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Tsuji Y, Koga T, Nonaka F, Nobusue K, Kawashiri SY, Yamanashi H, Maeda T, Arima K, Aoyagi K, Takahashi M, Kawaguchi S, Matsuda F, Fujii H, Kawano M, Nakamura H, Kawakami A, Tamai M. Identification of risk factors for elevated serum IgG4 levels in subjects in a large-scale health checkup cohort study. Front Immunol 2023; 14:1124417. [PMID: 36969256 PMCID: PMC10031005 DOI: 10.3389/fimmu.2023.1124417] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/27/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction To allow the identification of IgG4-related disease (IgG4-RD) from a subclinical phase as it is important to understand the risk of elevated serum IgG4 levels. We planned to evaluate serum IgG4 levels in the participants of the Nagasaki Islands Study (NaIS), a large-scale health checkup cohort study. Methods This study included 3,240 individuals who participated in the NaIS between 2016 and 2018 and consented to participate in the study. Serum IgG4, IgG, and IgE levels and human leukocyte antigen (HLA) genotyping results of the NaIS subjects as well as lifestyle habits and peripheral blood test results were analyzed. The magnetic bead panel assay (MBA) and the standard nephelometry immunoassay (NIA) were used to measure serum IgG4 levels. The data were evaluated using multivariate analysis to identify lifestyle and genetic factors associated with elevated serum IgG4 levels. Results Serum IgG4 levels measured with the NIA and MBA showed a tight positive correlation between the two groups (correlation coefficient 0.942). The median age of the participants in the NaIS was 69 years [63-77]. The median serum IgG4 level was 30.2 mg/dL [IQR 12.5-59.8]. Overall, 1019 (32.1%) patients had a history of smoking. When the subjects were stratified into three groups based on the smoking intensity (pack-year), the serum IgG4 level was significantly higher among those with a higher smoking intensity. Accordingly, the multivariate analysis identified a significant relationship between smoking status and serum IgG4 elevation. Conclusion In this study, smoking was identified as a lifestyle factor correlating positively with elevated serum IgG4 levels.
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Affiliation(s)
- Yoshika Tsuji
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- Center for Bioinformatics and Molecular Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- *Correspondence: Mami Tamai, ; Tomohiro Koga,
| | - Fumiaki Nonaka
- Department of Island and Community Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Kenichi Nobusue
- Department of Island and Community Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Department of Community Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of General Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Takahiro Maeda
- Department of General Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Kazuhiko Arima
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Meiko Takahashi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan
| | - Shuji Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan
| | - Hiroshi Fujii
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Mitsuhiro Kawano
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Nagasaki, Japan
- *Correspondence: Mami Tamai, ; Tomohiro Koga,
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Shimizu T, Kawashiri SY, Sato S, Kawazoe Y, Kuroda S, Kawasaki R, Ito Y, Morimoto S, Yamamoto H, Kawakami A. Discontinuation of methotrexate in rheumatoid arthritis patients achieving clinical remission by treatment with upadacitinib plus methotrexate (DOPPLER study): A study protocol for an interventional, multicenter, open-label and single-arm clinical trial with clinical, ultrasound and biomarker assessments. Medicine (Baltimore) 2022; 101:e28463. [PMID: 35029189 PMCID: PMC8758021 DOI: 10.1097/md.0000000000028463] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The administration of Janus kinase inhibitors as well as biological disease-modifying anti-rheumatic drugs has dramatically improved the clinical outcomes of patients with rheumatoid arthritis (RA). Previous trials have shown that upadacitinib, a Janus kinase inhibitor, can effectively improve disease activity and prevent progression of joint destruction in RA patients with inadequate responses to methotrexate (MTX). It remains unclear whether reduced disease activity can be maintained after discontinuation of MTX in patients treated with upadacitinib plus MTX. Thus, the aim of this study is to evaluate changes in disease activity after administration of upadacitinib plus MTX in RA patients who failed to achieve an adequate response to MTX and to determine whether clinical relapse can be avoided after discontinuation of MTX in those who achieved clinical remission. METHODS/DESIGN The proposed study is an interventional, multicenter, open-label, single-arm clinical trial with a 48-week follow-up. The cohort will include 155 RA patients with at least moderate disease activity during treatment with MTX. Patients will receive upadacitinib and MTX will be discontinued for those who achieve clinical remission. Disease activity will be evaluated longitudinally by measuring clinical disease activity indices and with musculoskeletal ultrasound (MSUS). The primary endpoint is the proportion of patients who sustain a disease activity score-28- C reactive protein score of ≤3.2 from week 24 to 48 after a disease activity score-28- C reactive protein score of <2.6 at week 24. Important secondary endpoints are changes from baseline MSUS scores. Serum levels of multiple biomarkers, including cytokines and chemokines, will be comprehensively analyzed. DISCUSSION The study results are expected to show the clinical benefit of the discontinuation of MTX after achieving clinical remission by treatment with upadacitinib plus MTX combination therapy. The strength of this study is the prospective evaluation of therapeutic efficacy using clinical disease activity indices and standardized MSUS, which can accurately and objectively evaluate disease activity at the joint level among patients drawn from multiple centers. Furthermore, parameters to predict clinical remission after administration of upadacitinib plus MTX combination therapy and nonclinical relapse after discontinuation of MTX will be screened by integrated multilateral assessments (i.e., clinical disease activity indices, MSUS findings, and serum biomarkers).
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Affiliation(s)
- Toshimasa Shimizu
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Community Medicine and, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Yurika Kawazoe
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Shohei Kuroda
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Rina Kawasaki
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasuko Ito
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Yamamoto
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Atsushi Kawakami
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Innovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Iwamoto N, Chiba K, Sato S, Shiraishi K, Watanabe K, Oki N, Okada A, Koga T, Kawashiri SY, Tamai M, Hosogaya N, Furuyama M, Kobayashi M, Saito K, Okubo N, Uetani M, Osaki M, Kawakami A. Inhibition of bone erosion, determined by high-resolution peripheral quantitative computed tomography (HR-pQCT), in rheumatoid arthritis patients receiving a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) plus denosumab vs csDMARD therapy alone: an open-label, randomized, parallel-group study. Arthritis Res Ther 2022; 24:264. [PMID: 36476479 PMCID: PMC9727996 DOI: 10.1186/s13075-022-02957-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This exploratory study compared the inhibition of bone erosion progression in rheumatoid arthritis (RA) patients treated with a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) plus denosumab versus csDMARD therapy alone and investigated the effects of denosumab on bone micro-architecture and other bone-related parameters using high-resolution peripheral quantitative computed tomography (HR-pQCT). METHODS In this open-label, randomized, parallel-group study, patients with RA undergoing treatment with a csDMARD were randomly assigned (1:1) to continue csDMARD therapy alone or to continue csDMARDs with denosumab (60-mg subcutaneous injection once every 6 months) for 12 months. The primary endpoint was the change from baseline in the depth of bone erosion, measured by HR-pQCT, in the second and third metacarpal heads at 6 months after starting treatment. Exploratory endpoints were also evaluated, and adverse events (AEs) were monitored for safety. RESULTS In total, 46 patients were enrolled, and 43 were included in the full analysis set (csDMARDs plus denosumab, N = 21; csDMARD therapy alone, N = 22). Most patients were female (88.4%), and the mean age was 65.3 years. The adjusted mean (95% confidence interval) change from baseline in the depth of bone erosion, measured by HR-pQCT, in the 2-3 metacarpal heads at 6 months was - 0.57 mm (- 1.52, 0.39 mm) in the csDMARDs plus denosumab group vs - 0.22 mm (- 0.97, 0.53 mm) in the csDMARD therapy alone group (between-group difference: - 0.35 mm [- 1.00, 0.31]; P = 0.2716). Similar results were shown for the adjusted mean between-group difference in the width and volume of bone erosion of the 2-3 metacarpal heads. Significant improvements in bone micro-architecture parameters were shown. The incidence of AEs and serious AEs was similar between the csDMARDs plus denosumab and the csDMARD therapy alone groups (AEs: 52.2% vs 56.5%; serious AEs: 4.3% vs 8.7%). CONCLUSIONS Although the addition of denosumab to csDMARDs did not find statistically significant improvements in bone erosion after 6 months of treatment, numerical improvements in these parameters suggest that the addition of denosumab to csDMARDs may be effective in inhibiting the progression of bone erosion and improving bone micro-architecture. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry, UMIN000030575. Japan Registry for Clinical Trials, jRCTs071180018.
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Affiliation(s)
- Naoki Iwamoto
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Ko Chiba
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shuntaro Sato
- grid.411873.80000 0004 0616 1585Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kazuteru Shiraishi
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kounosuke Watanabe
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Nozomi Oki
- grid.174567.60000 0000 8902 2273Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Akitomo Okada
- grid.415640.2Department of Rheumatology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562 Japan
| | - Tomohiro Koga
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shin-ya Kawashiri
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan ,grid.174567.60000 0000 8902 2273Departments of Community Medicine, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Mami Tamai
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Naoki Hosogaya
- grid.411873.80000 0004 0616 1585Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Masako Furuyama
- Department of Rheumatology, Nagasaki Kita Hospital, 800 Motomurago, Nishisonogigun Togitsucho, Nagasaki, 851-2103 Japan
| | - Makiko Kobayashi
- grid.410844.d0000 0004 4911 4738Primary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd, 3-5-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8426 Japan
| | - Kengo Saito
- grid.410844.d0000 0004 4911 4738Primary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd, 3-5-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8426 Japan
| | - Naoki Okubo
- grid.410844.d0000 0004 4911 4738Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co., Ltd, 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710 Japan
| | - Masataka Uetani
- grid.174567.60000 0000 8902 2273Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Makoto Osaki
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Atsushi Kawakami
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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Iwamoto N, Furukawa K, Endo Y, Shimizu T, Sumiyoshi R, Umeda M, Koga T, Kawashiri SY, Igawa T, Ichinose K, Tamai M, Origuchi T, Kawakami A. Methotrexate Alters the Expression of microRNA in Fibroblast-like Synovial Cells in Rheumatoid Arthritis. Int J Mol Sci 2021; 22:ijms222111561. [PMID: 34768991 PMCID: PMC8584010 DOI: 10.3390/ijms222111561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 12/15/2022] Open
Abstract
We aimed to investigate the effect of methotrexate (MTX) on microRNA modulation in rheumatoid arthritis fibroblast-like synovial cells (RA-FLS). RA-FLS were treated with MTX for 48 h. We then performed miRNA array analysis to investigate differentially expressed miRNAs. Transfection with miR-877-3p precursor and inhibitor were used to investigate the functional role of miR-877-3p in RA-FLS. Gene ontology analysis was used to investigate the cellular processes involving miR-877-3p. The production of cytokines/chemokines was screened by multiplex cytokine/chemokine bead assay and confirmed by ELISA and quantitative real-time PCR. The migratory and proliferative activities of RA-FLS were analyzed by wound healing assay and MKI-67 expression. MTX treatment altered the expression of 13 miRNAs (seven were upregulated and six were downregulated). Among them, quantitative real-time PCR confirmed that miR-877-3p was upregulated in response to MTX (1.79 ± 0.46-fold, p < 0.05). The possible target genes of miR-877-3p in RA-FLS revealed by the microarray analysis were correlated with biological processes. The overexpression of miR-877-3p decreased the production of GM-CSF and CCL3, and the overexpression of miR-877-3p inhibited migratory and proliferative activity. MTX altered the miR-877-3p expression on RA-FLS, and this alteration of miR-877-3p attenuated the abundant production of cytokines/chemokines and proliferative property of RA-FLS.
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Affiliation(s)
- Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
- Correspondence: ; Tel.: +81-95-819-7260; Fax: +81-95-849-7270
| | - Kaori Furukawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Yushiro Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
- Center for Bioinformatics and Molecular Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
- Division of Advanced Preventive Medical Sciences, Department of Community Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Mami Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
| | - Tomoki Origuchi
- Department of Physical Therapy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan;
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan; (K.F.); (Y.E.); (T.S.); (R.S.); (M.U.); (T.K.); (S.-y.K.); (T.I.); (K.I.); (M.T.); (A.K.)
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Endo Y, Kawashiri SY, Morimoto S, Nishino A, Okamoto M, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Koga T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Otsubo H, Takaoka H, Hamada H, Tsuru T, Nagano S, Yojiro A, Hidaka T, Tada Y, Kawakami A. Utility of a simplified ultrasonography scoring system among patients with rheumatoid arthritis: A multicenter cohort study. Medicine (Baltimore) 2021; 100:e23254. [PMID: 33429728 PMCID: PMC7793436 DOI: 10.1097/md.0000000000023254] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/21/2020] [Indexed: 01/05/2023] Open
Abstract
We aimed to evaluate the utility of a simplified ultrasonography (US) scoring system, which is desired in daily clinical practice, among patients with rheumatoid arthritis (RA) receiving biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs).A total of 289 Japanese patients with RA who were started on tumor necrosis factor inhibitors, abatacept, tocilizumab, or Janus kinase inhibitors between June 2013 and April 2019 at one of the 15 participating rheumatology centers were reviewed. We performed US assessment of articular synovia over 22 joints among bilateral wrist and finger joints, and the 22-joint (22j)-GS and 22-joint (22j)-PD scores were evaluated as an indicator of US activity using the sum of the GS and PD scores, respectively.The top 6 most affected joints included the bilateral wrist and second/third metacarpophalangeal joints. Therefore, 6-joint (6j)-GS and -PD scores were defined as the sum of the GS and PD scores from the 6 synovial sites over the aforementioned 6 joints, respectively. Although the 22j- or 6j-US scores were significantly correlated with DAS28-ESR or -CRP scores, the correlations were weak. Conversely, 6j-US scores were significantly and strongly correlated with 22j-US scores not only at baseline but also after therapy initiation.Using a multicenter cohort data, our results indicated that a simplified US scoring system could be adequately tolerated during any disease course among patients with RA receiving biological/targeted synthetic DMARDs.
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Affiliation(s)
- Yushiro Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Momoko Okamoto
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Sosuke Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Ayuko Takatani
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Mami Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
| | - Yukitaka Ueki
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Tamami Yoshitama
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Nobutaka Eiraku
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Naoki Matsuoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Akitomo Okada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Keita Fujikawa
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Hideo Otsubo
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Hirokazu Takaoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Hiroaki Hamada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Tomomi Tsuru
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Shuji Nagano
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Arinobu Yojiro
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Toshihiko Hidaka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Yoshifumi Tada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Japan
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Kawashiri SY, Shimizu T, Sato S, Morimoto S, Kawazoe Y, Sumiyoshi R, Hosogaya N, Fukushima C, Yamamoto H, Kawakami A. Switching from originator infliximab to biosimilar infliximab in Japanese patients with rheumatoid arthritis achieving clinical remission (the IFX-SIRIUS study I): Study protocol for an interventional, multicenter, open-label, single-arm and noninferiority clinical trial with clinical, ultrasound, and biomarker assessments. Medicine (Baltimore) 2020; 99:e21151. [PMID: 32791688 PMCID: PMC7387067 DOI: 10.1097/md.0000000000021151] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) into clinical practice has dramatically improve the clinical outcomes of individuals with rheumatoid arthritis (RA). However, bDMARDs are associated with high costs, which has resulted in restricted treatment access and a burden on medical insurance finances. Although biosimilars offer cost-saving, their effectiveness and safety must be established in Post-Marketing Surveillance (PMS). Infliximab (IFX), a chimeric monoclonal antibody to TNF-alpha, is the first bDMARD; its biosimilar, CT-P13, is the first biosimilar DMARD approved for RA treatment in Japan. We will evaluate whether switching from originator IFX to CT-P13 is not inferior for maintaining non-clinical relapse to continued treatment with originator IFX in RA patients achieving clinical remission. METHODS/DESIGN This study is an interventional, multicenter, open-label, single-arm against historical control and noninferiority clinical trial with a 24-week follow-up. Eighty RA patients who are treated by originator IFX for ≥24 weeks and are achieving clinical remission will be included. Patients will be switched to CT-P13 with the unchanged dosing regimen. We will evaluate disease activity by measuring clinical disease activity indices and by using musculoskeletal ultrasound (MSUS). The primary endpoint is the ratio of patients who experience a nonclinical relapse during the study period. Important secondary endpoints are the changes from the baseline of the MSUS scores. We will also comprehensively analyze the serum levels of many biomarkers such as cytokines and chemokines. DISCUSSION The study results are expected to show the noninferiority of switching to CT-P13 over the continuation of originator IFX. The strength of this study is its prospective evaluation of therapeutic efficacy using not only clinical disease activity indices but also MSUS to accurately and objectively evaluate disease activity at the joint level among patients drawn from multiple centers with a standardized evaluation by MSUS. We will explore whether parameters at baseline can predict a nonclinical relapse after switching from originator IFX to CT-P13 by integrating multilateral assessments, i.e., clinical disease activity indices, MSUS findings, and serum biomarkers. TRIAL REGISTRATION This study was registered in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp) on October 11, 2019 as jRCTs071190030.
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Affiliation(s)
- Shin-ya Kawashiri
- Departments of1Community Medicine
- Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Toshimasa Shimizu
- Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
- Clinical Research Center, Nagasaki University Hospital
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Remi Sumiyoshi
- Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
- Clinical Research Center, Nagasaki University Hospital
| | | | | | | | - Atsushi Kawakami
- Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
- Innovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Endo Y, Kawashiri SY, Morimoto S, Nishino A, Okamoto M, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Koga T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Hamada H, Tsuru T, Nagano S, Arinobu Y, Hidaka T, Tada Y, Kawakami A. Non-TNF inhibitor switchers versus TNF inhibitor cyclers from multicentre rheumatoid arthritis ultrasonography prospective cohort in Japan. Immunol Med 2020; 43:115-120. [DOI: 10.1080/25785826.2020.1757920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Yushiro Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Momoko Okamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Sosuke Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Ayuko Takatani
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Yukitaka Ueki
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Tamami Yoshitama
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Nobutaka Eiraku
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Naoki Matsuoka
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Akitomo Okada
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Keita Fujikawa
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Hiroaki Hamada
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Tomomi Tsuru
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Shuji Nagano
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Yojiro Arinobu
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Toshihiko Hidaka
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Yoshifumi Tada
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
- Kyushu multicenter rheumatoid arthritis ultrasound prospective observational cohort study group, Japan
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Nakane S, Umeda M, Kawashiri SY, Mukaino A, Ichinose K, Higuchi O, Maeda Y, Nakamura H, Matsuo H, Kawakami A. Detecting gastrointestinal manifestations in patients with systemic sclerosis using anti-gAChR antibodies. Arthritis Res Ther 2020; 22:32. [PMID: 32085768 PMCID: PMC7035754 DOI: 10.1186/s13075-020-2128-z] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/12/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patients with systemic sclerosis (SSc) complicated by gastrointestinal dysmotility are difficult to treat and have high mortality. To clarify the pathogenesis of gastrointestinal manifestations, we aimed to demonstrate the association among the clinical features of SSc, the serological markers, the autoantibodies against nicotinic acetylcholine receptor at autonomic ganglia (gAChR). METHODS Fifty patients were enrolled and divided into two groups according to the presence or absence of gastrointestinal manifestations, and the characteristics were analyzed between these two groups. We measured biomarkers and the autoantibodies against two gAChRα3 and β4 subunits to test sera samples. Furthermore, patients were classified based on the presence or absence of anti-gAChR autoantibodies, and their clinical features were compared. RESULTS In patients with SSc and gastrointestinal manifestations, digital ulcers were more frequent (p = 0.050) and VEGF expression was significantly higher (p = 0.038). Seven subjects with SSc were seropositive for α3 subunit, whereas one patient was seropositive for β4 subunit. The mean level of anti-gAChRα3 autoantibodies in SSc patients with gastrointestinal manifestations was significantly higher than that in SSc patients without gastrointestinal manifestations (p = 0.001). The group of patients with SSc and gAChR autoantibodies had significantly higher endostatin levels (p = 0.046). CONCLUSIONS This study is the first to demonstrate that clinical characteristics of SSc patients with seropositivity for gAChR autoantibodies. Patients with SSc have circulating autoantibodies against gAChR, which may contribute to gastrointestinal manifestations associated with this disease, suggesting that gAChR-mediated autonomic neurotransmission may provide a pathomechanism for gastrointestinal dysmotility in SSc.
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Affiliation(s)
- Shunya Nakane
- Department of Neuroimmunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Clinical Research, Nagasaki Kawatana Medical Center, Nagasaki, Japan
- Department of Neurology, Nagasaki Kawatana Medical Center, Nagasaki, Japan
- Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, 1-1-1, Honjo, Chuouku, Kumamoto-shi, Kumamoto, 860-8556 Japan
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Akihiro Mukaino
- Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, 1-1-1, Honjo, Chuouku, Kumamoto-shi, Kumamoto, 860-8556 Japan
- Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Osamu Higuchi
- Department of Clinical Research, Nagasaki Kawatana Medical Center, Nagasaki, Japan
| | - Yasuhiro Maeda
- Department of Neuroimmunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Clinical Research, Nagasaki Kawatana Medical Center, Nagasaki, Japan
- Department of Neurology, Nagasaki Kawatana Medical Center, Nagasaki, Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hidenori Matsuo
- Department of Neurology, Nagasaki Kawatana Medical Center, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Endo Y, Kawashiri SY, Koga T, Okamoto M, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Kawakami A. Reactive arthritis induced by active extra-articular tuberculosis: A case report. Medicine (Baltimore) 2019; 98:e18008. [PMID: 31804308 PMCID: PMC6919392 DOI: 10.1097/md.0000000000018008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Rare cases of reactive arthritis induced by active extra-articular tuberculosis (Poncet disease) have been reported. Complete response to antitubercular treatment and evidence of active extra-articular tuberculosis are the most important clinical features of Poncet disease. We report the case of successfully treated a patient with reactive arthritis induced by active extra-articular tuberculosis with a TNF inhibitor after sufficient antitubercular treatment. PATIENT CONCERNS A 56-year-old Japanese man was admitted to our department with polyarthralgia, low back pain, and high fever. The results of rheumatoid factor, anti-citrullinated protein antibody, human leukocyte antigen B27, and the assays for the detection of infections (with an exception of T-SPOT.TB) were all negative. Fluoro-deoxy-D-glucose-positron emission tomography with CT (PET/CT) showed moderate uptake in the right cervical, right supraclavicular, mediastinal, and abdominal lymph nodes. As magnetic resonance imaging and power Doppler ultrasonography showed peripheral inflammation (tendinitis, tenosynovitis, ligamentitis, and enthesitis in the limbs). DIAGNOSIS A diagnosis of tuberculous lymphadenitis was eventually established on the basis of lymph node biopsy results. There was no evidence of a bacterial infection including acid-fast bacteria in his joints, and the symptoms of polyarthralgia and low back pain were improved but not completely resolved with NSAID therapy; in addition, a diagnosis of reactive arthritis induced by active extraarticular tuberculosis was made. INTERVENTIONS The patient experienced persistent peripheral inflammation despite antitubercular treatment for more than nine months and was then successfully treated with a tumor necrosis factor inhibitor (adalimumab 40 mg every 2 weeks). OUTCOMES Finally, the patient responded to the treatment and has been in remission for over 4 months as of this writing. LESSONS In patients who present with symptoms associated with spondyloarthritis, it is important to distinguish between classic reactive arthritis and reactive arthritis induced by extra-articular tuberculosis infection. Introduction of biological agents should be carefully considered in settings where reactive arthritis induced by active extra-articular tuberculosis shows progression to chronicity despite sufficient antitubercular treatment.
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Sumiyoshi R, Koga T, Tsuji S, Endo Y, Takatani A, Shimizu T, Igawa T, Umeda M, Fukui S, Nishino A, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Kawakami A. Chlamydia-induced reactive arthritis diagnosed during gout flares: A case report and cumulative effect of inflammatory cytokines on chronic arthritis. Medicine (Baltimore) 2019; 98:e17233. [PMID: 31577714 PMCID: PMC6783181 DOI: 10.1097/md.0000000000017233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
RATIONALE The pathology of gouty arthritis and reactive arthritis (ReA) partially overlaps, and both diseases are characterized by the production of inflammatory cytokines associated with the activation of monocytes and macrophages. However, the precise cytokine profile of cases with a coexistence of both diseases is unknown, and there are few reports on the course of treatment in patients with both gouty arthritis and ReA. PATIENT CONCERNS A 39-year-old man with a recurrent episode of gouty arthritis presented prednisolone-resistant polyarthritis with high level of C-reactive protein (CRP). He had the features of gouty arthritis such as active synovitis of the first manifestation of metatarsophalangeal (MTP) joints and the presence of monosodium urate (MSU) crystals from synovial fluid. But he also had the features of ReA such as the presence of tenosynovitis in the upper limb, the positivity of human leukocyte antigen (HLA)-B27, a history of sexual contact and positive findings of anti-Chlamydia trachomatis-specific IgA and IgG serum antibodies. DIAGNOSES He was diagnosed with HLA-B27 associated Chlamydia-induced ReA accompanied by gout flares. INTERVENTIONS He was treated with 180 mg/day of loxoprofen, 1 mg/day of colchicine, and 10 mg/day of prednisolone for gout flares. However, his polyarthritis worsened with an increased level of CRP (23.16 mg/dL). Accordingly, we added 500 mg/day of salazosulfapyridine followed by adalimumab (ADA) 40 mg once every 2 weeks. OUTCOMES After starting ADA, the patient's symptoms and laboratory findings showed rapid improvement and he achieved clinical remission 1 month after initiation of ADA treatment. As of this writing, the patient's clinical remission has been maintained for >1 year. LESSONS This case suggests that with exacerbation of arthritis during gouty arthritis, coexistence with other pathologies such as peripheral spondyloarthritis should be considered, and early intensive treatment including tumor necrosis factor inhibitors may be necessary.
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Affiliation(s)
- Remi Sumiyoshi
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Tomohiro Koga
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
- Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Sosuke Tsuji
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Yushiro Endo
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Ayuko Takatani
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Toshimasa Shimizu
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Takashi Igawa
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Masataka Umeda
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
- Medical Education Development Center, Nagasaki University Hospital
| | - Shoichi Fukui
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Ayako Nishino
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
- Center for Comprehensive Community Care Education
| | - Shin-ya Kawashiri
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
- Department of Community Medicine, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Iwamoto
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Kunihiro Ichinose
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Mami Tamai
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Hideki Nakamura
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Tomoki Origuchi
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
| | - Atsushi Kawakami
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology
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Otsuka M, Koga T, Sumiyoshi R, Okamoto M, Endo Y, Tsuji S, Takatani A, Shimizu T, Igawa T, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Daisuke N, Kawakami A. Rheumatoid arthritis-like active synovitis with T-cell activation in a case of idiopathic multicentric Castleman disease: A case report. Medicine (Baltimore) 2019; 98:e15237. [PMID: 31045763 PMCID: PMC6504261 DOI: 10.1097/md.0000000000015237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
RATIONALE Idiopathic multicentric Castleman disease (iMCD) is a systemic disease with multiple regions of lymphadenopathy and systemic symptoms and associated with rheumatoid arthritis (RA) and collagen diseases. However, few reported have described the coexistence of iMCD and RA and the mechanisms by which iMCD induces arthritis remain elusive. We experienced a rare case of iMCD, wherein the patient exhibited symptoms of polyarthritis with high-grade fever. PATIENT CONCERNS A 34-year-old woman was admitted to our hospital for further evaluation of a high fever with polyarthritis. The levels of both rheumatoid factor and anticitrullinated protein antibody were negative. F-fluorodeoxyglucose/positron emission tomography-computed tomography showed lymphadenopathy with increased fluoro-2-deoxy-D-glucose uptake. Magnetic resonance imaging and musculoskeletal ultrasonography revealed active synovitis in the hands which was consistent with RA. DIAGNOSES We diagnosed iMCD based on human herpesvirus 8 negativity, HIV negativity, systemic lymphadenopathy, and pathologic findings of the lymph nodes. The patient did not satisfy the 2010 American College of Rheumatology and European League Against Rheumatism classification criteria for RA. Cytokine assay showed elevated serum levels of interleukin-17 and CXCL10, comparable to those in patients with RA. INTERVENTIONS We administered 15 mg/d of predonisolone. OUTCOMES After this treatment, the patient's symptoms showed improvement. As of this writing, we tapered the prednisolone to 7.5 mg/d, and the patient's remission has been maintained for >4 months. LESSONS The present case suggests that RA-like active synovitis may coexist in iMCD, resulting from aberrant T-cell activation and histologic examination using lymph node biopsy may help enable early diagnosis of iMCD.
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Affiliation(s)
- Mizuna Otsuka
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
- Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Momoko Okamoto
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Yushiro Endo
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Sosuke Tsuji
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Ayuko Takatani
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Mami Tamai
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Niino Daisuke
- Nagasaki Educational and Diagnostic Center of Pathology, Nagasaki University Hospital, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
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Endo Y, Koga T, Eguchi M, Okamoto M, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Kawakami A. Utility of power Doppler ultrasonography for detecting forefoot bursae in early rheumatoid arthritis: A case report. Medicine (Baltimore) 2018; 97:e13295. [PMID: 30572433 PMCID: PMC6320102 DOI: 10.1097/md.0000000000013295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Power Doppler ultrasonography (PDUS) in musculoskeletal ultrasound (MSUS) is a sensitive and reliable method for the assessment of rheumatoid arthritis (RA). The association between ultrasound-detectable forefoot bursae and the development of RA has gained attention. However, a few studies have evaluated the utility of PDUS for examining forefoot bursae in early RA. We report the case of an RA patient who developed reduced foot mobility and had detectable intermetatarsal bursitis with remarkable power Doppler (PD) signals in MSUS at the onset of RA. PATIENT CONCERNS A 40-year-old Japanese woman diagnosed with palindromic rheumatism visited our department due to sustained forefoot pain and difficulty walking. The levels of both rheumatoid factor (RF) and anticitrullinated protein antibody (ACPA) were high. She had opening toes with swelling in metatarsophalangeal (MTP) joints. PDUS showed intermetatarsal bursitis with mild MTP synovitis. DIAGNOSES We diagnosed RA by comprehensive judgment based on the 2010 American College of Rheumatology and European League Against Rheumatism classification criteria for RA. INTERVENTIONS We administered 6.0 mg/wk of methotrexate (MTX) and 2.0 mg/d of prednisolone (PSL) followed by an increase of MTX to 10 mg/wk. OUTCOMES After those treatments, the patient's symptoms showed improvement. As of this writing, the patient's remission has been maintained for >2 months. LESSONS Her case suggests that PDUS is useful for the detection of forefoot bursitis, and the detection of forefoot bursitis by PDUS may provide the opportunity to make an early diagnosis of RA.
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Hara K, Endo Y, Ishida M, Fujita Y, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Umeda M, Fukui S, Nishino A, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Migita K, Kawakami A, Koga T. Subclinical inflammation in a case of menstruation-induced familial Mediterranean fever: A case report. Medicine (Baltimore) 2018; 97:e12305. [PMID: 30235678 PMCID: PMC6160243 DOI: 10.1097/md.0000000000012305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Because most patients with familial Mediterranean fever (FMF) have attacks without any prodromal symptoms, and since it is suggested that patients with FMF have subclinical inflammation even during remission, a daily continuous administration of colchicine is recommended for patients with FMF even during remission. However, it is possible that intermittent colchicine therapy only during FMF attacks prevents the attacks completely in patients with FMF with expectable attacks. PATIENT CONCERNS A 31-year-old Japanese woman suffered high fever and arthralgia lasting for 2 to 3 days after each menstrual period's start. She was admitted to our hospital, and colchicine was administered immediately after her next period's start, and the febrile attack was completely prevented. DIAGNOSES We eventually diagnosed typical FMF. INTERVENTIONS Her remission has been maintained by intermittent colchicine therapy. OUTCOMES The genetic analysis revealed the G304R heterozygous mutation in exon 2 of the MEFV gene. Cytokine analysis suggested subclinical inflammation during the remission period. LESSONS This case suggests that taking an extensive medical history (including the relationship between fever attack and menstruation) is important in the diagnosis of female patients with FMF. This case also suggests that a continuous administration of colchicine may have to be considered to regulate subclinical inflammation even in patients with FMF with completely expectable attacks.
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Affiliation(s)
- Kazusato Hara
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Yushiro Endo
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Midori Ishida
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Yuya Fujita
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Sosuke Tsuji
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Ayuko Takatani
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Shoichi Fukui
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Mami Tamai
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
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14
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Iwamoto N, Fukui S, Takatani A, Shimizu T, Umeda M, Nishino A, Igawa T, Koga T, Kawashiri SY, Ichinose K, Tmai M, Nakamura H, Origuchi T, Chiba K, Osaki M, Jüngel A, Gay S, Kawakami A. Osteogenic differentiation of fibroblast-like synovial cells in rheumatoid arthritis is induced by microRNA-218 through a ROBO/Slit pathway. Arthritis Res Ther 2018; 20:189. [PMID: 30157923 PMCID: PMC6116572 DOI: 10.1186/s13075-018-1703-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 11/30/2017] [Accepted: 08/16/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Fibroblast-like synovial cells (FLS) have multilineage differentiation potential including osteoblasts. We aimed to investigate the role of microRNAs during the osteogenic differentiation of rheumatoid arthritis (RA)-FLS. METHODS RA-FLS were differentiated in osteogenic medium for 21 days. Osteogenic differentiation was evaluated by alkaline phosphatase (ALP) staining and Alizarin Red staining. MicroRNA (miRNA) array analysis was performed to investigate the differentially expressed miRNAs during osteogenic differentiation. Expression of miR-218-5p (miR-218) during the osteogenic differentiation was determined by quantitative real-time PCR. Transfections with an miR-218 precursor and inhibitor were used to confirm the targets of miR-218 and to analyze the ability of miR-218 to induce osteogenic differentiation. Secreted Dickkopf-1 (DKK1) from FLS transfected with miR-218 precursor/inhibitor or roundabout 1 (ROBO1) knockdown FLS established using ROBO1-small interfering RNA (siRNA) were measured by ELISA. RESULTS The miRNA array revealed that 12 miRNAs were upregulated and 24 miRNAs were downregulated after osteogenic differentiation. We observed that the level of miR-218 rose in the early phase of osteogenic differentiation and then decreased. Pro-inflammatory cytokines modified the expression of miR-218. The induction of miR-218 in RA-FLS decreased ROBO1 expression, and promoted osteogenic differentiation. Both the overexpression of miR-218 and the knockdown of ROBO1 in RA-FLS decreased DKK1 secretion. CONCLUSION We identified miR-218 as a crucial inducer of the osteogenic differentiation of RA-FLS. MiR-218 modulates the osteogenic differentiation of RA-FLS through the ROBO1/DKK-1 axis. The induction of the osteogenic differentiation of proliferating RA-FLS through the provision of miR-218 into RA-FLS or by boosting the cellular reservoir of miR-218 might thus become a therapeutic strategy for RA.
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Affiliation(s)
- Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shoichi Fukui
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Ayuko Takatani
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
- Medical Education Development Center, Nagasaki University School Hospital, Nagasaki, Japan
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
- Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
- Departments of Community Medicine, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Mami Tmai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Tomoki Origuchi
- Department of Physical Therapy, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ko Chiba
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Makoto Osaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Astrid Jüngel
- Center of Experimental Rheumatology, University Hospital Zurich and University of Zurich, Schlieren, Zurich, Switzerland
| | - Steffen Gay
- Center of Experimental Rheumatology, University Hospital Zurich and University of Zurich, Schlieren, Zurich, Switzerland
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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15
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Koga T, Umeda M, Endo Y, Ishida M, Fujita Y, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Fukui S, Nishino A, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Murakami N, Kitajima M, Kawakami A. Effect of a gonadotropin-releasing hormone analog for ovarian function preservation after intravenous cyclophosphamide therapy in systemic lupus erythematosus patients: a retrospective inception cohort study. Int J Rheum Dis 2018; 21:1287-1292. [DOI: 10.1111/1756-185x.13318] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Tomohiro Koga
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
- Center for Bioinformatics and Molecular Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Masataka Umeda
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
- Medical Education Development Center; Nagasaki University Hospital; Nagasaki Japan
| | - Yushiro Endo
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Midori Ishida
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Yuya Fujita
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Sosuke Tsuji
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Ayuko Takatani
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Toshimasa Shimizu
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Remi Sumiyoshi
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Takashi Igawa
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Shoichi Fukui
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
- Unit of Advanced Preventive Medical Sciences; Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Ayako Nishino
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
- Center for Comprehensive Community Care Education; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Shin-ya Kawashiri
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
- Unit of Advanced Preventive Medical Sciences; Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Naoki Iwamoto
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Kunihiro Ichinose
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mami Tamai
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Hideki Nakamura
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Tomoki Origuchi
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Naoko Murakami
- Department of Obstetrics and Gynecology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Michio Kitajima
- Department of Obstetrics and Gynecology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Atsushi Kawakami
- Division of Advanced Preventive Medical Sciences; Department of Immunology and Rheumatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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16
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Endo Y, Koga T, Ishida M, Fujita Y, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Umeda M, Fukui S, Nishino A, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Kuwana M, Hosono Y, Mimori T, Kawakami A. Recurrence of anti-MDA5 antibody-positive clinically amyopathic dermatomyositis after long-term remission: A case report. Medicine (Baltimore) 2018; 97:e11024. [PMID: 29952940 PMCID: PMC6039648 DOI: 10.1097/md.0000000000011024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Among all dermatomyositis (DM) patients, antimelanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) positive patients have significantly poor short-term mortality, whereas they experience less relapses over the long term after the remission. We report the case of a patient with anti-MDA5 Ab-positive clinically amyopathic dermatomyositis (CADM) with the recurrence of interstitial lung disease (ILD) after 7 years of remission. There has been no case report of an anti-MDA5 Ab-positive DM patient with the recurrence of ILD after 7 years of long-term remission. PATIENT CONCERNS A 70-year-old Japanese woman was diagnosed with anti-MDA5 Ab-positive CADM and ILD. After achieving 7 years long-term remission, she was admitted to our department with erythema on the fingers and interstitial pneumonia. Her anti-MDA5 Ab titer was elevated. DIAGNOSES We diagnosed recurrent CADM complicated with ILD. INTERVENTIONS We successfully treated her with 1,000 mg of methyl-prednisolone pulse and intravenous cyclophosphamide therapy followed by prednisolone 50 mg/day and an increase of cyclosporine. OUTCOMES After that treatment, the patient's skin symptoms and interstitial pneumonia were relieved. All laboratory investigations such as ferritin, the serum markers of interstitial pneumonia (i.e., SP-A, SP-D), and the titer of anti-MDA5 Ab showed signs of improvement. LESSONS Her case suggests that careful physical examinations and monitoring the serum markers are important even after long-term remission is achieved.
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Affiliation(s)
- Yushiro Endo
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Tomohiro Koga
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Midori Ishida
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Yuya Fujita
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Sosuke Tsuji
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Ayuko Takatani
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Toshimasa Shimizu
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Remi Sumiyoshi
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Takashi Igawa
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Masataka Umeda
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Shoichi Fukui
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Ayako Nishino
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Shin-ya Kawashiri
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Naoki Iwamoto
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Kunihiro Ichinose
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Mami Tamai
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Hideki Nakamura
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Tomoki Origuchi
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo
| | - Yuji Hosono
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Kawakami
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki
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17
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Suzuki T, Fukui S, Umekita K, Miyamoto J, Umeda M, Nishino A, Okada A, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Fujikawa K, Aramaki T, Mizokami A, Matsuoka N, Ueki Y, Eguchi K, Sato S, Hidaka T, Origuchi T, Okayama A, Kawakami A, Nakamura H. Brief Report: Attenuated Effectiveness of Tumor Necrosis Factor Inhibitors for Anti-Human T Lymphotropic Virus Type I Antibody-Positive Rheumatoid Arthritis. Arthritis Rheumatol 2018; 70:1014-1021. [DOI: 10.1002/art.40461] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 02/15/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Takahisa Suzuki
- Japanese Red Cross Nagasaki Genbaku Hospital; Nagasaki Japan
| | - Shoichi Fukui
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | | | - Junya Miyamoto
- Nagasaki University Hospital Clinical Research Center; Nagasaki Japan
| | | | - Ayako Nishino
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Akitomo Okada
- Japanese Red Cross Nagasaki Genbaku Hospital; Nagasaki Japan
| | - Tomohiro Koga
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Shin-ya Kawashiri
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Naoki Iwamoto
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Kunihiro Ichinose
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mami Tamai
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Keita Fujikawa
- Japan Community Healthcare Organization Isahaya General Hospital; Isahaya Japan
| | | | - Akinari Mizokami
- Japan Community Healthcare Organization Isahaya General Hospital; Isahaya Japan
| | - Naoki Matsuoka
- Nagasaki Medical Hospital of Rheumatology; Nagasaki Japan
| | | | | | - Shuntaro Sato
- Nagasaki University Hospital Clinical Research Center; Nagasaki Japan
| | | | - Tomoki Origuchi
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | | | - Atsushi Kawakami
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Hideki Nakamura
- Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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18
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Ichinose K, Sato S, Kitajima Y, Horai Y, Fujikawa K, Umeda M, Fukui S, Nishino A, Koga T, Kawashiri SY, Iwamoto N, Tamai M, Nakamura H, Origuchi T, Yasuhi I, Masuzaki H, Kawakami A. The efficacy of adjunct tacrolimus treatment in pregnancy outcomes in patients with systemic lupus erythematosus. Lupus 2018; 27:1312-1320. [PMID: 29665758 DOI: 10.1177/0961203318770536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systemic lupus erythematosus (SLE) involves multiple organ systems and primarily affects women during their reproductive years. Pregnancy in a woman with SLE may lead to higher rates of disease flares. Little is known regarding which medications are safe to maintain remission and/or treat flares throughout such pregnancies. Here we retrospectively analyzed the efficacy of tacrolimus (TAC) in the pregnancy outcomes of SLE patients. We studied the 54 deliveries of 40 SLE patients over an eight-year period from 2008 to 2016. We used analyses of covariance with adjustments for the propensity score and inverse probability of treatment weights to compare the patient backgrounds between the TAC users and non-TAC users. TAC was administered to the patient in 15 of the 54 (27.8%) pregnancies, and these patients had a significantly higher dose of prednisolone, hypocomplementemia, lower estimated glomerular filtration rate, past history of lupus nephritis, and complication with antiphospholipid syndrome. In the adjusted background of the TAC deliveries, the risks of decreased fetal body weight, low birth weight infant, non-reassuring fetal status (NRFS), and preterm birth were not increased compared to the non-TAC deliveries. Thrombocytopenia and hypertension during the pregnancy were extracted as independent predictive risk factors for decreased fetal body weight and NRFS, respectively. We had anticipated that the maternal and fetal outcomes in the TAC-use deliveries would be poor before the analysis; however, the TAC-use group showed no significant difference in risks contributing to outcomes compared to the non-TAC group, suggesting that adjunct TAC treatment corrected various risk factors during the lupus pregnancies.
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Affiliation(s)
- K Ichinose
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Sato
- 2 Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Y Kitajima
- 3 Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Y Horai
- 4 Department of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - K Fujikawa
- 5 Department of Rheumatology, JCHO Isahaya General Hospital, Isahaya, Japan
| | - M Umeda
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Fukui
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - A Nishino
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Koga
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Y Kawashiri
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - N Iwamoto
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M Tamai
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - H Nakamura
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Origuchi
- 6 Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - I Yasuhi
- 7 Department of Obstetrics and Gynecology, NHO Nagasaki Medical Center, Omura, Japan
| | - H Masuzaki
- 3 Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - A Kawakami
- 1 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Endo Y, Koga T, Suzuki T, Hara K, Ishida M, Fujita Y, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Umeda M, Fukui S, Nishino A, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Kuwana M, Kawakami A. Successful treatment of plasma exchange for rapidly progressive interstitial lung disease with anti-MDA5 antibody-positive dermatomyositis: A case report. Medicine (Baltimore) 2018; 97:e0436. [PMID: 29642214 PMCID: PMC5908626 DOI: 10.1097/md.0000000000010436] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE As the initial treatment of rapidly progressive interstitial lung disease (RPILD) with antimelanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab)-positive dermatomyositis (DM) patients, a combination of corticosteroids, cyclophosphamide, and calcineurin inhibitor is recommended. However, some of these patients have poor prognoses despite such intensive treatment. Other more effective treatments are desired. We report the case of an anti-MDA5 Ab-positive DM patient who had developed RPILD despite intensive treatments; she was treated successfully by a short-term plasma exchange (PE). PATIENT CONCERNS A 71-year-old Japanese woman was admitted to the rheumatology department of another hospital with progressive muscle weakness of the limbs and erythema on both upper eyelids and the fingers of both hands. She was suspected of having classical DM (CDM) based on the findings of typical skin and myositis. Although a chest computed tomography (CT) examination showed no findings of interstitial pneumonia at the first visit to the department, she newly presented interstitial pneumonia during her admission and her anti-MDA5 Ab titer was elevated. DIAGNOSES She was diagnosed with interstitial lung disease (ILD) with anti-MDA5 Ab-positive DM. INTERVENTIONS She was treated with 1000 mg of methyl-prednisolone pulse, 500 mg of intravenous cyclophosphamide therapy (IVCY) followed by prednisolone 40 mg/day with tapering, and oral cyclosporine 200 mg/day. However, her interstitial pneumonia worsened with increasing breathing difficulty and an increasing serum ferritin level. She was transferred to our department, and we initiated PE as an additional treatment. OUTCOMES After the PE treatment, all laboratory findings, for example, ferritin, KL-6, and the titer of anti-MDA5 Ab showed marked improvement, and the patient's skin symptoms and active interstitial pneumonia were relieved. LESSONS Our patient's case suggests that PE may be effective for RPILD in anti-MDA5 Ab-positive DM patients.
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Affiliation(s)
- Yushiro Endo
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Tomohiro Koga
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Takahisa Suzuki
- Department of Rheumatology, Japan Red Cross Nagasaki Genbaku Hospital, Nagasaki
| | - Kazusato Hara
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Midori Ishida
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Yuya Fujita
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Sosuke Tsuji
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Ayuko Takatani
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Toshimasa Shimizu
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Remi Sumiyoshi
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Takashi Igawa
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Masataka Umeda
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Shoichi Fukui
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Ayako Nishino
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Shin-ya Kawashiri
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Naoki Iwamoto
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Kunihiro Ichinose
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Mami Tamai
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Hideki Nakamura
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Tomoki Origuchi
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Kawakami
- Department of Rheumatology, Unit of Advanced Preventive Medical Sciences, Graduate School of Bio-medical Sciences, Nagasaki University
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Yamanashi H, Koyamatsu J, Nagayoshi M, Shimizu Y, Kawashiri SY, Kondo H, Fukui S, Tamai M, Sato S, Yanagihara K, Kawakami A, Maeda T. Human T-Cell Leukemia Virus-1 Infection Is Associated With Atherosclerosis as Measured by Carotid Intima-Media Thickness in Japanese Community-Dwelling Older People. Clin Infect Dis 2018. [DOI: 10.1093/cid/ciy168] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Hirotomo Yamanashi
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto
| | | | - Yuji Shimizu
- Department of Community Medicine, Sakamoto, Japan
| | | | | | | | - Mami Tamai
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Japan
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Sakamoto, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Japan
| | - Takahiro Maeda
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto
- Department of Community Medicine, Sakamoto, Japan
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21
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Tomita Y, Arima K, Tsujimoto R, Kawashiri SY, Nishimura T, Mizukami S, Okabe T, Tanaka N, Honda Y, Izutsu K, Yamamoto N, Ohmachi I, Kanagae M, Abe Y, Aoyagi K. Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults. Medicine (Baltimore) 2018; 97:e9721. [PMID: 29369207 PMCID: PMC5794391 DOI: 10.1097/md.0000000000009721] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P < .01), had longer 5 times chair stand time (P < .01), and more falls in the previous year (P < .05), pain (P < .01), and comorbidity (P < .05). Multivariate logistic regression analysis identified advanced age (odds ratios [OR], 1.57; 95% confidence interval [CI], 1.03-2.39), falls in the previous year (OR, 2.44; 95%CI, 1.29-4.64), and pain (OR, 1.82; 95%CI, 1.03-3.22) in men, and advanced age (OR, 1.59; 95%CI, 1.13-2.24), longer 5 times chair stand times (OR, 1.28; 95%CI, 1.04-1.59), falls in the previous year (OR, 2.59; 95%CI, 1.54-4.34), and pain (OR, 1.65; 95%CI, 1.06-2.55) in women as being independently associated with fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.
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Affiliation(s)
- Yoshihito Tomita
- Department of Public Health
- Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya
| | | | | | | | | | - Satoshi Mizukami
- Department of Public Health
- Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya
| | - Takuhiro Okabe
- Department of Public Health
- Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya
| | | | | | | | - Naoko Yamamoto
- Department of Health Science, Faculty of Medicine Kagoshima University, Kagoshima
| | - Izumi Ohmachi
- Department of Health Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mitsuo Kanagae
- Department of Public Health
- Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya
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22
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Nagayoshi M, Higashi M, Takamura N, Tamai M, Koyamatsu J, Yamanashi H, Kadota K, Sato S, Kawashiri SY, Koyama Z, Saito T, Maeda T. Social networks, leisure activities and maximum tongue pressure: cross-sectional associations in the Nagasaki Islands Study. BMJ Open 2017; 7:e014878. [PMID: 29217718 PMCID: PMC5728263 DOI: 10.1136/bmjopen-2016-014878] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Social environment is often associated with health outcomes, but epidemiological evidence for its effect on oral frailty, a potential risk factor for aspiration, is sparse. This study aimed to assess the association between social environment and tongue pressure, as an important measure of oral function. The study focused on family structure, social networks both with and beyond neighbours, and participation in leisure activities. DESIGN A population-based cross-sectional study. SETTING Annual health check-ups in a rural community in Japan. PARTICIPANTS A total of 1982 participants, all over 40 years old. Anyone with missing data for the main outcome (n=14) was excluded. OUTCOME MEASURES Tongue pressure was measured three times, and the maximum tongue pressure was used for analysis. A multivariable adjusted regression model was used to calculate parameter estimates (B) for tongue pressure. RESULTS Having a social network involving neighbours (B=2.43, P=0.0001) and taking part in leisure activities (B=1.58, P=0.005) were independently associated with higher tongue pressure, but there was no link with social networks beyond neighbours (B=0.23, P=0.77). Sex-specific analyses showed that for men, having a partner was associated with higher tongue pressure, independent of the number of people in the household (B=2.26, P=0.01), but there was no association among women (B=-0.24, P=0.72; P-interaction=0.059). CONCLUSIONS Having a social network involving neighbours and taking part in leisure activities were independently associated with higher tongue pressure. Marital status may be an important factor in higher tongue pressure in men.
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Affiliation(s)
- Mako Nagayoshi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koichiro Kadota
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shimpei Sato
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Zenya Koyama
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshiyuki Saito
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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23
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Yamanashi H, Shimizu Y, Higashi M, Koyamatsu J, Sato S, Nagayoshi M, Kadota K, Kawashiri S, Tamai M, Takamura N, Maeda T. Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults. Geriatr Gerontol Int 2017; 18:240-249. [DOI: 10.1111/ggi.13166] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 06/15/2017] [Accepted: 07/18/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Hirotomo Yamanashi
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
- Department of Clinical Medicine, