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Endo H, Ishikawa K, Nomura R, Yamaguchi D, Shindo K, Oka K, Nakamura H. Cerebral hyperperfusion syndrome after endovascular reperfusion therapy for medium vessel occlusion: A case report. Radiol Case Rep 2024; 19:1771-1775. [PMID: 38406317 PMCID: PMC10891283 DOI: 10.1016/j.radcr.2024.01.087] [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: 11/12/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
Cerebral hyperperfusion syndrome is a rare but serious complication after revascularization procedures for cerebrovascular diseases. Cerebral hyperperfusion syndrome can develop after treatment of acute ischemic stroke, including intravenous thrombolysis and endovascular treatment of large vessel occlusion. However, to the best of our knowledge, there are no previous reports describing cerebral hyperperfusion syndrome after endovascular treatment of medium vessel occlusion (eg, anterior cerebral artery A2/3 segment). We report a case of cerebral hyperperfusion syndrome after endovascular reperfusion therapy for medium vessel occlusion. A 70-year-old woman with a history of hypertension and dyslipidemia was transferred by ambulance to our hospital because of immobility and slurred speech. She had mild right lower extremity paralysis, and her symptoms appeared improved compared with onset. She was diagnosed with cerebral infarction in the left frontal lobe. After hospitalization, her neurological symptoms worsened and she was referred to our department. We performed endovascular reperfusion therapy for left anterior cerebral artery A2 occlusion. Recanalization was achieved with residual stenosis. Despite the lack of complications associated with the procedure, the patient had prolonged disorientation, severe hemiplegia, and aphasia. Arterial spin labeling demonstrated hyperperfusion in the left anterior cerebral artery area. The symptoms gradually improved under strict blood pressure control. This report provides evidence that cerebral hyperperfusion syndrome can occur even after endovascular treatment for medium vessel occlusion. Arterial spin labeling was useful in detecting hyperperfusion.
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Affiliation(s)
- Hideki Endo
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-2, Kawazoe, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
- Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido 060-8570, Japan
| | - Kohei Ishikawa
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-2, Kawazoe, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
- Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido 060-8570, Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-2, Kawazoe, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
- Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido 060-8570, Japan
| | - Daishi Yamaguchi
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-2, Kawazoe, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
- Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido 060-8570, Japan
| | - Koichiro Shindo
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-2, Kawazoe, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
- Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido 060-8570, Japan
| | - Koji Oka
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-2, Kawazoe, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido 060-8570, Japan
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Ogaya Y, Kadota T, Hamada M, Nomura R, Nakano K. Characterization of the unique oral microbiome of children harboring Helicobacter pylori in the oral cavity. J Oral Microbiol 2024; 16:2339158. [PMID: 38617439 PMCID: PMC11011227 DOI: 10.1080/20002297.2024.2339158] [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: 01/13/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024] Open
Abstract
Objective Helicobacter pylori infection is acquired in childhood via the oral cavity, although its relationship with the characteristics of the oral microbiome has not been elucidated. In this study, we performed comprehensive analysis of the oral microbiome in children and adults with or without H. pylori in the oral cavity. Methods Bacterial DNA was extracted from 41 adult and 21 child saliva specimens, and H. pylori was detected using PCR. 16S rRNA gene amplification was performed for next-generation sequencing. Bioinformatic analyses were conducted using Quantitative Insights into Microbial Ecology 2 (QIIME 2). Results Faith's phylogenetic diversity analysis showed a significant difference between H. pylori-negative adult and child specimens in terms of α-diversity (p < 0.05), while no significant difference was observed between H. pylori-positive adult and child specimens. There was also a significant difference in β-diversity between H. pylori-positive and negative child specimens (p < 0.05). Taxonomic analysis at the genus level revealed that Porphyromonas was the only bacterium that was significantly more abundant in both H. pylori-positive adults and children than in corresponding negative specimens (p < 0.01 and p < 0.05, respectively). Conclusion These results suggest unique oral microbiome characteristics in children with H. pylori infection in the oral cavity.
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Affiliation(s)
- Yuko Ogaya
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Tamami Kadota
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Masakazu Hamada
- Department of Oral & Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
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Yasuda J, Yasuda H, Nomura R, Matayoshi S, Inaba H, Gongora E, Iwashita N, Shirahata S, Kaji N, Akitomo T, Mitsuhata C, Uchiyama J, Fukuyama T, Matsumoto-Nakano M, Nakano K, Murakami M. Investigation of periodontal disease development and Porphyromonas gulae FimA genotype distribution in small dogs. Sci Rep 2024; 14:5360. [PMID: 38438471 PMCID: PMC10912432 DOI: 10.1038/s41598-024-55842-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/28/2024] [Indexed: 03/06/2024] Open
Abstract
In dogs, Porphyromonas gulae is a major periodontal pathogen with 41-kDa proteins polymerizing to form a filamentous structure called fimbriae or pili, termed FimA. FimA is classified into three genotypes: A, B, and C, and there are combinations of types A, B, C, A/B, A/C, B/C, and A/B/C. Periodontal disease is the most common oral disease in small dogs, but the periodontal disease status and P. gulae colonization at each dog age and breed remain unclear. In this study, we stratified 665 small dogs and analyzed the periodontal status and distribution of P. gulae with each FimA genotype. Dogs with periodontal disease and FimA genotype tended to increase with age. The dogs with at least one FimA genotype had significantly more severe periodontal disease compared with P. gulae-negative dogs (P < 0.01). Additionally, periodontal status was significantly associated with specific FimA genotype distribution in Toy Poodles and Chihuahuas (P < 0.05), whereas there was no such association in Dachshunds. These results suggest that the onset of periodontal disease and P. gulae colonization are related and progress with age. The relationship between periodontal disease and FimA genotype may differ depending on the dog breeds.
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Affiliation(s)
- Junya Yasuda
- Department of Molecular Biology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Yasuda Veterinary Clinic, Meguro, Tokyo, Japan
| | | | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Naoki Iwashita
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Bioalch, Fuchu, Tokyo, Japan
| | - So Shirahata
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Primo Animal Hospital, Sagamihara, Kanagawa, Japan
| | - Noriyuki Kaji
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Tatsuya Akitomo
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Chieko Mitsuhata
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Jumpei Uchiyama
- Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomoki Fukuyama
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masaru Murakami
- Department of Molecular Biology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
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Kusaka S, Haruta A, Kawada-Matsuo M, Nguyen-Tra Le M, Yoshikawa M, Kajihara T, Yahara K, Hisatsune J, Nomura R, Tsuga K, Ohge H, Sugai M, Komatsuzawa H. Oral and rectal colonization of methicillin-resistant Staphylococcus aureus in long-term care facility residents and their association with clinical status. Microbiol Immunol 2024; 68:75-89. [PMID: 38230847 DOI: 10.1111/1348-0421.13111] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024]
Abstract
Staphylococcus aureus is a commensal bacterium in humans, but it sometimes causes opportunistic infectious diseases such as suppurative skin disease, pneumonia, and enteritis. Therefore, it is important to determine the prevalence of S. aureus and methicillin-resistant S. aureus (MRSA) in individuals, especially older adults. In this study, we investigated the prevalence of S. aureus and MRSA in the oral cavity and feces of residents in long-term care facilities (LTCFs). S. aureus was isolated from the oral cavity of 61/178 (34.3%) participants, including 28 MRSA-positive participants (15.7%), and from the feces of 35/127 (27.6%) participants, including 16 MRSA-positive participants (12.6%). S. aureus and MRSA were isolated from both sites in 19/127 individuals (15.0%) and 10/127 individuals (7.9%), respectively. Among 19 participants with S. aureus isolation from both sites, 17 participants showed the same sequence type (ST) type. Then, we analyzed the correlation of S. aureus and MRSA in the oral cavity and rectum with the participant's condition. S. aureus and MRSA positivity in the oral cavity was significantly related to tube feeding, while there was no correlation of rectal S. aureus/MRSA with any factors. Our findings regarding the oral inhabitation of MRSA and its risk factors indicate the importance of considering countermeasures against MRSA infection in LTCFs.
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Affiliation(s)
- Satoru Kusaka
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Miki Kawada-Matsuo
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Mi Nguyen-Tra Le
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshiki Kajihara
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Junzo Hisatsune
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroki Ohge
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Motoyuki Sugai
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hitoshi Komatsuzawa
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
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Ito S, Misaki T, Nagasawa Y, Nomura R, Naka S, Fukunaga A, Matsuoka D, Matayoshi S, Matsumoto-Nakano M, Nakano K. Porphyromonas gingivalis infection in the oral cavity is associated with elevated galactose-deficient IgA1 and increased nephritis severity in IgA nephropathy. Clin Exp Nephrol 2024; 28:192-200. [PMID: 37806974 DOI: 10.1007/s10157-023-02411-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/18/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The relationship between the major periodontal bacteria, Porphyromonas gingivalis, and the pathogenesis of IgA nephropathy (IgAN)-particularly with respect to galactose-deficient IgA1 (Gd-IgA1)-has not been fully elucidated. METHODS Saliva samples from 30 IgAN patients and 44 patients with chronic kidney disease (CKD) were subjected to analysis of P. gingivalis status via polymerase chain reaction using a set of P. gingivalis-specific primers. The associations between P. gingivalis presence and clinical parameters, including plasma Gd-IgA1, were analyzed in each group. RESULTS Compared with the CKD group, the IgAN group demonstrated significantly higher plasma Gd-IgA1 levels (p < 0.05). Compared with the P. gingivalis-negative subgroup, the P. gingivalis-positive subgroup exhibited significantly higher plasma Gd-IgA1 levels in both IgAN and CKD patients (p < 0.05). Additionally, among IgAN patients, the P. gingivalis-positive subgroup displayed significantly higher plasma Gd-IgA1 and urine protein levels, compared with the P. gingivalis-negative subgroup (p < 0.05). With respect to renal biopsy findings, the frequencies of segmental glomerulosclerosis and tubular atrophy/interstitial fibrosis were significantly greater in the P. gingivalis-positive subgroup than in the P. gingivalis-negative subgroup, according to the Oxford classification of IgAN (p < 0.05). CONCLUSION Our findings suggest an association between the presence of P. gingivalis in the oral cavity and the pathogenesis of IgAN, mediated by increased levels of Gd-IgA1.
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Affiliation(s)
- Seigo Ito
- Department of Internal Medicine, Japan Self-Defense Force Iruma Hospital, Iruma, Saitama, Japan
| | - Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.
- Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan.
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Akiko Fukunaga
- Division of Dentistry, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Daiki Matsuoka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Matayoshi S, Tojo F, Suehiro Y, Okuda M, Takagi M, Ochiai M, Kadono M, Mikasa Y, Okawa R, Nomura R, Itoh Y, Itoh N, Nakano K. Effects of mouthwash on periodontal pathogens and glycemic control in patients with type 2 diabetes mellitus. Sci Rep 2024; 14:2777. [PMID: 38307981 PMCID: PMC10837110 DOI: 10.1038/s41598-024-53213-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024] Open
Abstract
Periodontitis is known to be associated with type 2 diabetes mellitus (T2DM), and gargling with mouthwash is known to reduce the incidence of periodontitis by inhibiting periodontal pathogens. However, the effects of mouthwash on oral and systemic conditions in patients with T2DM remain unknown. In this study, we investigated the effects of gargling with mouthwash on the number of red complex species, including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, and HbA1c levels in patients with T2DM. Patients were instructed to gargle with water for 6 months, followed by gargling with mouthwash containing chlorhexidine gluconate for the subsequent 6 months. At each clinic visit, saliva was collected and bacterial DNA was extracted to detect red complex species using the polymerase chain reaction technique. The HbA1c level was determined using a blood sample. The number of red complex species significantly decreased in younger or male patients who gargled with mouthwash. Furthermore, HbA1c levels significantly decreased in younger patients or patients with higher HbA1c levels who gargled with mouthwash. These results suggest that gargling with mouthwash reduces the number of red complex species and improves the hyperglycemic status in patients with T2DM, especially younger patients.
