ml; DEX) oral rinse for treating stomatitis in a subset of pts (USA).
Methods
Postmenopausal pts with HR+, HER2− ABC previously untreated for advanced disease received EVE (10 mg/day) + LET (2.5 mg/day).At disease progression, pts were offered EVE (10 mg/day) + EXE (25 mg/day). Pts who had at least one episode of stomatitis received oral stomatitis daily questionnaire (OSDQ), which is a 6 question pt-reported outcome (PRO) survey (Stiff et al, JCO. 2006). A subset of these pts (USA) was randomized (1:1) to receive DEX or standard of care (SOC). The primary objective of investigator-assessed progression-free survival in the first-line setting for ABC was presented previously. A secondary objective was to evaluate the effectiveness of the DEX oral rinse in reducing the severity and duration of stomatitis, using OSDQ data.
Results
Of the total 202 pts enrolled in this study, 52 pts were enrolled in USA, of which, 24 (46.2%) were randomized to receive DEX (n=11) or SOC (n=13), upon confirmation of stomatitis. The median duration of first stomatitis episode was longer per OSDQ (DEX, not estimable vs SOC, 13.7 wk) compared with physician-reported duration (DEX, 1.6 wk vs SOC, 1.9 wk). PRO OSDQ results were similar in both arms.
Among the 202 pts enrolled, 89 (44.1%) filled the OSDQ at their first stomatitis episode. The median time from treatment initiation to first stomatitis episode was 1.7 wk; median duration of stomatitis was 13.7 wk (OSDQ) vs 2.1 wk (physician reported). The majority of pts experiencing stomatitis had moderate/little/no soreness, moderate/low/no pain, and stomatitis had low/no effect on daily activities (Table 1).
Table 1. OSDQ Key Results (N=87)Questions (Score)First Day of Stomatitis Episode, n (%)End of First Stomatitis Episode, n (%)Overall healthPoor (0-4)20 (23.0)23 (26.4)Moderate (5-7)40 (46.0)32 (36.8)Perfect (8-10)27 (31.0)32 (36.8)Mouth and throat sorenessNo/a little/moderate (0-2)64 (73.6)84 (96.6)A lot or extreme (3-4)23 (26.4)3 (3.4)Mouth pain severityNo/low/moderate (0-4)51 (58.6)73 (83.9)Severe (5-7)24 (27.6)10 (11.5)Unbearable (8-10)12 (13.8)4 (4.6)Effect on daily activitiesNo/low (0-4)70 (80.5)78 (89.7)Moderate (5-7)11 (12.6)4 (4.6)High (8-10)6 (6.9)5 (5.7)
Conclusions
Overall, patient-reported median duration of stomatitis was longer than that reported by physicians, most likely due to differences in perceptions and the challenges in collecting and cleaning PRO data. Overall good health score was maintained in the majority of pts experiencing stomatitis and stomatitis had low/no effect on daily activities. However, these results, especially in the randomized subset need to be interpreted with caution owing to the small sample size, missing data and lack of commercially available DEX in most countries.
Citation Format: Villanueva C, Tsugawa K, Toyama T, Noh W, Jeong J, Cardoso F, Sriuranpong V, Srimuninnimit V, Ozguroglu M, Kendall S, Falkson C, Cianfrocca M, Manlius C, Lin JCJ, Ringeisen F, Ridolfi A, Royce M. Stomatitis in patients treated with first-line everolimus (EVE) plus letrozole (LET): Results from BOLERO-4 trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-11-08.
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Affiliation(s)
- C Villanueva
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - K Tsugawa
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - T Toyama
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - W Noh
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - J Jeong
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - F Cardoso
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - V Sriuranpong
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - V Srimuninnimit
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - M Ozguroglu
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - S Kendall
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - C Falkson
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - M Cianfrocca
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - C Manlius
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - JCJ Lin
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - F Ringeisen
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - A Ridolfi
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
| | - M Royce
- CHU de Besançon, Besançon, France; St. Marianna University School of Medicine, Kawasaki, Japan; Nagoya City University Hospital, Nagoya, Japan; Korea Cancer Center Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal; Chulalongkorn Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand; Cerrahpasa Medical School, Istanbul, Turkey; Utah Cancer Specialists, Salt Lake, UT; University of Alabama Comprehensive Cancer Center, Birmingham, AL; Banner MD Anderson Cancer Center, Gilbert, AZ; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma S.A.S, Paris, France; University of New Mexico Cancer Center, Albuquerque, NM
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Imaizumi T, Yano C, Numata A, Tsugawa K, Hayakari R, Matsumiya T, Yoshida H, Watanabe S, Tsuruga K, Kawaguchi S, Murakami M, Tanaka H. Interferon (IFN)-Induced Protein 35 (IFI35), a Type I Interferon-Dependent Transcript, Upregulates Inflammatory Signaling Pathways by Activating Toll-Like Receptor 3 in Human Mesangial Cells. Kidney Blood Press Res 2016; 41:635-642. [PMID: 27639618 DOI: 10.1159/000447932] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Activation of Toll-like receptor 3 (TLR3) signaling followed by type I interferon (IFN) expression is crucial in antiviral and "pseudoviral" immune reactions in renal mesangial cells (MCs). These reactions are probably involved in the pathogenesis of chronic kidney disease (CKD). However, the role of IFN-induced 35-kDa protein 35 (IFI35), a type I IFN-dependent transcript, in glomerular inflammation is unclear. Here, we aimed to investigate the expression and the role of IFI35 in IFN-β/retinoic acid-inducible gene-I (RIG-I)/CCL5 and IFN-β/melanoma differentiation-associated gene 5 (MDA5)/CXCL10 axes in MCs. METHODS We treated human MCs with polyinosinic-polycytidylic acid (poly IC), an authentic double-stranded RNA, then analysed the IFI35 expression by reverse transcription-polymerase chain reaction and western blotting. To examine the regulation of IFI35 expression, we subjected MCs to RNA interference (siRNA) against IFN-β, RIG-I, and MDA5. RESULTS Activation of TLR3 by poly IC induces the IFI35 expression in MCs. siRNA against IFN-β inhibited poly IC-induced IFI35 expression. Knockdown of IFI35 resulted in a decrease of poly IC-induced RIG-I and MDA5 protein as well as decreased CCL5 and CXCL10 mRNA and protein expression. However, it did not affect the expression of none of phosphorylated signal transducers or activator of transcription (STAT) 1 protein, or RIG-I and MDA5 in mRNA levels. CONCLUSION Regional expression of IFI35 and its dysregulation may be involved in the pathogenesis of glomerular inflammation in CKD.
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Affiliation(s)
- Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Tsugawa K, Imaizumi T, Watanabe S, Tsuruga K, Yoshida H, Tanaka H. Clarithromycin attenuates the expression of monocyte chemoattractant protein-1 by activating toll-like receptor 4 in human mesangial cells. Clin Exp Nephrol 2016; 21:573-578. [PMID: 27614743 DOI: 10.1007/s10157-016-1333-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/05/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Signaling pathways induced by the activation of renal toll-like receptor 4 (TLR4) play a pivotal role in chronic kidney disease (CKD). Some recent studies suggested that clarithromycin (CAM), a 14-membered ring macrolide, exerts renoprotective effects by suppressing proinflammatory chemokines. However, its beneficial effects on signaling pathways through renal TLR4 activation are unknown. METHODS Cultured human mesangial cells (MCs) were treated with lipopolysaccharide (LPS). Expression of monocyte chemoattractant protein-1 (MCP-1/CCL2) and interleukin-8 (IL-8/CXCL8) was analyzed by quantitative RT-PCR and enzyme-linked immunosorbent assay. Signaling pathways affected by CAM were determined by examining the activation of nuclear factor-κB (NF-κB) and p38 mitogen-activated protein kinase (MAPK) by performing western blotting. RESULTS CAM inhibited both the mRNA and protein expression of MCP-1 without cell injury but did not affect those expressions of IL-8 in LPS-stimulated MCs. Interestingly, CAM decreased p38 MAPK activation by inhibiting phosphorylation but did not affect NF-κB activation. CONCLUSION Our results indicated that CAM exerted renoprotective effects by suppression of p38 MAPK activity and by decreasing the expression of MCP-1 in LPS-stimulated MCs. Given the implication of TLR4 signaling in CKD, CAM may be a potential treatment of choice for CKD.
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Affiliation(s)
- Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki University, Hirosaki, 036-8563, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki University, Hirosaki, 036-8563, Japan
| | - Kazushi Tsuruga
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki University, Hirosaki, 036-8563, Japan
| | - Hidemi Yoshida
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki University, Hirosaki, 036-8563, Japan. .,Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, 036-8560, Japan.
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Kubo K, Aizawa T, Watanabe S, Tsugawa K, Tsuruga K, Ito E, Joh K, Tanaka H. Does Dent disease remain an underrecognized cause for young boys with focal glomerulosclerosis? Pediatr Int 2016; 58:747-9. [PMID: 27324082 DOI: 10.1111/ped.12944] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/19/2015] [Accepted: 01/26/2016] [Indexed: 12/11/2022]
Abstract
Focal glomerulosclerosis (FGS) is a histologic entity that causes significant proteinuria in children. Although its etiology varies, recent reports indicated that some young male patients with FGS had underlying Dent disease. We describe the case of a 14-year-old Japanese boy who presented with persistent non-nephrotic range proteinuria, hematuria, and renal insufficiency. The patient was initially diagnosed as having FGS associated with scattered tubulointerstitial fibrosis. Although he had neither nephrocalcinosis nor family history of renal disease including urolithiasis, increased excretion of urinary β2 microglobulin was noted. Genetic analysis for Dent disease indicated a mutation (c.726 + 1G > A) in Chloride Channel, Voltage-Sensitive 5 (CLCN5). Given a recent hypothesis that Dent disease may be underrecognized in children with FGS, a careful diagnostic evaluation for possible underlying Dent disease should be considered in young boys who present with persistent albuminuria associated with high-grade low-molecular-weight proteinuria.
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Affiliation(s)
- Kaori Kubo
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Kazushi Tsuruga
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Etsuro Ito
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Kensuke Joh
- Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan.,Department of Pathology, Tohoku University Graduate School of Medicine, Hirosaki, Japan
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Niikura N, Tomotaki A, Miyata H, Iwamoto T, Kawai M, Anan K, Hayashi N, Aogi K, Ishida T, Masuoka H, Iijima K, Masuda S, Tsugawa K, Kinoshita T, Nakamura S, Tokuda Y. Changes in tumor expression of HER2 and hormone receptors status after neoadjuvant chemotherapy in 21 755 patients from the Japanese breast cancer registry. Ann Oncol 2016; 27:480-7. [DOI: 10.1093/annonc/mdv611] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 11/28/2015] [Indexed: 12/17/2022] Open
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Nagasawa S, Ohta T, Tsugawa K. Abstract P5-06-05: MED12 exon 2 mutations in phyllodes tumors of the breast. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-06-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Exon 2 of MED12, a subunit of the transcriptional mediator complex, has been frequently mutated in uterine leiomyomas and breast fibroadenomas; however, it has been rarely mutated in other tumors. Although the mutations were also found in uterine leiomyosarcomas, the frequency was significantly lower than in uterine leiomyomas.
Here, we examined the MED12 mutation in phyllodes tumors, another biphasic tumor with epithelial and stromal components related to breast fibroadenomas. Mutations in
MED12 exon 2 were analyzed in nine fibroadenomas and eleven phyllodes tumors via
Sanger sequencing. A panel of cancer- and sarcoma-related genes was also analyzed using Ion Torrent next-generation sequencing. Six mutations in fibroadenomas, including those previously reported (6/9, 67%), and five mutations in phyllodes tumors (5/11, 45%) were observed. Three mutations in the phyllodes tumors were missense mutations at
Gly44, which is common in uterine leiomyomas and breast fibroadenomas. In addition, two deletion mutations (in-frame c.133_144del12 and loss of splice acceptor
c.100-68_137del106) were observed in the phyllodes tumors. No other recurrent mutation was observed with next-generation sequencing. Frequent mutations in MED12 exon 2 in the phyllodes tumors suggest that it may share genetic etiology with uterine leiomyoma, a subgroup of uterine leiomyosarcomas and breast fibroadenoma.
Citation Format: Nagasawa S, Ohta T, Tsugawa K. MED12 exon 2 mutations in phyllodes tumors of the breast. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-06-05.
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Affiliation(s)
- S Nagasawa
- Divison of Breast and Endocrine Surgery, St.Marianna Universeity School of Medicine, Kawasaki, Japan; Divison of Translational Oncology, St.Marianna Universeity School of Medicine, Kawasaki, Japan
| | - T Ohta
- Divison of Breast and Endocrine Surgery, St.Marianna Universeity School of Medicine, Kawasaki, Japan; Divison of Translational Oncology, St.Marianna Universeity School of Medicine, Kawasaki, Japan
| | - K Tsugawa
- Divison of Breast and Endocrine Surgery, St.Marianna Universeity School of Medicine, Kawasaki, Japan; Divison of Translational Oncology, St.Marianna Universeity School of Medicine, Kawasaki, Japan
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Tsuruga K, Aizawa T, Watanabe S, Tsugawa K, Yoshida H, Imaizumi T, Ito E, Tanaka H. Expressions of mRNA for innate immunity-associated functional molecules in urinary sediment in immunoglobulin A nephropathy. Nephrology (Carlton) 2015; 20:916-21. [PMID: 26058859 DOI: 10.1111/nep.12533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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] [Accepted: 06/03/2015] [Indexed: 01/06/2023]
Abstract
AIM It has been reported that the innate immune system plays a pivotal role in the pathogenesis of immunoglobulin A nephropathy (IgAN). To explore non-invasive monitoring of disease activity in children with IgAN, we examined whether expressions of mRNA for innate immunity-associated functional molecules: CC ligand chemokine 5 (CCL5), fractalkine/CX3CL1, interferon-γ-induced protein 10 (IP-10), monocyte chemoattractant protein 1 (MCP-1), retinoic acid-inducible gene-I (RIG-I), and toll-like receptor 3 (TLR3) in urinary sediment from patients with IgAN correlate with histologic parameters. METHODS Twenty consecutive children with IgAN and four children with thin basement membrane disease (serving as a non-inflammatory control) were enrolled in this pilot study. Urinary mRNA expressions of target genes were examined real-time quantitative polymerase chain reaction. RESULTS The expressions of CCL5, fractalkine and RIG-I were significantly increased in IgAN (all P < 0.05). Although no significant correlation was observed between mRNA expressions of these three molecules and clinical parameters, such as levels of urinary protein excretion, degrees of occult blood in urine and serum albumin, the expression of fractalkine was significantly correlated with the histological activity index (P = 0.022) and the chronicity index (P = 0.005). Furthermore, intense glomerular immune activity of fractalkine was observed in biopsy specimens in patients with moderately to severe proliferative IgAN. CONCLUSION Regional expression of fractalkine may be involved in the pathogenesis of childhood IgAN. Although our present findings remain preliminary, measurement of mRNA expression of fractalkine in urinary sediment could be used as a non-invasive method for predicting histologic severity in IgAN in children. Further studies of this issue are needed.
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Affiliation(s)
- Kazushi Tsuruga
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Tomomi Aizawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Shojiro Watanabe
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Koji Tsugawa
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hidemi Yoshida
- Department of Vascular Biology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Etsuro Ito
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
| | - Hiroshi Tanaka
- Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Japan
- Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, Japan
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Nagasawa S, Tsugawa K. P226 LSD1 is associated with poor prognosis in basal-like breast cancer. Breast 2015. [DOI: 10.1016/s0960-9776(15)70258-4] [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: 10/23/2022] Open
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Bando H, Ohno S, Kato T, Tamura N, Asada Y, Watanabe C, Tsugawa K, Suzuki N, Shimizu C. PO33 Clinical practice guideline for preservation of fertility in breast cancer patients in Japan. Breast 2014. [DOI: 10.1016/s0960-9776(14)70043-8] [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: 11/24/2022] Open
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Ishikawa T, Shimizu D, Tanabe M, Oba MS, Sasaki T, Morita S, Kida K, Nawata S, Mogami M, Doi T, Tsugawa K, Ogata H, Kosaka Y, Sengoku N, Saito Y, Suzuki Y, Suto A, Chishima T, Ichikawa Y, Endo I, Tokuda Y. Abstract P3-14-08: A randomized phase II trial comparing docetaxel plus cyclophosphamide with epirubicin plus cyclophosphamide followed by docetaxel as neoadjuvant chemotherapy for hormone receptor-negative breast cancer. Kanagawa breast oncology group (KBOG) 1101 study. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-14-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Taxane-based regimens have been developed and used widely to treat breast cancer. It has therefore become important to identify subgroups of patients in which anthracyclines are indispensable. Pathological response to neoadjuvant chemotherapy (NAC) predicts prognosis in hormone-negative subtypes. We therefore initiated a randomized phase II NAC study to compare a taxane with and without an anthracycline in these breast-cancer subtypes.
Aim: To determine the safety and activity of six cycles of docetaxel and cyclophosphamide (TC6) compared with 5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel (FEC-D), and to examine the predictive factors for each regimen.
Methods: Eligibility criteria were operable hormone-receptor-negative breast cancer, age younger than 75 years and ECOG PS0-1. According to HER2 status, patients were randomly assigned to TC (75/600 mg/m2) every 3 weeks X 6 or FEC (500/100/500 mg/m2) every 3 weeks X 3 followed by D (100 mg/m2) every 3 weeks X 3. The primary endpoint was the rate of pathological complete response (pCR; grade 3). Triple-negative (TN) breast cancer was subdivided by cytokeratin 5/6 and epidermal growth factor receptor into basal- and non-basal subtypes. Secondary endpoints were safety, breast-conserving surgery, disease-free survival, overall survival, and predictive factors: Ki-67, p53, aldehyde dehydrogenase (ALDH) 1 and topoisomerase 2A by both immunohistochemistry and fluorescence in situ hybridization for each regimen.
Results: Ninety-seven of 103 patients were analyzed successfully (50 for FEC-D and 47 for TC6). Significantly more severe adverse events (grade 2) were observed in FEC-D-treated patients (poor appetite, nausea and vomiting: p = 0.001; febrile neutropenia: p = 0.016). The pCR rate tended to be higher in FEC-D-treated patients compared with TC6-treated patients (pCR: 36.0 vs. 25.5%, n.s.). FEC-D treatment was significantly more effective than TC6 in basal-type (p = 0.033) but not in non-basal and HER2 subtypes. ALDH1 was associated with resistance to both regimens (FEC-D: p = 0.047, TC6: p = 0.085)
Conclusions: TC6 was safer, but not more effective than FEC-D. TC6 was significantly less active than FEC-D in basal subtype, and equivalent to FEC-D in HER2 and non-basal subtypes. Concurrent use of trastuzumab with TC could thus represent a reasonable option for NAC in HER2-subtype patients. ALDH1 could provide a marker for novel strategies such as stem cell-based therapies for breast cancer. Analyses on pathological factors in surgical specimens after NAC will be presented at the meeting.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-14-08.
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Affiliation(s)
- T Ishikawa
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - D Shimizu
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - M Tanabe
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - MS Oba
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - T Sasaki
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - S Morita
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - K Kida
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - S Nawata
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - M Mogami
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - T Doi
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - K Tsugawa
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - H Ogata
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Y Kosaka
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - N Sengoku
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Y Saito
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Y Suzuki
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - A Suto
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - T Chishima
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Y Ichikawa
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - I Endo
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Y Tokuda
- Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Shonan-Kinen Hospital, Kamakura, Kanagawa, Japan; Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Kitasato University, Sagamihara, Kanagawa, Japan; Endocrine and Breast Surgery, Tokai University, Isehara, Kanagawa, Japan; Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
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Enokido K, Watanabe C, Nakamura S, Ogiya A, Osako T, Akiyama F, Horio A, Iwata H, Ohno S, Kojima Y, Tsugawa K, Motomura K, Hayashi N, Yamauchi H, Sato N. Abstract P2-18-03: Feasibility of sentinel node biopsy following neoadjuvant chemotherapy in cytology-proven node positive breast cancer before chemotherapy. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-18-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Sentinel node biopsy (SNB) for the node negative breast cancer is standard treatment as an accurate assessment of axillary lymph node status; however, axillary node dissection is a standard procedure for the node positive breast cancer. Neoadjuvant chemotherapy (NAC) has become the standard of care for patients with locally advanced breast cancer. It is reported that 40% of node positive disease convert to node negative after NAC. It remains controversial whether SLB could be applied to patients who present with node-positive disease before neoadjuvant chemotherapy. In this study, we evaluated the accuracy of SNB following NAC in breast cancer patients presenting with cytology-proven axillary node metastasis before chemotherapy.
METHODS: A multicenter prospective study was performed from September 2011 to April 2013 in 101 breast cancer patients with positive axillary nodes, proven by ultrasound-guided fine-needle aspiration at initial diagnosis (T1-3, N1, M0). After the confirmation of patients as clinically node-negative by preoperative imaging following NAC, all patients underwent breast surgery, with SNB and complete axillary lymph node dissection. The sentinel nodes were examined by hematoxylin-eosin staining, immunohistochemical analysis or one-step nucleic acid amplification assay (OSNA).The false negative rate and detection rate were analyzed.
RESULTS: Among the 101 patients analyzed, all cases presented with invasive ductal carcinoma. with a mean tumor size of 3.4cm. Thirty-six cases were hormone receptor (HR) positive and HER2 negative (Lum), 14 cases were HR positive and HER2 positive (Triple-Positive), 27 cases were positive for HER2 (HER2-enriched), and 24 cases were Triple-Negative. After neoadjuvant chemotherapy, a complete clinical response in the primary tumor was seen in 24.8%(25/101), a partial response in 66.3%(67/101), and no response in 7.9%(8/101). Pathological complete response of primary tumor was 39.6%. The pathological complete nodal response rate was 42.2%. The sentinel lymph node could be identified in 91 of 101 cases (90.1%); 88.9% (32/36) of patients with Lum, 100%(14/14)of those with Triple-Positive, 85.2% (23/27) of those with HER2-enriched, and 91.7% (22/24)% of those with Triple-Negative breast cancer subtype. The false negative rate was 12.7%; 35.7 (5/14) for Lum, 0% (0/8) for Triple-Positive, 5.0% (1/20) for HER2-enriched, and 7.7% (1/13) for Triple-Negative subtype (P = 0.03).
CONCLUSION: SNB following NAC in patients with node-positive breast cancer was found to be technically feasible, but is not recommended for the Lum subtype. However, it might be safely considered in selected patients, those with Triple-Positive, HER2-enrich and Triple-Negative subtype breast cancers.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-18-03.
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Affiliation(s)
- K Enokido
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - C Watanabe
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - S Nakamura
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - A Ogiya
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - T Osako
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - F Akiyama
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - A Horio
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - H Iwata
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - S Ohno
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - Y Kojima
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - K Tsugawa
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - K Motomura
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - N Hayashi
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - H Yamauchi
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
| | - N Sato
- Showa University Hospital, Tokyo, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; National Kyushu Cancer Center, Japan; St. Marianna University School of Medicine, Kawasaki; Osaka Medical Center for Cancer and Cardiovascular Diseases; St Luke's International Hospital; Niigata Cancer Center Hospital
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Yagata H, Yamauchi H, Horii R, Osako T, Iwase T, Akiyama F, Kinoshita T, Tsuda H, Tsugawa K, Nakamura S. Abstract P1-01-12: The Performance of the One Step Nucleic acid Amplification (OSNA) Assay in Breast Cancer Patients with Receiving Preoperative Systemic Therapy. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p1-01-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The OSNA (One Step Nucleic acid Amplification) assay is a semi-automated lymph node examination method using molecular biological technique. The OSNA assay has been validated for breast cancer patients without receiving preoperative systemic therapy (PST) by several clinical studies and has currently become more popular as sentinel lymph node (SLN) examination method with the following two main advantages; 1) to allow examination of the whole portion of a node, 2) to allow intraoperative judgment of metastasis positive or negative. However, the feasibility of the OSNA assay in breast cancer patients treated by PST has never been confirmed. In this multi-central clinical study, we compared the judgments of the OSNA assay and of pathological examination on lymph nodes dissected after receiving PST to evaluate the performance of the OSNA assay.
Material & Methods: Three hundred two nodes dissected from the 80 breast cancer patients who received PST were examined. Each lymph node was divided at 2mm intervals and the slices were alternately applied to the OSNA assay and pathological examination with H&E staining and CK19 immunohistochemical staining of permanent-section. In pathological examination, judgments of metastasis positive or negative were determined by one central-review pathologist according to the criteria of AJCC 7th edition (“positive” if >0.2mm metastases were detected).
Result: The overall concordance rate between the OSNA assay and pathological examination was 91.1% (275/302) with sensitivity of 88.3% (53/60) and specificity of 91.7% (222/242) (Table). These results are very similar to those of the Japanese clinical validation study in breast cancer patients without receiving PST which was conducted by the almost same protocol (Tamaki Y, et al. Clin Cancer Res, 2009, 15: 2879–2884).
Conclusion & Discussion: These results indicate the OSNA assay can be applicable for breast cancer patients after receiving PST as well as breast cancer patients without receiving PST. The OSNA assay will enable to examine the whole portion of nodes, leading to more detection of metastases (especially micrometastases) and more exact nodal staging for breast cancer patients treated by PST. Also, for the patients who receive sentinel lymph node biopsy after PST, the OSNA assay will be useful as intraoperative examination method of SLNs because it is expected to provide more correct judgments than current intraoperative methods such as frozen-section or touch-print cytology.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-01-12.
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Affiliation(s)
- H Yagata
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - H Yamauchi
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - R Horii
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - T Osako
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - T Iwase
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - F Akiyama
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - T Kinoshita
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - H Tsuda
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - K Tsugawa
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
| | - S Nakamura
- St. Luke's International Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital, Tokyo, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Showa University School of Medicine, Tokyo, Japan
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Enokido K, Nakamura S, Tsugawa K, Kojima Y, Iwata H, Ohno S, Akiyama F, Motomura K. Sentinel lymph node biopsy following neoadjuvant chemotherapy in clinically node-negative breast cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15 Background: Sentinel lymph node biopsy (SLNB) is a widely accepted staging method for patients with early breast cancer. But SLNB following neoadjuvant chemotherapy (NAC) is also controversial because of insufficient evidence to recommend as a standard procedure. The aim of our study was to demonstrate the feasibility of SNLB following NAC. Methods: The clinical study of SLNB for clinically node-negative breast cancer patient was conducted as a large cohort study to confirm the identification rate and safety of this procedure. It was investigated by The Japanese Breast Cancer Society and was accomplished between the years March 2008 and October 2009. In this study 11,228 cases are registered before SLNB from 64 institutions. Of the 11,228 eligible cases, analysis was conducted among 489 cases that were introduced neoadjuvant chemotherapy. Results: SLNB was performed in 110 cases before NAC, 379 cases after NAC. The sentinel node identification rate before NAC was 106/110 cases (96.4%), after NAC was 373/379 cases (98.4%). Intraoperative frozen section analysis was performed in 280 cases, 71 cases were positive. The remaining 219 patients displayed no metastasis in the intraoperative examination, and 6 of these 219 (2.7%) were positive in the final pathological analysis. Conclusions: The identification rate of SLNB following NAC is not inferior to the result of major clinical studies previously reported in the world. There is insufficient evidence to recommend this as a standard procedure. Further research with subgroup analysis is necessary to identify whether SLNB following NAC is feasible or not (planned study). The primary end point for Group A is local relapse rate, Group B is not only the accuracy and false negative rate also the utility of One-step Nucleic Acid Amplification (OSNA).
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Affiliation(s)
- K. Enokido
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - S. Nakamura
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - K. Tsugawa
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - Y. Kojima
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - H. Iwata
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - S. Ohno
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - F. Akiyama
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - K. Motomura
- Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
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Kojima Y, Tsugawa K, Enokido K, Iwata H, Ohno S, Akiyama F, Motomura K, Watanabe C, Nakamura S. A nomogram to predict nonsentinel lymph node involvement in breast cancer patients with sentinel lymph node metastases. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14 Background: Several nomograms have been described as predictors of non-sentinel axially lymph node (non-SN) metastases in breast cancer with positive sentinel nodes (SN). However, all these predicting models were based on data from western countries. The purpose of this study was to examine predictive factors of non-SN status among SN metastatic patients, in order to develop a nomogram based on Japanese large data set. Methods: This research was analyzed by using a clinical database of 11,228 Japanese breast cancer patients who registerd to cohort study as SN biopsy between March 2008 and Octover 2009 in Japan. We reviewed data retrospectively to extract patients with SN metastases who underwent complementary axillary lymph node dissection. In this cohort, we examined predictive factors of non-SN metastases. All clinical and pathologic features were analyzed to predict the non-SN status, by using univariate and multivariate logistic regression model. A receiver operating characteristic curve was constructed and the area under the curve (AUC) was calculated. Results: Among the database, SN metastases were found in 1,029 patients, and 345 (33.5%) were non-SN positive. Univariate analysis showed a significant association between non-SN involvement and primary tumor size (p<0.001), histologic grade (p=0.011), lymphatic invasion (p<0.001), venous invasion (p=0.005) and the number of involved SNs among all identified SNs (p<0.001). Tumor size (p<0.001), lymphatic invasion (p<0.001), and the size of SN metastasis (p<0.001) were associated with non-SN metastasis in multivariate analysis. Based on the multivariate analysis, we developed a scoring system to predict the likelihood of non-SN metastases in breast cancer patients with SN involvement. The discriminatory ability of our nomogram, as measured by the AUC, was 0.752. Conclusions: In patients with invasive breast cancer and a positive SN, primary tumor size, lymphatic invasion, and the size of SN metastases among all identified SNs were independently predictive of non-SN involvement, and used for a nomogram. Validation study will be performed in the future investigation.
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Affiliation(s)
- Y. Kojima
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - K. Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - K. Enokido
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - H. Iwata
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - S. Ohno
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - F. Akiyama
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - K. Motomura
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - C. Watanabe
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
| | - S. Nakamura
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan; Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan; Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan; Division of Pathology, the Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast and
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Sato N, Honma K, Noguchi S, Tamaki Y, Tsuda H, Kinoshita T, Nakamura S, Tsugawa K, Suzuki K, Tsujimoto M, Yoshidome K, Akiyama F, Iwase T, Takabatake D, Nishimura R, Taniyama K, Kato H, Umemura S, Tokuda Y, Kamio T. Multi-institutional evaluation of sentinel lymph node (SLN) examination by one-step nucleic acid amplification (OSNA) assay in breast cancer: Performance of metastases detection and prediction of additional non-sentinel lymph node (non-SLN) involvement. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kojima Y, Yamauchi H, Tsunoda H, Kikuchi M, Honda S, Yoshida A, Yagata H, Tsugawa K, Nakamura S. Abstract P2-02-06: Efficacy and Cost Benefit of Preoperative MRI in the Diagnostic Procedure for Operable Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p2-02-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose
The role of preoperative MRI for operable breast cancer is controversial. In this study, we evaluate the efficacy of preoperative MRI as a diagnostic tool to determine the most appropriate procedure (i.e; mastectomy or partial mastectomy) for operable breast cancer patients and cost saving benefit from selecting the most appropriate procedure.
Patients and Methods
From January 2006 to December 2007, we retrospectively studied 1149 patients. All of these patients were diagnosed with breast cancer and consequently underwent mammography (MMG), ultrasound (US) and MRI before surgery so as to determine the optimal procedure. We extracted all the cases which required changes in procedures due to the MRI findings, and compared the radiological data to the clinical and pathological outcomes. Furthermore, we studied the overall cost differences between using MRI and not using MRI. Results
In seventy seven cases, 6.7% of the total, operational changes were made because of preoperative MRI findings, which resulted in better operational outcomes. The main reason for procedural changes was the MRI findings revealed more extensive lesions, which pathologically proven to be in situ lesions. In some cases, additional lesions were pointed out by the MRI, which led us to avoid undertreatment. Among 77 cases, 69 were pathologically proven to have accurate radiological diagnosis and appropriate procedural change with MRI. The positive predictive value of preoperative MRI for partial resection was 99.1% and that for total mastectomy was 97.1%. The calculated cost difference for appropriate procedural change with MRI compared with not using MRI was $4,340. From our data, in 69 cases among 1149 received this appropriate change, $260 per case would be saved, which assumed to be more than $130 million in a year.
Conclusion
Adding preoperative MRI in the diagnostic procedures for the accurate operation in breast cancer might be effective. Usage of MRI preoperatively also save the inappropriate cost in breast cancer operations.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-06.
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Affiliation(s)
- Y Kojima
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - H Yamauchi
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - H Tsunoda
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - M Kikuchi
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - S Honda
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - A Yoshida
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - H Yagata
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - K Tsugawa
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
| | - S. Nakamura
- St.Luke's International Hospital, Tokyo, Japan; Showa University, Tokyo, Japan
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