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Affiliation(s)
- Saaya Matayoshi
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan.
| | - Fumikazu Tojo
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Makoto Okuda
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Misato Takagi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Marin Ochiai
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Maika Kadono
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yusuke Mikasa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Rena Okawa
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshito Itoh
- Itoh Internal Medicine Clinic, Osaka, Japan
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Naoto Itoh
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Itoh Internal Medicine Clinic, Osaka, Japan
| | - Kazuhiko Nakano
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
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Nomura R, Suehiro Y, Tojo F, Matayoshi S, Okawa R, Hamada M, Naka S, Matsumoto-Nakano M, Unesaki R, Koumoto K, Kawauchi K, Nishikata T, Akitomo T, Mitsuhata C, Yagi M, Mizoguchi T, Fujikawa K, Taniguchi T, Nakano K. Inhibitory Effects of Shikonin Dispersion, an Extract of Lithospermum erythrorhizon Encapsulated in β-1,3-1,6 Glucan, on Streptococcus mutans and Non-Mutans Streptococci. Int J Mol Sci 2024; 25:1075. [PMID: 38256148 PMCID: PMC10816867 DOI: 10.3390/ijms25021075] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/06/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Shikonin is extracted from the roots of Lithospermum erythrorhizon, and shikonin extracts have been shown to have inhibitory effects on several bacteria. However, shikonin extracts are difficult to formulate because of their poor water solubility. In the present study, we prepared a shikonin dispersion, which was solubilized by the inclusion of β-1,3-1,6 glucan, and analysed the inhibitory effects of this dispersion on Streptococcus mutans and non-mutans streptococci. The shikonin dispersion showed pronounced anti-S. mutans activity, and inhibited growth of and biofilm formation by this bacterium. The shikonin dispersion also showed antimicrobial and antiproliferative effects against non-mutans streptococci. In addition, a clinical trial was conducted in which 20 subjects were asked to brush their teeth for 1 week using either shikonin dispersion-containing or non-containing toothpaste, respectively. The shikonin-containing toothpaste decreased the number of S. mutans in the oral cavity, while no such effect was observed after the use of the shikonin-free toothpaste. These results suggest that shikonin dispersion has an inhibitory effect on S. mutans and non-mutans streptococci, and toothpaste containing shikonin dispersion may be effective in preventing dental caries.
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Affiliation(s)
- Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (Y.S.); (F.T.); (S.M.); (R.O.); (K.N.)
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (M.Y.); (T.M.); (K.F.); (T.T.)
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Hiroshima, Japan; (T.A.); (C.M.)
| | - Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (Y.S.); (F.T.); (S.M.); (R.O.); (K.N.)
| | - Fumikazu Tojo
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (Y.S.); (F.T.); (S.M.); (R.O.); (K.N.)
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (Y.S.); (F.T.); (S.M.); (R.O.); (K.N.)
| | - Rena Okawa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (Y.S.); (F.T.); (S.M.); (R.O.); (K.N.)
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (M.Y.); (T.M.); (K.F.); (T.T.)
| | - Masakazu Hamada
- Department of Oral & Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan;
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Okayama, Japan; (S.N.); (M.M.-N.)
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Okayama, Japan; (S.N.); (M.M.-N.)
| | - Rika Unesaki
- Faculty of Frontiers of Innovative Research in Science and Technology (FIRST), Konan University, Kobe 650-0047, Hyogo, Japan; (R.U.); (K.K.); (K.K.); (T.N.)
| | - Kazuya Koumoto
- Faculty of Frontiers of Innovative Research in Science and Technology (FIRST), Konan University, Kobe 650-0047, Hyogo, Japan; (R.U.); (K.K.); (K.K.); (T.N.)
| | - Keiko Kawauchi
- Faculty of Frontiers of Innovative Research in Science and Technology (FIRST), Konan University, Kobe 650-0047, Hyogo, Japan; (R.U.); (K.K.); (K.K.); (T.N.)
| | - Takahito Nishikata
- Faculty of Frontiers of Innovative Research in Science and Technology (FIRST), Konan University, Kobe 650-0047, Hyogo, Japan; (R.U.); (K.K.); (K.K.); (T.N.)
| | - Tatsuya Akitomo
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Hiroshima, Japan; (T.A.); (C.M.)
| | - Chieko Mitsuhata
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Hiroshima, Japan; (T.A.); (C.M.)
| | - Masatoshi Yagi
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (M.Y.); (T.M.); (K.F.); (T.T.)
- Pharmacrea Kobe Co., Ltd., Kobe 651-0085, Hyogo, Japan
| | - Toshiro Mizoguchi
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (M.Y.); (T.M.); (K.F.); (T.T.)
- TSET Co., Ltd., Kariya 448-0022, Aichi, Japan
| | - Koki Fujikawa
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (M.Y.); (T.M.); (K.F.); (T.T.)
- TSET Co., Ltd., Kariya 448-0022, Aichi, Japan
| | - Taizo Taniguchi
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (M.Y.); (T.M.); (K.F.); (T.T.)
- Pharmacrea Kobe Co., Ltd., Kobe 651-0085, Hyogo, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (Y.S.); (F.T.); (S.M.); (R.O.); (K.N.)
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (M.Y.); (T.M.); (K.F.); (T.T.)
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Nakatogawa H, Hokamura K, Nomura R, Nakano K, Umemura K, Morita A, Homma Y, Tanaka T. Is oral Streptococcus mutans with collagen-binding protein a risk factor for intracranial aneurysm rupture or formation? Cerebrovasc Dis 2024:000536203. [PMID: 38219720 DOI: 10.1159/000536203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/01/2024] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVE Streptococcus mutans (SM) with the collagen-binding protein Cnm is a unique member of the oral resident flora because it causes hemorrhagic vascular disorders. In the multicenter study, we examined the relationship between Cnm-positive SM (CP-SM) and intracranial aneurysm (IA) rupture, which remains unknown. METHODS Between May 2013 and June 2018, we collected whole saliva samples from 431 patients with ruptured IAs (RIAs) and 470 patients with unruptured IAs (UIAs). Data were collected on age, sex, smoking and drinking habits, family history of subarachnoid hemorrhage, aneurysm size, number of teeth, and comorbidities of lifestyle disease. RESULTS There was no difference in the positivity rate of patients with CP-SM between the patients with RIAs (17.2%) and those with UIAs (19.4%). The rate of positivity for CP-SM was significantly higher in all IAs <5 mm than in those ≥10 mm in diameter (P=0.0304). In the entire cohort, the rate of positivity for CP-SM was lower in larger aneurysms than in smaller aneurysms (P=0.0393). CONCLUSIONS The rate of positivity for CP-SM was lower among patients with large UIAs. These findings are consistent with the hypothesis that CP-SM plays a role in the formation of vulnerable IAs that tend to rupture before becoming larger.
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Akitomo T, Kusaka S, Usuda M, Kametani M, Kaneki A, Nishimura T, Ogawa M, Mitsuhata C, Nomura R. Fusion of a Tooth with a Supernumerary Tooth: A Case Report and Literature Review of 35 Cases. Children (Basel) 2023; 11:6. [PMID: 38275427 PMCID: PMC10814903 DOI: 10.3390/children11010006] [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] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024]
Abstract
Tooth fusion is a dental anomaly with a prevalence of 0.1% in permanent dentition. The aim of this paper is to present the occurrence, region of fusion, and prognosis of fused tooth which is a very rare case in the literature. The authors present a very rare case with a maxillary right lateral incisor fused to a supernumerary tooth on the palatal side. The eruption was delayed, but eruption occurred naturally at 9 years and 6 months. However, cone-beam computed tomography at 11 years and 6 months revealed it was diagnosed as a fused tooth. The authors undertook a literature review over the past 10 years and found 30 articles about fused teeth between permanent teeth and supernumerary teeth. It was more common in males than females and there were no differences depending on the occurrence. Mesiodistal fusion was more common in the incisor region, while labiopalatal fusion was more common in the molar region. Most cases required dental treatment with a surgical approach, root canal treatment, or orthodontic treatment. The present study highlights the importance of long-term follow-up and suggests the region of fusion and prognosis of the fused tooth may vary depending on the occurrence.
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Affiliation(s)
- Tatsuya Akitomo
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (S.K.); (M.U.); (M.K.); (A.K.); (T.N.); (M.O.); (C.M.); (R.N.)
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10
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Ikeda S, Saito S, Hosoki S, Tonomura S, Yamamoto Y, Ikenouchi H, Ishiyama H, Tanaka T, Hattori Y, Friedland RP, Carare RO, Kuriyama N, Yakushiji Y, Hara H, Koga M, Toyoda K, Nomura R, Takegami M, Nakano K, Ihara M. Harboring Cnm-expressing Streptococcus mutans in the oral cavity relates to both deep and lobar cerebral microbleeds. Eur J Neurol 2023; 30:3487-3496. [PMID: 36708081 DOI: 10.1111/ene.15720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/03/2022] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cerebral microbleeds (CMBs) influence long-term prognoses of stroke patients. Streptococcus mutans expressing the collagen-binding protein Cnm induces cerebrovascular inflammation, impairing blood brain barrier integrity and causing cerebral bleeding. Here, we examine the association of Cnm-positive S. mutans with CMBs. METHODS Acute stroke patients were selected from a single-center registry database. Oral carriage of Cnm-positive or Cnm-negative S. mutans was determined using polymerase chain reaction assays. The associations of Cnm-positive S. mutans with CMB number and specifically the presence of >10 CMBs were examined using quasi-Poisson and logistic regression models, respectively. RESULTS This study included 3154 stroke patients, of which 428 patients (median [interquartile range] age, 73.0 [63.0-81.0] years; 269 men [62.9%]) underwent oral bacterial examinations. In total, 326 patients harbored S. mutans. After excluding four patients without imaging data, we compared patients with Cnm-positive (n = 72) and Cnm-negative (n = 250) S. mutans. Harboring Cnm-positive S. mutans was independently associated with the presence of >10 CMBs (adjusted odds ratio 2.20 [1.18-4.10]) and higher numbers of deep and lobar CMBs (adjusted risk ratio 1.61 [1.14-2.27] for deep; 5.14 [2.78-9.51] for lobar), but not infratentorial CMBs, after adjusting for age, sex, hypertension, stroke type, National Institutes of Health Stroke Scale score, and cerebral amyloid angiopathy. CONCLUSIONS Harboring Cnm-positive S. mutans was independently associated with a higher number of CMBs in deep and lobar locations. Reducing Cnm-positive S. mutans in the oral cavity may serve as a novel therapeutic approach for stroke.
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Affiliation(s)
- Shuhei Ikeda
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Satoshi Hosoki
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shuichi Tonomura
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yumi Yamamoto
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hajime Ikenouchi
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hiroyuki Ishiyama
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yorito Hattori
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Robert P Friedland
- Department of Neurology, University of Louisville, Louisville, Kentucky, USA
| | - Roxana O Carare
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Nagato Kuriyama
- Shizuoka Graduate University of Public Health, Shizuoka, Japan
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Yakushiji
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
- Department of Neurology, Kansai Medical University Medical Center, Hirakata, Japan
| | - Hideo Hara
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
- Department of Pediatric Dentistry, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
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11
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Shindo K, Ishikawa K, Nomura R, Morishita M, Oka K, Nakamura H. Mechanical thrombectomy for middle cerebral artery occlusion caused by intracranial internal carotid artery stenosis: A case report. Radiol Case Rep 2023; 18:3054-3059. [PMID: 37434618 PMCID: PMC10331069 DOI: 10.1016/j.radcr.2023.05.070] [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: 02/27/2023] [Revised: 05/18/2023] [Accepted: 05/28/2023] [Indexed: 07/13/2023] Open
Abstract
Tandem internal carotid artery (ICA)/middle cerebral artery (MCA) occlusions are occasionally observed in patients with acute ischemic stroke. Most of them are caused by lesions at the origin of the ICA. In cases of intracranial ICA stenosis, the formation of a large thrombus causing MCA occlusion is extremely rare. Herein We report a case of acute MCA occlusion caused by intracranial ICA stenosis. A 62-year-old female presented with aphasia, right-side weakness, and a National Institute of Health Stroke Scale (NIHSS) score of 5. Magnetic resonance imaging (MRI) showed early ischemic infarction at the precentral gyrus. Left ICA and M1 occlusion were suspected on magnetic resonance angiography. However, the patient had complained of right-side numbness 6 days before the onset. Hence the stroke was assumed to have progressed slowly, and acute occlusion of the left ICA was eliminated as a suspected diagnosis. After admission, the symptoms worsened. MRI showed enlargement of the cerebral infarction. Computed tomography angiography showed complete occlusion of the left M1 and recanalization of the left ICA with severe stenosis of the petrous portion. The etiology of the MCA occlusion was determined to be atherothromboembolism. Percutaneous transluminal angioplasty (PTA) was performed for ICA stenosis, followed by mechanical thrombectomy (MT) for the MCA occlusion. Recanalization of the MCA was achieved. After Seven days, the NIHSS score reduced from a pre-MT assessment of 17-2. PTA followed by MT was safe and effective for treating MCA occlusion caused by intracranial ICA stenosis.
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Affiliation(s)
- Koichiro Shindo
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-3-1 Kawazoe 2-jo, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido Japan
| | - Kohei Ishikawa
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido Japan
| | - Masahiro Morishita
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido Japan
| | - Koji Oka
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-3-1 Kawazoe 2-jo, Minami-ku, Sapporo, Hokkaido 005-8555, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido Japan
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12
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Usuda M, Kametani M, Hamada M, Suehiro Y, Matayoshi S, Okawa R, Naka S, Matsumoto-Nakano M, Akitomo T, Mitsuhata C, Koumoto K, Kawauchi K, Nishikata T, Yagi M, Mizoguchi T, Fujikawa K, Taniguchi T, Nakano K, Nomura R. Inhibitory Effect of Adsorption of Streptococcus mutans onto Scallop-Derived Hydroxyapatite. Int J Mol Sci 2023; 24:11371. [PMID: 37511130 PMCID: PMC10379008 DOI: 10.3390/ijms241411371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Hydroxyapatite adsorbs various substances, but little is known about the effects on oral bacteria of adsorption onto hydroxyapatite derived from scallop shells. In the present study, we analyzed the effects of adsorption of Streptococcus mutans onto scallop-derived hydroxyapatite. When scallop-derived hydroxyapatite was mixed with S. mutans, a high proportion of the bacterial cells adsorbed onto the hydroxyapatite in a time-dependent manner. An RNA sequencing analysis of S. mutans adsorbed onto hydroxyapatite showed that the upregulation of genes resulted in abnormalities in pathways involved in glycogen and histidine metabolism and biosynthesis compared with cells in the absence of hydroxyapatite. S. mutans adsorbed onto hydroxyapatite was not killed, but the growth of the bacteria was inhibited. Electron microscopy showed morphological changes in S. mutans cells adsorbed onto hydroxyapatite. Our results suggest that hydroxyapatite derived from scallop shells showed a high adsorption ability for S. mutans. This hydroxyapatite also caused changes in gene expression related to the metabolic and biosynthetic processes, including the glycogen and histidine of S. mutans, which may result in a morphological change in the surface layer and the inhibition of the growth of the bacteria.
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Affiliation(s)
- Momoko Usuda
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Mariko Kametani
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masakazu Hamada
- Department of Oral & Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
| | - Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
| | - Rena Okawa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Tatsuya Akitomo
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Chieko Mitsuhata
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Kazuya Koumoto
- Faculty of Frontiers of Innovative Research in Science and Technology (FIRST), Konan University, Kobe 650-0047, Japan
| | - Keiko Kawauchi
- Faculty of Frontiers of Innovative Research in Science and Technology (FIRST), Konan University, Kobe 650-0047, Japan
| | - Takahito Nishikata
- Faculty of Frontiers of Innovative Research in Science and Technology (FIRST), Konan University, Kobe 650-0047, Japan
| | - Masatoshi Yagi
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
- Pharmacrea Kobe Co., Ltd., Kobe 651-0085, Japan
| | - Toshiro Mizoguchi
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
- TSET Co., Ltd., Kariya 448-0022, Japan
| | - Koki Fujikawa
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
- TSET Co., Ltd., Kariya 448-0022, Japan
| | - Taizo Taniguchi
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
- Pharmacrea Kobe Co., Ltd., Kobe 651-0085, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
- Joint Research Laboratory of Next-Generation Science for Oral Infection Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan
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Imazato S, Nakatsuka T, Kitagawa H, Sasaki JI, Yamaguchi S, Ito S, Takeuchi H, Nomura R, Nakano K. Multiple-Ion Releasing Bioactive Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler: Innovative Technology for Dental Treatment and Care. J Funct Biomater 2023; 14:jfb14040236. [PMID: 37103326 PMCID: PMC10142353 DOI: 10.3390/jfb14040236] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023] Open
Abstract
Surface Pre-Reacted Glass-ionomer (S-PRG) filler, which releases strontium (Sr2+), borate (BO33-), fluoride (F-), sodium (Na+), silicate (SiO32-), and aluminum (Al3+) ions at high concentrations, is a unique glass filler that are utilized in dentistry. Because of its multiple-ion releasing characteristics, S-PRG filler exhibits several bioactivities such as tooth strengthening, acid neutralization, promotion of mineralization, inhibition of bacteria and fungi, inhibition of matrix metalloproteinases, and enhancement of cell activity. Therefore, S-PRG filler per se and S-PRG filler-containing materials have the potential to be beneficial for various dental treatments and care. Those include restorative treatment, caries prevention/management, vital pulp therapy, endodontic treatment, prevention/treatment of periodontal disease, prevention of denture stomatitis, and perforation repair/root end filling. This review summarizes bioactive functions exhibited by S-PRG filler and its possible contribution to oral health.
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Affiliation(s)
- Satoshi Imazato
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan
| | - Toshiyuki Nakatsuka
- Marketing Department, Shofu Inc., 11 Kamitakamatsu-cho, Fukuine, Higashiyama, Kyoto 605-0983, Kyoto, Japan
| | - Haruaki Kitagawa
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan
| | - Jun-Ichi Sasaki
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan
| | - Satoshi Yamaguchi
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan
| | - Shuichi Ito
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari 061-0293, Hokkaido, Japan
| | - Hiroki Takeuchi
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Hiroshima, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan
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14
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Akitomo T, Kusaka S, Iwamoto Y, Usuda M, Kametani M, Asao Y, Nakano M, Tachikake M, Mitsuhata C, Nomura R. Five-Year Follow-Up of a Child with Non-Syndromic Oligodontia from before the Primary Dentition Stage: A Case Report. Children (Basel) 2023; 10:children10040717. [PMID: 37189966 DOI: 10.3390/children10040717] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Congenital absence of teeth is a major dental abnormality in pediatric dentistry and the absence of six or more teeth is defined as oligodontia. Few reports of patients with non-syndromic oligodontia without systemic disease have continued dental follow-up from an early age. METHODS We performed the five-year follow-up from before the eruption of the primary dentition of a Japanese child with non-syndromic oligodontia and analyzed changes in dental arch growth. RESULTS At the oral examination at the age of 1 year and 2 months, eight primary incisors were congenitally absent. Therefore, we made dentures for the patient at the age of 3 years and 4 months. From the age of 5 years and 1 month, the child received articulation training for dysarthria from a speech therapist to improve the function and appearance of the oral cavity. Measurement of the patient's dental models revealed a particularly narrow dental arch, especially between the primary canines. CONCLUSIONS Our findings highlight the importance of treatment for patients with non-syndromic oligodontia from an early age by multiple medical professionals, recognizing that the missing teeth affect the growth of the maxillofacial region.
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Affiliation(s)
- Tatsuya Akitomo
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Satoru Kusaka
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Yuko Iwamoto
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Momoko Usuda
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Mariko Kametani
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Yuria Asao
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masashi Nakano
- Department of Pediatric Dentistry, Hiroshima University Hospital, Hiroshima 734-8553, Japan
| | - Meiko Tachikake
- Department of Pediatric Dentistry, Hiroshima University Hospital, Hiroshima 734-8553, Japan
| | - Chieko Mitsuhata
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
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15
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Huang H, Okamoto M, Watanabe M, Matsumoto S, Moriyama K, Komichi S, Ali M, Matayoshi S, Nomura R, Nakano K, Takahashi Y, Hayashi M. Development of Rat Caries-Induced Pulpitis Model for Vital Pulp Therapy. J Dent Res 2023; 102:574-582. [PMID: 36913545 PMCID: PMC10152557 DOI: 10.1177/00220345221150383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Rodent animal models for vital pulp therapy are commonly used in dental research because their tooth anatomy and cellular processes are similar to the anatomy and processes in humans. However, most studies have been conducted using uninfected sound teeth, which makes it difficult to adequately assess the inflammatory shift after vital pulp therapy. In the present study, we aimed to establish a caries-induced pulpitis model based on the conventional rat caries model and then evaluate inflammatory changes during the wound-healing process after pulp capping in a model of reversible pulpitis induced by carious infection. To establish the caries-induced pulpitis model, the pulpal inflammatory status was investigated at different stages of caries progression by immunostaining targeted to specific inflammatory biomarkers. Immunohistochemical staining revealed that both Toll-like receptor 2 and proliferating cell nuclear antigen were expressed in moderate and severe caries-stimulated pulp, indicating that an immune reaction occurred at both stages of caries progression. M2 macrophages were predominant in moderate caries-stimulated pulp, whereas M1 macrophages were predominant in the severe caries-stimulated pulp. Pulp capping in teeth with moderate caries (i.e., teeth with reversible pulpitis) led to complete tertiary dentin formation within 28 d after treatment. Impaired wound healing was observed in teeth with severe caries (i.e., teeth with irreversible pulpitis). During the wound-healing process in reversible pulpitis after pulp capping, M2 macrophages were predominant at all time points; their proliferative capacity was upregulated in the early stage of wound healing compared with healthy pulp. In conclusion, we successfully established a caries-induced pulpitis model for studies of vital pulp therapy. M2 macrophages have an important role in the early stages of the wound-healing process in reversible pulpitis.
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Affiliation(s)
- H Huang
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Okamoto
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Watanabe
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - S Matsumoto
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - K Moriyama
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - S Komichi
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Ali
- Department of Restorative Dentistry, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - S Matayoshi
- Department of Pediatric Dentistry, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - R Nomura
- Department of Pediatric Dentistry, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan.,Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima
| | - K Nakano
- Department of Pediatric Dentistry, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - Y Takahashi
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Hayashi
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
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16
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Misaki T, Naka S, Suzuki H, Lee M, Aoki R, Nagasawa Y, Matsuoka D, Ito S, Nomura R, Matsumoto-Nakano M, Suzuki Y, Nakano K. cnm-positive Streptococcus mutans is associated with galactose-deficient IgA in patients with IgA nephropathy. PLoS One 2023; 18:e0282367. [PMID: 36862654 PMCID: PMC9980772 DOI: 10.1371/journal.pone.0282367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/13/2023] [Indexed: 03/03/2023] Open
Abstract
The presence of Streptococcus mutans expressing Cnm protein encoded by cnm (cnm-positive S. mutans) in the oral cavity is associated with immunoglobulin A (IgA) nephropathy (IgAN). However, the precise mechanism by which cnm-positive S. mutans is involved in the pathogenesis of IgAN remains unclear. The present study evaluated glomerular galactose-deficient IgA1 (Gd-IgA1) to clarify the association between the presence of cnm-positive S. mutans and glomerular Gd-IgA1 in patients with IgAN. The presence of S. mutans and cnm-positive S. mutans was evaluated by polymerase chain reaction in saliva specimens from 74 patients with IgAN or IgA vasculitis. Immunofluorescent staining of IgA and Gd-IgA1 using KM55 antibody in clinical glomerular tissues was then performed. There was no significant association between the glomerular staining intensity of IgA and the positive rate of S. mutans. However, there was a significant association between the glomerular staining intensity of IgA and the positive rate of cnm-positive S. mutans (P < 0.05). There was also a significant association between the glomerular staining intensity of Gd-IgA1 (KM55) and the positive rate of cnm-positive S. mutans (P < 0.05). The glomerular staining intensity of Gd-IgA1 (KM55) was not associated with the positive rate of S. mutans. These results suggest that cnm-positive S. mutans in the oral cavity is associated with the pathogenesis of Gd-IgA1 in patients with IgAN.
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Affiliation(s)
- Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
- Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan
- * E-mail:
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Hitoshi Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Mingfeng Lee
- Department of Nephrology, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Ryosuke Aoki
- Department of Nephrology, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Daiki Matsuoka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Seigo Ito
- Department of Internal Medicine, Japan Self-Defense Iruma Hospital, Iruma, Saitama, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Yusuke Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kazuhiko Nakano
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Shirahata S, Iwashita N, Sasaki R, Nomura R, Murakami M, Yasuda J, Yasuda H, Nakajima K, Inaba H, Matsumoto-Nakano M, Nakano K, Uchiyama J, Fukuyama T. Possible association of fimA genotype of Porphyromonas gulae with the severity of periodontal disease and the number of permanent teeth in dogs. Front Vet Sci 2023; 10:1022838. [PMID: 36814464 PMCID: PMC9939633 DOI: 10.3389/fvets.2023.1022838] [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: 08/19/2022] [Accepted: 01/12/2023] [Indexed: 02/08/2023] Open
Abstract
Previous research has demonstrated that Porphyromonas gulae (P. gulae) significantly contributes to the development of periodontal disease in dogs. Porphyromonas gulae is divided into three subtypes according to the 41-kDa filamentous appendage (fimA), defined as types A, B, and C. This study aimed to elucidate the association between fimA type of P. gulae with the number of permanent teeth, reflecting the severity of periodontal disease. Two hundred twenty-five dogs were categorized by P. gulae fimA type as negative, type A dominant, type B dominant, and type C dominant. The stage of periodontal disease in P. gulae-positive dogs increased with age, particularly in type C dominant dogs. Correspondingly, the number of permanent teeth in P. gulae fimA type C-dominant dogs was significantly lower than that of P. gulae-negative dogs, suggesting there is a significant association between fimA type of P. gulae and the number of permanent teeth resulting from the development of periodontal disease.
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Affiliation(s)
- So Shirahata
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan,Primo Animal Hospital Sagamiharachuo, Sagamihara, Kanagawa, Japan
| | - Naoki Iwashita
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan,Bioalchemis, Fuchu, Tokyo, Japan
| | - Rie Sasaki
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masaru Murakami
- Laboratory of Molecular Biology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Junya Yasuda
- SPECTRUM LAB. JAPAN Co., LTD., Yasuda Veterinary Clinic, Tokyo, Japan
| | - Hidemi Yasuda
- AlphaVets Co., LTD., Yasuda Veterinary Clinic, Tokyo, Japan
| | | | - Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Jumpei Uchiyama
- Department of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan
| | - Tomoki Fukuyama
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan,*Correspondence: Tomoki Fukuyama ✉
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Ishikawa K, Endo H, Nomura R, Yamaguchi D, Oka K, Nakamura H. Acute reperfusion therapy via occluded vertebral artery using a guiding sheath for posterior circulation tandem occlusion: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22480. [PMID: 36647256 PMCID: PMC9844521 DOI: 10.3171/case22480] [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] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/05/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Vertebral artery (VA) size, anatomy, and occlusion status should be considered when selecting endovascular access for basilar artery mechanical thrombectomy. In a patient with concomitant basilar artery and VA occlusion and a patent but hypoplastic contralateral VA, the occluded VA should be selected. The authors report a technique that utilizes advancing a guiding sheath with attached dilator via an occluded VA. OBSERVATIONS A 65-year-old male presented with disturbed consciousness because of an acute infarction of the brainstem and cerebellum caused by a basilar artery occlusion. Cerebral angiography showed a hypoplastic right VA and occlusion of the left VA at the origin. A regular wire was easily advanced through the occlusion and a 4-Fr diagnostic catheter was advanced into the distal left VA. A 6-Fr guiding sheath with attached dilator was placed in the left VA beyond the occlusion by exchanging it over a long wire. After removing the basilar artery thrombus, balloon angioplasty was performed at the left VA origin. Complete revascularization of the posterior circulation was achieved. LESSONS A guiding sheath with dilator can advance across and dilate a VA occlusion at the origin to provide rapid access to the basilar artery.
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Affiliation(s)
- Kohei Ishikawa
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and ,Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
| | - Hideki Endo
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and ,Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and ,Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
| | - Daishi Yamaguchi
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and ,Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
| | - Koji Oka
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; and
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
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19
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Nomura R, Nagasawa Y, Misaki T, Ito S, Naka S, Okunaka M, Watanabe M, Tsuzuki K, Matsumoto-Nakano M, Nakano K. Distribution of periodontopathic bacterial species between saliva and tonsils. Odontology 2022:10.1007/s10266-022-00776-8. [DOI: 10.1007/s10266-022-00776-8] [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] [Received: 08/24/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
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20
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Otsugu M, Mikasa Y, Kitamura T, Suehiro Y, Matayoshi S, Nomura R, Nakano K. Clinical characteristics of children and guardians possessing CBP-positive Streptococcus mutans strains: a cross-sectional study. Sci Rep 2022; 12:17510. [PMID: 36266432 PMCID: PMC9585102 DOI: 10.1038/s41598-022-22378-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/13/2022] [Indexed: 01/12/2023] Open
Abstract
Streptococcus mutans is a major etiological agent for dental caries. We previously demonstrated that S. mutans strains expressing collagen-binding proteins (CBPs) were related to the pathogenesis of systemic diseases. However, their acquisition and colonization remain unknown. Here, we investigated the detection rates of CBP-positive S. mutans strains in children and their guardians to clarify the background for the acquisition and colonization in children. Saliva samples were collected from children and their mothers, and detection of S. mutans and collagen-binding genes (cnm, cbm) was performed by PCR after DNA extraction. The oral status of each child was examined, and their mothers were asked to complete a questionnaire. The isolation rate of Cnm-positive S. mutans was significantly higher in mothers than in children. Notably, the possession rates of CBP-positive strains in children were significantly higher in children whose mothers had CBP-positive strains than in children whose mothers did not have these strains. Furthermore, children with CBP-positive strains had a significantly shorter breastfeeding period than children without these strains. The present results suggest that nutritional feeding habits in infancy are one of the factors involved in the acquisition and colonization of CBP-positive S. mutans strains.
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Affiliation(s)
- Masatoshi Otsugu
- grid.136593.b0000 0004 0373 3971Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871 Japan
| | - Yusuke Mikasa
- grid.136593.b0000 0004 0373 3971Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871 Japan
| | - Takahiro Kitamura
- grid.136593.b0000 0004 0373 3971Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871 Japan
| | - Yuto Suehiro
- grid.136593.b0000 0004 0373 3971Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871 Japan
| | - Saaya Matayoshi
- grid.136593.b0000 0004 0373 3971Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871 Japan
| | - Ryota Nomura
- grid.136593.b0000 0004 0373 3971Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871 Japan ,grid.257022.00000 0000 8711 3200Department of Pediatric Dentistry, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuhiko Nakano
- grid.136593.b0000 0004 0373 3971Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871 Japan
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Ishikawa K, Shindo K, Endo H, Nomura R, Yoshihara R, Oka K, Nakamura H. The endothelialization on carotid web treated with dual layer stent placement: a case report. Radiol Case Rep 2022; 17:3855-3858. [PMID: 35982721 PMCID: PMC9379973 DOI: 10.1016/j.radcr.2022.07.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/18/2022] [Accepted: 07/23/2022] [Indexed: 11/24/2022] Open
Abstract
Carotid webs are known to cause acute ischemic stroke in younger adults and have a high recurrence rate. Herein, we report a case of a symptomatic carotid web in a 51-year-old man who was transferred to our hospital after developing consciousness disturbance and left hemiparesis. He was diagnosed with right middle cerebral artery occlusion and underwent mechanical thrombectomy. Because his carotid web was the likely embolic source, we performed carotid artery stenting using a dual-layer stent to crimp the vessel wall and secure closure of the web pocket. Follow-up angiography was performed at 3 weeks after stenting, and endothelialization on the web pocket was confirmed. The high scaffolding effect of the dual layer stent may promote the endothelialization on the carotid web.
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22
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Naka S, Matsuoka D, Goto K, Misaki T, Nagasawa Y, Ito S, Nomura R, Nakano K, Matsumoto-Nakano M. Cnm of Streptococcus mutans is important for cell surface structure and membrane permeability. Front Cell Infect Microbiol 2022; 12:994014. [PMID: 36176579 PMCID: PMC9513430 DOI: 10.3389/fcimb.2022.994014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022] Open
Abstract
Streptococcus mutans, a Gram-positive facultative anaerobic bacterium, is a major pathogen of dental caries. The protein Cnm of S. mutans is involved in collagen binding, but its other biological functions are unknown. In this study, a Cnm-deficient isogenic mutant and a complementation strain were generated from a Cnm-positive S. mutans strain to help determine the properties of Cnm. Initially, comparison of the cell surface structure was performed by electron microscopy, which demonstrated that Cnm appears to be localized on the cell surface and associated with a protruding cell surface structure. Deep RNA sequencing of the strains revealed that the defect in Cnm caused upregulated expression of many genes related to ABC transporters and cell-surface proteins, while a few genes were downregulated. The amount of biofilm formed by the Cnm-defective strain increased compared with the parental and complemented strains, but the biofilm structure was thinner because of elevated expression of genes encoding glucan synthesis enzymes, leading to increased production of extracellular polysaccharides. Particular antibiotics, including bacitracin and chloramphenicol, had a lower minimum inhibitory concentration for the Cnm-defective strain than particular antibiotics, including bacitracin and chloramphenicol, compared with the parental and complemented strains. Our results suggest that S. mutans Cnm is located on the cell surface, gives rise to the observed protruding cell surface, and is associated with several biological properties related to membrane permeability.
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Affiliation(s)
- Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Daiki Matsuoka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kana Goto
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
- Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu, Japan
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Seigo Ito
- Department of Internal Medicine, Japan Self-Defense Iruma Hospital, Iruma, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Division of Oral infection and Disease Control, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Division of Oral infection and Disease Control, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- *Correspondence: Michiyo Matsumoto-Nakano,
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23
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Nomura R. Influence of crowd size on home advantage in the Japanese football league. Front Sports Act Living 2022; 4:927774. [PMID: 36157902 PMCID: PMC9500178 DOI: 10.3389/fspor.2022.927774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/11/2022] [Indexed: 12/05/2022] Open
Abstract
This study aimed to investigate the influence of crowd size on home advantage (HA). Data of the 2019 and 2020 seasons of the J1 League (Japan Professional Football's First Division League) were analyzed. Matches during the 2019 season were played under regular conditions, while there was low stadium occupancy during the 2020 season to prevent the spread of COVID-19. Regarding average points won, HA disappeared. By using multiple group structural equation modeling, it was examined the routes of influence via which a reduction in crowd size influenced HA. The results indicated that the influence from the crowd size to the referee's decisions disappeared during the 2020 season. However, the factors including the referee's decisions have lower effects on the outcome factor. Hence, no dominant route was detected in the present study.
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Yamaguchi D, Endo H, Ishikawa K, Nomura R, Oka K, Nakamura H. Large vessel occlusions requiring repeated mechanical thrombectomy caused by silent myocardial infarction in a young adult. J Stroke Cerebrovasc Dis 2022; 31:106761. [PMID: 36095858 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106761] [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: 05/11/2022] [Accepted: 09/04/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Silent myocardial ischemia, defined as objective evidence of myocardial ischemia without symptoms, is associated with ischemic stroke. Nevertheless, silent myocardial infarction is a rare cause of ischemic stroke, especially in young adults with no medical history. MATERIALS AND METHODS Herein, we report a young adult patient with acute ischemic stroke treated with repeated mechanical thrombectomy for recurrent large vessel occlusions caused by left ventricular thrombus following a silent myocardial infarction. RESULTS A 40-year-old man was transferred by ambulance to our hospital because of a generalized seizure. He was diagnosed with cerebral infarction and left middle cerebral artery occlusion. We performed intravenous thrombolysis and mechanical thrombectomy. Recanalization was achieved and his symptoms gradually improved. However, the day after treatment he developed bilateral cerebellar infarction and basilar artery occlusion. We performed a second mechanical thrombectomy and recanalization was achieved. Transthoracic echocardiography revealed a mobile left ventricular thrombus. Although he had no previous chest symptomatic episodes, cardiac examination confirmed myocardial infarction of unknown onset. He was diagnosed with acute ischemic stroke with large vessel occlusions caused by left ventricular thrombus following a silent myocardial infarction. Anticoagulation therapy reduced the amount of thrombus. At 1-year follow-up, he had not experienced any recurrences or symptoms. CONCLUSIONS Silent myocardial infarction should be considered a cause of ischemic stroke in young adults, even without any vascular risk factors. Recurrent large vessel occlusion may occur in patients with left ventricular thrombus, and repeated mechanical thrombectomy should be considered for treatment.
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Affiliation(s)
- Daishi Yamaguchi
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
| | - Hideki Endo
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan.
| | - Kohei Ishikawa
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan; Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
| | - Koji Oka
- Department of Neurosurgery, Nakamura Memorial South Hospital, Hokkaido, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, Hokkaido, Japan
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25
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Nomura R, Fujiwara K, Ikeguchi T. Superposed recurrence plots for reconstructing a common input applied to neurons. Phys Rev E 2022; 106:034205. [PMID: 36266847 DOI: 10.1103/physreve.106.034205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/21/2022] [Indexed: 06/16/2023]
Abstract
In the brain, common inputs play an important role in eliciting synchronous firing in the assembly of neurons. However, common inputs are usually unknown to observers. If an unobserved common input can be reconstructed only from outputs, it would be beneficial to the understanding of communication in the brain. Thus, we have developed a method for reconstructing a common input only from output firing rates of uncoupled neuron models. To this end, we propose a superposed recurrence plot (SRP) comprising points determined by using a union of points at each pixel among multiple recurrence plots. The SRP method can reconstruct a common input when using various types of neurons with different firing rate baselines, even when using uncoupled neuron models that exhibit chaotic responses. The SRP method robustly reconstructs the common input applied to the neuron models when we select adequate time windows to calculate the firing rates in accordance with the width of the fluctuations. These results suggest that certain information is embedded in the firing rate. These findings could be a possible basis for analyzing whole-brain communication utilizing rate coding.
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Affiliation(s)
- Ryota Nomura
- Graduate School of Engineering, Tokyo University of Science, 6-3-1, Niijuku, Katsushika-ku, Tokyo 125-8585, Japan
- Faculty of Human Education, Kagoshima Immaculate Heart University, 2365, Amatatsu-cho, Satsumasendai, Kagoshima 895-0011, Japan
| | - Kantaro Fujiwara
- International Research Center for Neurointelligence, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Tohru Ikeguchi
- Graduate School of Engineering, Tokyo University of Science, 6-3-1, Niijuku, Katsushika-ku, Tokyo 125-8585, Japan
- Faculty of Engineering, Tokyo University of Science, 6-3-1, Niijuku, Katsushika-ku, Tokyo 125-8585, Japan
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26
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Ishikawa K, Endo H, Shindo K, Nomura R, Oka K, Nakamura H. Mechanical thrombectomy for acute fetal posterior cerebral artery occlusion with a hidden unruptured cerebral aneurysm: illustrative case. Journal of Neurosurgery: Case Lessons 2022; 4:CASE22291. [PMID: 36051776 PMCID: PMC9426352 DOI: 10.3171/case22291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/27/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Fetal posterior cerebral artery occlusion is rare and often presents with severe neurological symptoms. Although acute recanalization therapy is commonly used for cerebral vessel occlusion, unruptured cerebral aneurysms can be hidden distal to the occluded vessels. OBSERVATIONS An 87-year-old man presented with consciousness disturbance and right hemiparesis. The authors diagnosed left fetal posterior cerebral artery occlusion and performed mechanical thrombectomy. A stent retriever was deployed from the middle cerebral artery M1 segment across the mural thrombus of the internal carotid artery. After the first pass, the fetal posterior cerebral artery remained occluded, with confirmation of a contrast effect around the thrombus. Because the anatomical course of the fetal posterior cerebral artery was unidentified, the procedure was stopped. At 1-week recovery, magnetic resonance imaging revealed complete recanalization and a fetal posterior cerebral artery aneurysm hidden within the occluded site. Blood flow was directed to the aneurysm, and the thrombus within the aneurysm simultaneously occluded the fetal posterior cerebral artery. LESSONS To avoid critical complications following mechanical thrombectomy for fetal posterior cerebral artery occlusion, hidden aneurysms should be suspected when a “fried egg–like” contrast effect is observed around the thrombus.
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Affiliation(s)
- Kohei Ishikawa
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan; and
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Hideki Endo
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan; and
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Koichiro Shindo
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan; and
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan; and
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Koji Oka
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan; and
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
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Okazaki S, Mine Y, Iwamoto Y, Urabe S, Mitsuhata C, Nomura R, Kakimoto N, Murayama T. Analysis of the feasibility of using deep learning for multiclass classification of dental anomalies on panoramic radiographs. Dent Mater J 2022; 41:889-895. [PMID: 36002296 DOI: 10.4012/dmj.2022-098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the feasibility study was to construct deep learning models for the classification of multiple dental anomalies in panoramic radiographs. Panoramic radiographs with single supernumerary teeth and/or odontomas were considered the "case" group; panoramic radiographs with no dental anomalies were considered the "control" group. The dataset comprised 150 panoramic radiographs: 50 each of no dental anomalies, single supernumerary teeth, and odontomas. To classify the panoramic radiographs into case and control categories, we employed AlexNet, which is a convolutional neural network model. AlexNet was able to classify whole panoramic radiographs into two or three classes, according to the presence or absence of supernumerary teeth or odontomas. The performance metrics of the three-class classification were 70%, 70.8%, 70%, and 69.7% for accuracy, precision, sensitivity, and F1 score, respectively, in the macro average. These results support the feasibility of using deep learning to detect multiple dental anomalies in panoramic radiographs.
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Affiliation(s)
- Shota Okazaki
- Department of Medical System Engineering, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Yuichi Mine
- Department of Medical System Engineering, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Yuko Iwamoto
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Shiho Urabe
- Department of Medical System Engineering, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Chieko Mitsuhata
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Takeshi Murayama
- Department of Medical System Engineering, Graduate School of Biomedical and Health Sciences, Hiroshima University
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Misaki T, Naka S, Nagasawa Y, Matsuoka D, Ito S, Nomura R, Matsumoto-Nakano M, Nakano K. Simultaneous Presence of Campylobacter rectus and Cnm-Positive Streptococcus mutans in the Oral Cavity Is Associated with Renal Dysfunction in IgA Nephropathy Patients: 5-Year Follow-Up Analysis. Nephron Clin Pract 2022; 147:134-143. [PMID: 35998579 DOI: 10.1159/000525511] [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: 02/08/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The simultaneous presence of Streptococcus mutans expressing the Cnm protein encoded by cnm (i.e., cnm-positive S. mutans) and Campylobacter rectus in the oral cavity has been associated with proteinuria in patients with IgA nephropathy (IgAN). OBJECTIVES The present study evaluated the relationship between renal function and oral bacteria in patients with IgAN over 5 years of follow-up. METHODS The presence of C. rectus and cnm-positive S. mutans in saliva samples of 117 patients with IgAN was initially evaluated by polymerase chain reaction. Patients were then divided into four groups according to the results of C. rectus and cnm-positive S. mutans detection: group A: C. rectus (-), cnm-positive S. mutans (-); group B: C. rectus (+), cnm-positive S. mutans (-); group C: C. rectus (-), cnm-positive S. mutans (+); and group D: C. rectus (+), cnm-positive S. mutans (+). Clinical characteristics were prospectively followed for 5 years. RESULTS Serum creatinine levels were significantly higher in group D than in group A over 5 years of follow-up. Additionally, the proportion of patients with an estimated glomerular filtration rate <45 mL/min increased over time; it was significantly greater in group D than in group A over 5 years of follow-up. CONCLUSION These results suggest that the simultaneous presence of C. rectus and cnm-positive S. mutans in the oral cavity is associated with renal dysfunction in IgAN patients.
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Affiliation(s)
- Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.,Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu, Japan
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuyuki Nagasawa
- Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Daiki Matsuoka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Seigo Ito
- Department of Internal Medicine, Japan Self-Defense Iruma Hospital, Iruma, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Nakano
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
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Mitsuhata C, Kado N, Hamada M, Nomura R, Kozai K. Characterization of the unique oral microbiome of children with Down syndrome. Sci Rep 2022; 12:14150. [PMID: 35986204 PMCID: PMC9391446 DOI: 10.1038/s41598-022-18409-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
Down syndrome creates an abnormal oral environment, including susceptibility to periodontal disease at a young age, but there are no detailed studies of the oral microbiome in children with Down syndrome. In this study, we performed a comprehensive analysis of the oral bacteria of 40 children with Down syndrome and 40 non-Down syndrome children. Microbial DNA was extracted from dental plaque specimens and the V4 hypervariable region of the bacterial 16S rRNA gene was analyzed using the MiSeq platform. There were significant differences between the Down syndrome and non-Down syndrome groups in mean numbers of operational taxonomic units, and α- and β-diversity (P < 0.05). Interestingly, significant differences in α- and β-diversity between the two groups were only observed in subjects with gingival inflammation, but not in those without gingival inflammation (P < 0.05). Taxonomic analysis at the genus or species levels showed significant differences in relative abundance levels of certain bacteria between the Down syndrome and non-Down syndrome groups, including Corynebacterium, Abiotrophia and Lautropia (P < 0.05). These results suggest that children with Down syndrome may have a unique oral microbiome that could impact the development of dental diseases common in people with the syndrome.
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Yoshida S, Inaba H, Nomura R, Nakano K, Matsumoto-Nakano M. Green tea catechins inhibit Porphyromonas gulae LPS-induced inflammatory responses in human gingival epithelial cells: Running title. J Oral Biosci 2022; 64:352-358. [PMID: 35660639 DOI: 10.1016/j.job.2022.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the anti-inflammatory effects of green tea catechins in immortalized human gingival epithelial cells (Ca9-22) stimulated with Porphyromonas gulae lipopolysaccharide (LPS). METHODS Ca9-22 cells were incubated with P. gulae LPS (10 μg/ml) with or without green tea catechins, epigallocatechin-3-gallate (EGCg), epigallocatechin (EGC), epicatechin-3-gallate (ECG), and epicatechin (EC) (each at 50 μM), for 6 or 24 hours. Real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay were used to determine the induction of cyclooxygenase 2 (COX2), tumor necrosis factor alpha (TNF-ɑ), interleukin 6 (IL-6), and IL-8. Furthermore, the expression of toll-like receptors (TLRs) 2 and 4 was examined using real-time PCR and western blotting analysis, and phosphorylation of the p38 and ERK1/2 was examined using western blotting analysis. RESULTS At the mRNA and protein levels, EGCg, EGC, ECG, and EC were found to significantly inhibit COX2, TNF-ɑ, IL-6, and IL-8. Furthermore, the levels of ERK1/2 and p38 phosphorylation induced by P. gulae LPS were decreased following the addition of each of the catechins, as well as TLR2 and 4 mRNA and protein. CONCLUSIONS These findings indicate that green tea catechins are potent inhibitors of inflammatory responses induced by P. gulae LPS, and may also be useful for prevention and/or attenuation of periodontitis.
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Affiliation(s)
- Sho Yoshida
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Hosoki S, Hattori Y, Saito S, Takegami M, Tonomura S, Yamamoto Y, Ikeda S, Hosomi N, Oishi N, Morita Y, Miyamoto Y, Nomura R, Nakano K, Ihara M. Risk Assessment of Cnm-Positive Streptococcus mutans in Stroke Survivors (RAMESSES): Protocol for a Multicenter Prospective Cohort Study. Front Neurol 2022; 13:816147. [PMID: 35645961 PMCID: PMC9133813 DOI: 10.3389/fneur.2022.816147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The role of commensal microbiota in systemic diseases, including brain diseases, has attracted increasing attention. Oral infectious diseases, such as dental caries and periodontitis, are also involved in cerebrovascular diseases and cognitive impairment. Cerebral microbleeds (CMBs) and intracerebral hemorrhage due to small vessel disease (SVD), are presumably associated with a high risk of vascular cognitive impairment and stroke. We previously reported that Streptococcus mutans (S. mutans, the main pathogen of dental caries), harboring the cnm gene that encodes the collagen-binding protein Cnm, is associated with the development of hypertensive intracerebral hemorrhage and aggravation of CMBs. We also proposed a mechanism by which the circulating Cnm-expressing S. mutans causes intracerebral hemorrhage or CMBs; it binds to denuded basement membranes mainly composed of collagen IV through damaged tight junctions or it directly invades endothelial cells, resulting in blood-brain barrier injury. In November 2018, we initiated a multicenter, prospective cohort study (RAMESSES: Risk Assessment of Cnm-positive S. mutans in Stroke Survivors; UMIN Clinical Trials Registry: UMIN000045559) to explore the longitudinal association between Cnm-positive S. mutans and CMBs with comprehensive dental findings, which should determine the effect of Cnm-positive S. mutans in the oral cavity on the risk of CMB development and cognitive decline. Methods Fifteen domestic institutes will be enlisted to enroll 230 patients who have at least one CMB in the deep brain area and develop a stroke within the past year. The prevalence of Cnm-positive S. mutans based on oral specimens and dental hygiene will be examined. The primary outcome is the number of newly developed deep CMBs. The secondary outcomes include the new development of lobar, subtentorial, or any type of CMBs; symptomatic intracerebral hemorrhage or ischemic stroke; changes in cognitive function or frailty; major bleeding; all-cause mortality; and antibody titers against periodontal pathogens. The observation period will be 2 years. Discussion The 2-year longitudinal prospective cohort study is expected to establish the role of Cnm-positive S. mutans in SVD including CMBs and intracerebral hemorrhage from the perspective of the “brain-oral axis” and provide guidance for novel prophylactic strategies against Cnm-positive S. mutans-induced SVD.
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Affiliation(s)
- Satoshi Hosoki
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yorito Hattori
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
- *Correspondence: Yorito Hattori
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shuichi Tonomura
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yumi Yamamoto
- Department of Molecular Innovation in Lipidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shuhei Ikeda
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Naohisa Hosomi
- Department of Neurology, Chikamori Hospital, Kochi, Japan
- Department of Disease Model, Research Institute of Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Naoya Oishi
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiro Miyamoto
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
- Masafumi Ihara
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Ishikawa K, Endo H, Shindo K, Nomura R, Oka K, Nakamura H. Aberrant right subclavian artery with right type 1 proatlantal artery and segmental dysplasia of the right internal carotid artery: a case report. Surg Radiol Anat 2022; 44:709-713. [PMID: 35486164 DOI: 10.1007/s00276-022-02950-7] [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: 02/15/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE We present a case of an aberrant right subclavian artery (ARSA) with extremely rare vascular anomalies. CASE REPORT A 69-year-old woman was suspected to have right internal carotid artery (ICA) stenosis. Computed tomography angiography demonstrated an ARSA and hypoplasia of the right ICA. The proximal segment of the right vertebral artery (VA) was aplasia, and a right type 1 proatlantal artery (PA) arose from the right common carotid artery. Cerebral angiography demonstrated segmental dysplasia of the right ICA. The ascending intrapetrous segment and the ascending foramen lacerum-horizontal intracavernous segment of the right ICA demonstrated hypoplasia. The collateral pathways promoted reconstitution of each of the distal segments. Left internal carotid angiography demonstrated anterior communicating artery aneurysm and sufficient cross flow to the contralateral middle cerebral artery via the AcomA. DISCUSSION A type 1 PA with an ARSA may result in the regression of the right dorsal aorta with persistence of the first cervical intersegmental artery. Although there are few findings of a relationship between an ARSA and intracranial artery anomalies, a developmental error of the right dorsal aorta may cause such complex vascular anomalies. CONCLUSION Knowledge of anatomical variations in patients with ARSA is useful when performing angiography or endovascular therapy, as well as during clinical follow-up.
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Affiliation(s)
- Kohei Ishikawa
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-3-1 Kawazoe 2-jo, Minami-ku, Sapporo, Hokkaido, 005-8555, Japan.
| | - Hideki Endo
- Department of Neurosurgery, Nakamura Memorial Hospital, 291, Minami 1-jo Nishi 14-chome, Chuo-ku, Sapporo, Hokkaido, 060-8570, Japan
| | - Koichiro Shindo
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-3-1 Kawazoe 2-jo, Minami-ku, Sapporo, Hokkaido, 005-8555, Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-3-1 Kawazoe 2-jo, Minami-ku, Sapporo, Hokkaido, 005-8555, Japan
| | - Koji Oka
- Department of Neurosurgery, Nakamura Memorial South Hospital, 2-3-1 Kawazoe 2-jo, Minami-ku, Sapporo, Hokkaido, 005-8555, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, 291, Minami 1-jo Nishi 14-chome, Chuo-ku, Sapporo, Hokkaido, 060-8570, Japan
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Suehiro Y, Nomura R, Matayoshi S, Otsugu M, Iwashita N, Nakano K. Evaluation of the collagen-binding properties and virulence of killed Streptococcus mutans in a silkworm model. Sci Rep 2022; 12:2800. [PMID: 35181690 PMCID: PMC8857238 DOI: 10.1038/s41598-022-06345-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
Streptococcus mutans, a major pathogen of dental caries, is also known as a causative agent of cardiovascular disease. A 120 kDa collagen-binding protein (Cnm) of S. mutans is an important contributor to the pathogenicity of cardiovascular disease. Although dead bacteria have been detected in cardiovascular specimens by molecular biological methods, the pathogenicity of the bacteria remains unknown. Here, we analyzed the pathogenicity of killed S. mutans by focusing on collagen-binding ability and the effects on silkworms. In live S. mutans, Cnm-positive S. mutans had high collagen-binding activity, while Cnm-negative S. mutans had no such activity. After treatment with killed Cnm-positive S. mutans, amoxicillin-treated bacteria still had collagen-binding ability, while lysozyme-treated bacteria lost this ability. When live and amoxicillin-treated S. mutans strains were administered to silkworms, the survival rates of the silkworms were reduced; this reduction was more pronounced in Cnm-positive S. mutans infection than in Cnm-negative S. mutans infection. However, the administration of any of the lysozyme-treated bacteria did not reduce the survival rate of the silkworms. These results suggest that amoxicillin-killed Cnm-positive S. mutans strains maintain collagen-binding properties and pathogenicity in the silkworm model, and are possibly associated with pathogenicity in cardiovascular diseases.
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Affiliation(s)
- Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Masatoshi Otsugu
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Naoki Iwashita
- Laboratory of Veterinary Pharmacology, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, 252-5201, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
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Nagasawa Y, Misaki T, Ito S, Naka S, Wato K, Nomura R, Matsumoto-Nakano M, Nakano K. Title IgA Nephropathy and Oral Bacterial Species Related to Dental Caries and Periodontitis. Int J Mol Sci 2022; 23:725. [PMID: 35054910 PMCID: PMC8775524 DOI: 10.3390/ijms23020725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/23/2022] Open
Abstract
A relationship between IgA nephropathy (IgAN) and bacterial infection has been suspected. As IgAN is a chronic disease, bacteria that could cause chronic infection in oral areas might be pathogenetic bacteria candidates. Oral bacterial species related to dental caries and periodontitis should be candidates because these bacteria are well known to be pathogenic in chronic dental disease. Recently, several reports have indicated that collagen-binding protein (cnm)-(+) Streptococcs mutans is relate to the incidence of IgAN and the progression of IgAN. Among periodontal bacteria, Treponema denticola, Porphyromonas gingivalis and Campylobacte rectus were found to be related to the incidence of IgAN. These bacteria can cause IgAN-like histological findings in animal models. While the connection between oral bacterial infection, such as infection with S. mutans and periodontal bacteria, and the incidence of IgAN remains unclear, these bacterial infections might cause aberrantly glycosylated IgA1 in nasopharynx-associated lymphoid tissue, which has been reported to cause IgA deposition in mesangial areas in glomeruli, probably through the alteration of microRNAs related to the expression of glycosylation enzymes. The roles of other factors related to the incidence and progression of IgA, such as genes and cigarette smoking, can also be explained from the perspective of the relationship between these factors and oral bacteria. This review summarizes the relationship between IgAN and oral bacteria, such as cnm-(+) S. mutans and periodontal bacteria.
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Affiliation(s)
- Yasuyuki Nagasawa
- Department of General Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan
| | - Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Shizuoka, Japan;
- Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu 433-8558, Shizuoka, Japan
| | - Seigo Ito
- Department of Internal Medicine, Japan Self-Defense Gifu Hospital, Kakamigahara 502-0817, Gifu, Japan;
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Okayama, Japan; (S.N.); (M.M.-N.)
| | - Kaoruko Wato
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (K.W.); (R.N.); (K.N.)
| | - Ryota Nomura
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (K.W.); (R.N.); (K.N.)
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Okayama, Japan; (S.N.); (M.M.-N.)
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (K.W.); (R.N.); (K.N.)
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Oliveira LT, Alves LA, Harth-Chu EN, Nomura R, Nakano K, Mattos-Graner RO. VicRK and CovR polymorphisms in Streptococcus mutans strains associated with cardiovascular infections. J Med Microbiol 2021; 70. [PMID: 34939562 DOI: 10.1099/jmm.0.001457] [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] [Indexed: 12/16/2022] Open
Abstract
Introduction. Streptococcus mutans, a common species of the oral microbiome, expresses virulence genes promoting cariogenic dental biofilms, persistence in the bloodstream and cardiovascular infections.Gap statement. Virulence gene expression is variable among S. mutans strains and controlled by the transcription regulatory systems VicRK and CovR.Aim. This study investigates polymorphisms in the vicRK and covR loci in S. mutans strains isolated from the oral cavity or from the bloodstream, which were shown to differ in expression of covR, vicRK and downstream genes.Methodology. The transcriptional activities of covR, vicR and vicK were compared by RT-qPCR between blood and oral strains after exposure to human serum. PCR-amplified promoter and/or coding regions of covR and vicRK of 18 strains (11 oral and 7 blood) were sequenced and compared to the reference strain UA159.Results. Serum exposure significantly reduced covR and vicR/K transcript levels in most strains (P<0.05), but reductions were higher in oral than in blood strains. Single-nucleotide polymorphisms (SNPs) were detected in covR regulatory and coding regions, but SNPs affecting the CovR effector domain were only present in two blood strains. Although vicR was highly conserved, vicK showed several SNPs, and SNPs affecting VicK regions important for autokinase activity were found in three blood strains.Conclusions. This study reveals transcriptional and structural diversity in covR and vicR/K, and identifies polymorphisms of functional relevance in blood strains, indicating that covR and vicRK might be important loci for S. mutans adaptation to host selective pressures associated with virulence diversity.
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Affiliation(s)
- Letícia T Oliveira
- Department of Oral Diagnosis, Piracicaba Dental School - State University of Campinas, Piracicaba, SP, Brazil
| | - Lívia A Alves
- Department of Oral Diagnosis, Piracicaba Dental School - State University of Campinas, Piracicaba, SP, Brazil
| | - Erika N Harth-Chu
- Department of Oral Diagnosis, Piracicaba Dental School - State University of Campinas, Piracicaba, SP, Brazil
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University, Graduate School of Dentistry, Osaka, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University, Graduate School of Dentistry, Osaka, Japan
| | - Renata O Mattos-Graner
- Department of Oral Diagnosis, Piracicaba Dental School - State University of Campinas, Piracicaba, SP, Brazil
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Matsuda M, Endo H, Ishikawa K, Nomura R, Ishizuka T, Oka K, Nakamura H. Extremely tortuous superior cerebellar artery mimicking an aneurysm. Surg Neurol Int 2021; 12:569. [PMID: 34877055 PMCID: PMC8645463 DOI: 10.25259/sni_864_2021] [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] [Received: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 11/08/2022] Open
Abstract
Background: An extremely tortuous superior cerebellar artery is a rare anomaly. We report a case of an extremely tortuous superior cerebellar artery mimicking an aneurysm. Case Description: A 77-year-old woman was initially diagnosed with unruptured cerebral aneurysm at the right basilar artery-superior cerebellar artery junction by magnetic resonance angiography. Catheter angiogram revealed that there was no apparent aneurysm at the basilar artery-superior cerebellar artery junction and the lesion was actually an extremely tortuous superior cerebellar artery. Conclusion: Although an extremely tortuous superior cerebellar artery is rare, it should be considered when examining other vascular lesions.
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Affiliation(s)
- Megumi Matsuda
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan
| | - Hideki Endo
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan
| | - Kohei Ishikawa
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan
| | - Tomoaki Ishizuka
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan.,Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Koji Oka
- Department of Neurosurgery, Nakamura Memorial South Hospital, Sapporo, Hokkaido, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
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Nomura R, Kitamura T, Matayoshi S, Ohata J, Suehiro Y, Iwashita N, Okawa R, Nakano K. Inhibitory effect of a gel paste containing surface pre-reacted glass-ionomer (S-PRG) filler on the cariogenicity of Streptococcus mutans. Sci Rep 2021; 11:23495. [PMID: 34873234 PMCID: PMC8648751 DOI: 10.1038/s41598-021-02924-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022] Open
Abstract
Surface pre-reacted glass-ionomer (S-PRG) filler is a bioactive functional glass that releases six different ions. Although several dental materials containing S-PRG filler have been developed, few self-care products containing S-PRG filler have been reported. We investigated the inhibitory effects of PRG gel paste containing S-PRG filler on Streptococcus mutans, a major pathogen of dental caries. PRG gel paste inhibited bacterial growth of S. mutans in a concentration-dependent manner, and all S. mutans were killed in the presence of ≥ 1% PRG gel paste. Additionally, it was difficult for S. mutans to synthesize insoluble glucan from sucrose in the presence of 0.1% PRG gel paste. A biofilm formation model was prepared in which slices of bovine enamel were infected with S. mutans after treatment with or without PRG gel paste. Biofilm formation was inhibited significantly more on the enamel treated with PRG gel paste than on enamel without PRG gel paste (P < 0.001). The inhibitory effects on bacterial growth and biofilm formation were more prominent with PRG gel paste than with S-PRG-free gel paste, suggesting that PRG gel paste may be effective as a self-care product to prevent dental caries induced by S. mutans.
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Affiliation(s)
- Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
| | - Takahiro Kitamura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Jumpei Ohata
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Naoki Iwashita
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Rena Okawa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Nagasawa Y, Nomura R, Misaki T, Ito S, Naka S, Wato K, Okunaka M, Watabe M, Fushimi K, Tsuzuki K, Matsumoto-Nakano M, Nakano K. Relationship between IgA Nephropathy and Porphyromonas gingivalis; Red Complex of Periodontopathic Bacterial Species. Int J Mol Sci 2021; 22:13022. [PMID: 34884826 PMCID: PMC8657970 DOI: 10.3390/ijms222313022] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 12/30/2022] Open
Abstract
IgA nephropathy (IgAN) has been considered to have a relationship with infection in the tonsil, because IgAN patients often manifest macro hematuria just after tonsillitis. In terms of oral-area infection, the red complex of periodontal bacteria (Porphyromonas gingivalis (P. gingivalis), Treponema denticol (T. denticola) and Tannerella forsythia (T. forsythia)) is important, but the relationship between these bacteria and IgAN remains unknown. In this study, the prevalence of the red complex of periodontal bacteria in tonsil was compared between IgAN and tonsillitis patients. The pathogenicity of IgAN induced by P. gingivalis was confirmed by the mice model treated with this bacterium. The prevalence of P. gingivalis and T. forsythia in IgAN patients was significantly higher than that in tonsillitis patients (p < 0.001 and p < 0.05, respectively). A total of 92% of tonsillitis patients were free from red complex bacteria, while only 48% of IgAN patients had any of these bacteria. Nasal administration of P. gingivalis in mice caused mesangial proliferation (p < 0.05 at days 28a nd 42; p < 0.01 at days 14 and 56) and IgA deposition (p < 0.001 at day 42 and 56 after administration). Scanning-electron-microscopic observation revealed that a high-density Electron-Dense Deposit was widely distributed in the mesangial region in the mice kidneys treated with P. gingivalis. These findings suggest that P. gingivalis is involved in the pathogenesis of IgAN.
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Affiliation(s)
- Yasuyuki Nagasawa
- Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Division of Oral infection and Disease Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (K.W.); (K.N.)
| | - Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Shizuoka 430-8558, Hamamatsu, Japan;
- Department of Nursing, Faculty of Nursing, Seirei Christopher University, Shizuoka 433-8558, Hamamatsu, Japan
| | - Seigo Ito
- Department of Internal medicine, Japan Self-Defense Gifu Hospital, Gifu 502-0817, Kakamigahara, Japan;
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Okayama, Japan; (S.N.); (M.M.-N.)
| | - Kaoruko Wato
- Department of Pediatric Dentistry, Division of Oral infection and Disease Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (K.W.); (K.N.)
| | - Mieko Okunaka
- Department of Otolaryngology, Meiwa Hospital, Nishinomiya 663-8186, Hyogo, Japan; (M.O.); (M.W.); (K.F.)
| | - Maiko Watabe
- Department of Otolaryngology, Meiwa Hospital, Nishinomiya 663-8186, Hyogo, Japan; (M.O.); (M.W.); (K.F.)
| | - Katsuya Fushimi
- Department of Otolaryngology, Meiwa Hospital, Nishinomiya 663-8186, Hyogo, Japan; (M.O.); (M.W.); (K.F.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan;
| | - Kenzo Tsuzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan;
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Okayama, Japan; (S.N.); (M.M.-N.)
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Division of Oral infection and Disease Control, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan; (K.W.); (K.N.)
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Urmi AS, Inaba H, Nomura R, Yoshida S, Ohara N, Asai F, Nakano K, Matsumoto-Nakano M. Roles of Porphyromonas gulae proteases in bacterial and host cell biology. Cell Microbiol 2021; 23:e13312. [PMID: 33486854 DOI: 10.1111/cmi.13312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/19/2023]
Abstract
Porphyromonas gulae, an animal-derived periodontal pathogen, expresses several virulence factors, including fimbria, lipopolysaccharide (LPS) and proteases. We previously reported that its invasive efficiency was dependent on fimbriae types. In addition, P. gulae LPS increased inflammatory responses via toll-like receptors. The present study was conducted to investigate the involvement of P. gulae proteases in bacterial and host cell biology. Porphyromonas gulae strains showed an ability to agglutinate mouse erythrocytes and also demonstrated co-aggregation with Actinomyces viscosus, while the protease inhibitors antipain, PMSF, TLCK and leupeptin diminished P. gulae proteolytic activity, resulting in inhibition of haemagglutination and co-aggregation with A. viscosus. In addition, specific proteinase inhibitors were found to reduce bacterial cell growth. Porphyromonas gulae inhibited Ca9-22 cell proliferation in a multiplicity of infection- and time-dependent manner. Additionally, P. gulae-induced decreases in cell contact and adhesion-related proteins were accompanied by a marked change in cell morphology from well spread to rounded. In contrast, inhibition of protease activity prevented degradation of proteins, such as E-cadherin, β-catenin and focal adhesion kinase, and also blocked inhibition of cell proliferation. Together, these results indicate suppression of the amount of human proteins, such as γ-globulin, fibrinogen and fibronectin, by P. gulae proteases, suggesting that a novel protease complex contributes to bacterial virulence.
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Affiliation(s)
- Alam Saki Urmi
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
| | - Sho Yoshida
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naoya Ohara
- Department of Oral Microbiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and the Advanced Research Center for Oral and Craniofacial Sciences, Dental School, Okayama University, Okayama, Japan
| | - Fumitoshi Asai
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Yoshida S, Inaba H, Nomura R, Murakami M, Yasuda H, Nakano K, Matsumoto-Nakano M. Efficacy of FimA antibody and clindamycin in silkworm larvae stimulated with Porphyromonas gulae. J Oral Microbiol 2021; 13:1914499. [PMID: 33968314 PMCID: PMC8079003 DOI: 10.1080/20002297.2021.1914499] [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: 12/13/2022] Open
Abstract
Objective: Porphyromonas gulae, a major periodontal pathogen in animals, possesses fimbriae that have been classified into three genotypes (A, B, C) based on the diversity of fimA genes encoding fimbrillin protein (FimA). P. gulae strains with type C fimbriae were previously shown to be more virulent than other types. In this study, we further examined the host toxicity mediated by P. gulae fimbriae by constructing recombinant FimA (rFimA) expression vectors for each genotype and raised antibodies to the purified proteins. Methods and Results: All larvae died within 204 h following infection with P. gulae type C at the low-dose infection, whereas type A and B did not. Among fimA types, the survival rates of the larvae injected with rFimA type C were remarkably decreased, while the survival rates of the larvae injected with rFimA type A and type B were greater than 50%. Clindamycin treatment inhibited the growth of type C strains in a dose-dependent manner, resulting in an increased rate of silkworm survival. Finally, type C rFimA-specific antiserum prolonged the survival of silkworm larvae stimulated by infection with P. gulae type C strain or injection of rFimA type C protein. Conclusion: These results suggested that type C fimbriae have high potential for enhancement of bacterial pathogenesis, and that both clindamycin and anti-type C rFimA-specific antibodies are potent inhibitors of type C fimbriae-induced toxicity. This is the first report to establish a silkworm infection model using P. gulae for toxicity assessment.
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Affiliation(s)
- Sho Yoshida
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Masaru Murakami
- Departments of Pharmacology, Veterinary Public Health II and Molecular Biology, School of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | | | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Kunihara T, Wilkens H, Halank M, Held M, Nomura R, Igarashi T, Sata F, Schäfers HJ. Haemodynamic benefit of bridging use of bosentan prior to pulmonary endarterectomy. Eur J Cardiothorac Surg 2021; 60:840-847. [PMID: 33755096 DOI: 10.1093/ejcts/ezab137] [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: 07/11/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Some patients present with excessive pulmonary hypertension (PH) prior to pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH). This study was performed to evaluate the clinical role of pretreatment before PEA in CTEPH patients. METHODS A total of 370 patients with CTEPH undergoing first PEA between 2003 and 2017 were divided into those receiving pretreatment with bosentan (group B: n = 119) and those without targeted pretreatment for PH (group C: n = 251). After selecting patients given bosentan (2-8 months) and using propensity score matching, comparable patient cohorts (n = 23 each) were created from both groups. PEA was performed in the standard manner, and the median number of extracted segments was 14. RESULTS There were no significant differences in perioperative demographic characteristics or 30-day mortality (overall 5.7%) between the groups before and after matching. In patients with preoperative pulmonary vascular resistance (PVR) ≥800 dynes s/cm5, a significantly larger decrease in PVR was found in group B (78%) compared to group C (68%) (P = 0.033). There was no significant difference in late survival between the groups after matching. The frequency of residual/persistent PH (mean pulmonary artery pressure >25 mmHg) was lower in group B than in group C, although the difference was not significant (22% vs 39%, respectively, P = 0.200). Advanced age and longer cardiopulmonary bypass time were independent predictors of both 30-day mortality and residual/persistent PH (odds ratio: age, 1.053, 1.013, cardiopulmonary bypass time, 1.065, 1.010, respectively). CONCLUSIONS Preoperative treatment of CTEPH patients with bosentan for 2-8 months can improve post-PEA PVR without adverse clinical events in patients with a high preoperative PVR. A temporary bridging regime appears beneficial in selected patients prior to PEA.
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Affiliation(s)
- Takashi Kunihara
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Heinrike Wilkens
- Department of Pulmonary Medicine, Saarland University Medical Center, Homburg/Saar, Germany
| | - Michael Halank
- Department of Internal Medicine I, Pneumology, University Hospital Dresden, Dresden, Germany
| | - Matthias Held
- Department of Internal Medicine and Respiratory Care, Mission Medical Hospital, Würzburg, Germany
| | - Ryota Nomura
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Takashi Igarashi
- Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Japan
| | | | - Hans-Joachim Schäfers
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany
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Naka S, Wato K, Misaki T, Ito S, Matsuoka D, Nagasawa Y, Nomura R, Matsumoto-Nakano M, Nakano K. Streptococcus mutans induces IgA nephropathy-like glomerulonephritis in rats with severe dental caries. Sci Rep 2021; 11:5784. [PMID: 33707585 PMCID: PMC7952735 DOI: 10.1038/s41598-021-85196-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
The mechanisms underlying immunoglobulin A nephropathy (IgAN), the most common chronic form of primary glomerulonephritis, remain poorly understood. Streptococcus mutans, a Gram-positive facultatively anaerobic oral bacterium, is a common cause of dental caries. In previous studies, S. mutans isolates that express Cnm protein on their cell surface were frequently detected in IgAN patients. In the present study, inoculation of Cnm-positive S. mutans in the oral cavities of 2-week-old specific-pathogen free Sprague-Dawley rats fed a high-sucrose diet for 32 weeks produced severe dental caries in all rats. Immunohistochemical analyses of the kidneys using IgA- and complement C3-specific antibodies revealed positive staining in the mesangial region. Scanning electron microscopy revealed a wide distribution of electron dense deposits in the mesangial region and periodic acid-Schiff staining demonstrated prominent proliferation of mesangial cells and mesangial matrix. These results suggest that IgAN-like glomerulonephritis was induced in rats with severe dental caries by Cnm-positive S. mutans.
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Affiliation(s)
- Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kaoruko Wato
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
- Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan
| | - Seigo Ito
- Department of Nephrology and Endocrinology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Daiki Matsuoka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuyuki Nagasawa
- Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
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Shiga Y, Aoki S, Hosomi N, Nomura R, Nakamori M, Nezu T, Tachiyama K, Kamimura T, Kinoshita N, Shimomura R, Hayashi Y, Matsushima H, Imamura E, Ueno H, Wakabayashi S, Nakano K, Kohriyama T, Maruyama H. cnm-Positive Streptococcus mutans and diffusion-weighted imaging hyperintensities in acute intracerebral hemorrhage. Eur J Neurol 2021; 28:1581-1589. [PMID: 33426742 DOI: 10.1111/ene.14725] [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: 12/15/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Strains of Streptococcus mutans expressing the cell surface collagen-binding protein, Cnm, encoded by cnm (cnm-positive S. mutans), are associated with hypertensive intracerebral hemorrhage (ICH) and the occurrence of cerebral microbleeds (CMBs). Small diffusion-weighted imaging (DWI) hyperintensities in patients with acute ICH are also associated with CMBs. However, the association between cnm-positive S. mutans and DWI hyperintensities is unclear. Hence, this study aimed to investigate the association between cnm-positive S. mutans and DWI hyperintensities in patients with acute ICH. METHODS Patients with acute ICH were prospectively registered at three hospitals. Dental plaque specimens were collected within 4 days after admission, and cnm-positive S. mutans was detected using the polymerase chain reaction. Magnetic resonance imaging at 14 ± 5 days after admission was used to evaluate DWI hyperintensities and CMBs. RESULTS A total of 197 patients were enrolled in this study. cnm-positive S. mutans was detected in 30 patients (15.2%), and DWI hyperintensities were observed in 56 patients (28.4%). Patients with cnm-positive S. mutans had a higher frequency of DWI hyperintensities (50.0% vs 24.6%; p = 0.008) and a higher number of CMBs (5.5 vs 1.5; p < 0.001) than those without cnm-positive S. mutans. Multivariable logistic analysis revealed that the presence of cnm-positive S. mutans was independently associated with DWI hyperintensities (OR 2.38; 95% CI 1.01-5.61; p = 0.047) after adjusting for several confounding factors. CONCLUSION This study found an association between the presence of cnm-positive S. mutans and DWI hyperintensities in patients with acute ICH.
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Affiliation(s)
- Yuji Shiga
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Naohisa Hosomi
- Department of Neurology, Chikamori Hospital, Kochi, Japan.,Department of Disease Model, Research Institute of Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Keisuke Tachiyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Teppei Kamimura
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Naoto Kinoshita
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Department of Neurology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Ryo Shimomura
- Department of Neurology, Brain Attack Center Ota Memorial Hospital, Fukuyama, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Hayato Matsushima
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Hiroki Ueno
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | | | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Tatsuo Kohriyama
- Department of Neurology, Brain Attack Center Ota Memorial Hospital, Fukuyama, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Nomura R, Ohata J, Otsugu M, Okawa R, Naka S, Matsumoto-Nakano M, Nakano K. Inhibitory effects of flavedo, albedo, fruits, and leaves of Citrus unshiu extracts on Streptococcus mutans. Arch Oral Biol 2021; 124:105056. [PMID: 33517170 DOI: 10.1016/j.archoralbio.2021.105056] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/05/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
OBJECTVES Citrus unshiu has been shown to exhibit antimicrobial effects against citrus diseases. In the present study, C. unshiu was divided into flavedo, albedo, fruits, and leaves; the inhibitory effects of these extracts on Streptococcus mutans, a major pathogen of dental caries, were investigated. DESIGN C. unshiu specimens were separated into flavedo, albedo, fruits, and leaves. First, pH values and polyphenol amounts in Citrus extracts were measured. In addition, Citrus extract was added to the bacterial suspensions of S. mutans MT8148, and inhibitory effects of C. unshiu extracts on MT8148 for antimicrobial activity, bacterial growth, and biofilm formation were analyzed. These assays were also performed using C. sinensis extracts. RESULTS Among these extracts, albedo exhibited a pH value closest to neutral, while the fruits exhibited the most acidic pH value; the pH values significantly differed between these extracts (P < 0.05). In addition, the amounts of polyphenols were significantly higher in albedo than in other extracts (P < 0.001). All extracts showed inhibitory effects on MT8148 for antimicrobial activity, bacterial growth and biofilm formation. These inhibitory effects were significantly stronger in flavedo, albedo, and fruits, compared with leaves (P < 0.05). Furthermore, extracts of Citrus sinensis also showed inhibitory effects on S. mutans, although these effects were weaker than the effects of C. unshiu. CONCLUSION These results suggest that extracts from C. unshiu fruits exhibit inhibitory effects on S. mutans, among which albedo may be especially useful for dental caries prevention due to its neutral pH and abundant polyphenols, in addition to its inhibitory effects.
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Affiliation(s)
- Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
| | - Jumpei Ohata
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masatoshi Otsugu
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Rena Okawa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Matayoshi S, Okawa R, Nomura R, Kakimoto N, Nakano K. Resorption of entire impacted maxillary primary canine by permanent successor. Pediatric Dental Journal 2020. [DOI: 10.1016/j.pdj.2020.06.006] [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: 11/29/2022]
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Hosoki S, Saito S, Tonomura S, Ishiyama H, Yoshimoto T, Ikeda S, Ikenouchi H, Yamamoto Y, Hattori Y, Miwa K, Friedland RP, Carare RO, Nakahara J, Suzuki N, Koga M, Toyoda K, Nomura R, Nakano K, Takegami M, Ihara M. Oral Carriage of Streptococcus mutans Harboring the cnm Gene Relates to an Increased Incidence of Cerebral Microbleeds. Stroke 2020; 51:3632-3639. [PMID: 33148146 PMCID: PMC7678651 DOI: 10.1161/strokeaha.120.029607] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 01/18/2023]
Abstract
Supplemental Digital Content is available in the text. Cerebral microbleeds (CMB) are associated with stroke and cognitive impairment. We previously reported a high prevalence of CMB in people with Streptococcus mutans expressing Cnm, a collagen-binding protein in the oral cavity. S.mutans is a major pathogen responsible for dental caries. Repeated challenge with S.mutans harboring the cnm gene encoding Cnm induced cerebral bleeding in stroke-prone spontaneously hypertensive rats. The purpose of this longitudinal study is to examine the relationship of cnm-positive S.mutans to the development of CMB.
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Affiliation(s)
- Satoshi Hosoki
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan.,Department of Neurology, Keio University School of Medicine, Tokyo, Japan (S.H., J.N., N.S., K.T.)
| | - Satoshi Saito
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan.,Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan (S.S., R.N., K.N.).,Faculty of Medicine, University of Southampton, United Kingdom (S.S., R.O.C.)
| | - Shuichi Tonomura
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan.,Department of Neurology, Graduate School of Medicine, Kyoto University, Japan (S.T.)
| | - Hiroyuki Ishiyama
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Yoshimoto
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shuhei Ikeda
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hajime Ikenouchi
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yumi Yamamoto
- Department of Molecular Innovation in Lipidemiology (Y.Y.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yorito Hattori
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kaori Miwa
- Department of Cerebrovascular Medicine (K.M., M.K., K.T.), National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Roxana O Carare
- Faculty of Medicine, University of Southampton, United Kingdom (S.S., R.O.C.)
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan (S.H., J.N., N.S., K.T.)
| | - Norihiro Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan (S.H., J.N., N.S., K.T.)
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine (K.M., M.K., K.T.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine (K.M., M.K., K.T.), National Cerebral and Cardiovascular Center, Suita, Japan.,Department of Neurology, Keio University School of Medicine, Tokyo, Japan (S.H., J.N., N.S., K.T.)
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan (S.S., R.N., K.N.)
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan (S.S., R.N., K.N.)
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology (M.T.), National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masafumi Ihara
- Department of Neurology (S.H., S.S., S.T., H. Ishiyama, T.Y., S.I., H. Ikenouchi, Y.H., M.I.), National Cerebral and Cardiovascular Center, Suita, Japan
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Nomura R, Otsugu M, Hamada M, Matayoshi S, Teramoto N, Iwashita N, Naka S, Matsumoto-Nakano M, Nakano K. Potential involvement of Streptococcus mutans possessing collagen binding protein Cnm in infective endocarditis. Sci Rep 2020; 10:19118. [PMID: 33154489 PMCID: PMC7645802 DOI: 10.1038/s41598-020-75933-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022] Open
Abstract
Streptococcus mutans, a significant contributor to dental caries, is occasionally isolated from the blood of patients with infective endocarditis. We previously showed that S. mutans strains expressing collagen-binding protein (Cnm) are present in the oral cavity of approximately 10-20% of humans and that they can effectively invade human umbilical vein endothelial cells (HUVECs). Here, we investigated the potential molecular mechanisms of HUVEC invasion by Cnm-positive S. mutans. The ability of Cnm-positive S. mutans to invade HUVECs was significantly increased by the presence of serum, purified type IV collagen, and fibrinogen (p < 0.001). Microarray analyses of HUVECs infected by Cnm-positive or -negative S. mutans strains identified several transcripts that were differentially upregulated during invasion, including those encoding the small G protein regulatory proteins ARHGEF38 and ARHGAP9. Upregulation of these proteins occurred during invasion only in the presence of serum. Knockdown of ARHGEF38 strongly reduced HUVEC invasion by Cnm-positive S. mutans. In a rat model of infective endocarditis, cardiac endothelial cell damage was more prominent following infection with a Cnm-positive strain compared with a Cnm-negative strain. These results suggest that the type IV collagen-Cnm-ARHGEF38 pathway may play a crucial role in the pathogenesis of infective endocarditis.
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Affiliation(s)
- Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Masatoshi Otsugu
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Masakazu Hamada
- Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | | | - Naoki Iwashita
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
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Nomura R, Yamazaki F, Egawa Y. Syphilitic aortitis: chronic left coronary ostial occlusion and aortic regurgitation with aortitis. Gen Thorac Cardiovasc Surg 2020; 69:736-739. [PMID: 33098530 DOI: 10.1007/s11748-020-01523-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/12/2020] [Indexed: 12/15/2022]
Abstract
Before the discovery of penicillin, tertiary syphilis was the most common cause of thoracic aneurysms, but now cardiovascular syphilis is a clinical rarity in developed countries. We report a case of 69-year-old man who presented with sudden onset breathlessness that worsened insidiously for 2 months. Diagnosis of syphilitic aortitis was confirmed by laboratory findings, contrast computed tomography, echocardiography and coronary angiography. The patient underwent successful coronary artery bypass graft, aortic valve replacement and ascending aortic replacement. A high level of suspicion and awareness is needed for the diagnosis of the now rare disease.
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Affiliation(s)
- Ryota Nomura
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, 10-93 Otemachi, Aoi-ku, Shizuoka, 420-8630, Japan.
| | - Fumio Yamazaki
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, 10-93 Otemachi, Aoi-ku, Shizuoka, 420-8630, Japan
| | - Yuki Egawa
- Department of Pathology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
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Inaba H, Yoshida S, Nomura R, Kato Y, Asai F, Nakano K, Matsumoto-Nakano M. Porphyromonas gulae lipopolysaccharide elicits inflammatory responses through toll-like receptor 2 and 4 in human gingivalis epithelial cells. Cell Microbiol 2020; 22:e13254. [PMID: 32827217 DOI: 10.1111/cmi.13254] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/16/2019] [Revised: 07/12/2020] [Accepted: 07/13/2020] [Indexed: 12/29/2022]
Abstract
Porphyromonas gulae, a Gram-negative black-pigmented anaerobe, has been associated with periodontal disease in companion animals and its virulence has been attributed to various factors, including lipopolysaccharide (LPS), protease and fimbriae. Toll-like receptors (TLRs) recognise pathogen-associated molecular patterns, such as peptidoglycan, lipids, lipoproteins, nucleic acid and LPS. Following P. gulae infection, some inflammatory responses are dependent on both TLR2 and TLR4. In addition, a recent clinical study revealed that acute and persistent inflammatory responses enhance the expressions of TLR2 and TLR4 in the oral cavity. In this study, we investigated the interaction between P. gulae LPS and human gingivalis epithelial cells (Ca9-22 cells). P. gulae LPS was found to increase TLR2 and TLR4 mRNA expressions and protein productions, and enhanced inflammatory responses, such as COX2 , TNF-ɑ, IL-6 and IL-8. Stimulated Ca9-22 cells exhibited phosphorylation of ERK1/2 and p38, and their inhibitors diminished inflammatory responses, while knockdown of the TLR2 and/or TLR4 genes with small interfering RNA (siRNA) prevented inflammatory responses. Moreover, p38 and ERK1/2 phosphorylation was decreased in TLR2 and TLR4 gene knockdown cells. These findings suggest that P. gulae LPS activates p38 and ERK1/2 via TLR2 and TLR4, leading to inflammatory responses in human gingival epithelial cells.
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Affiliation(s)
- Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Sho Yoshida
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yukio Kato
- Department of Veterinary Public Health II, School of Veterinary Medicine, Azabu University, Sagamihara, Japan
| | - Fumitoshi Asai
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Naka S, Wato K, Misaki T, Ito S, Nagasawa Y, Nomura R, Matsumoto-Nakano M, Nakano K. Intravenous administration of Streptococcus mutans induces IgA nephropathy-like lesions. Clin Exp Nephrol 2020; 24:1122-1131. [PMID: 32909181 PMCID: PMC7599197 DOI: 10.1007/s10157-020-01961-1] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
Background IgA nephropathy (IgAN) is one of the most frequently occurring types of chronic glomerulonephritis. Previous analyses have revealed that a major pathogen of dental caries, Streptococcus mutans [which expresses collagen-binding protein (Cnm) on its surface], is involved in the pathogenesis of IgAN. Methods Cnm-positive S. mutans isolated from a patient with IgAN was intravenously administered to specific pathogen-free Sprague–Dawley rats to evaluate their kidney conditions. Results The urinary protein level of the S. mutans group reached a plateau at 30 days, with increased numbers of mesangial cells and an increased mesangial matrix. The numbers of rats with IgA-positive and/or C3-positive glomeruli were significantly greater in the S. mutans group than in the control group at 45 days (P < 0.05). Electron microscopy analyses revealed electron-dense depositions in the mesangial area among rats in the S. mutans group. There were significantly more CD68-positive cells (macrophages) in the glomeruli of the S. mutans group than in the glomeruli of the control group during the late phase (P < 0.05), similar to the findings in patients with IgAN. Conclusion Our results suggested that intravenous administration of Cnm-positive S. mutans caused transient induction of IgAN-like lesions in rats.
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Affiliation(s)
- Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Kaoruko Wato
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Taro Misaki
- Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.,Department of Nursing, Faculty of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan
| | - Seigo Ito
- Department of Nephrology and Endocrinology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yasuyuki Nagasawa
- Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Ryota Nomura
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Kazuhiko Nakano
- Division of Oral Infection and Disease Control, Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
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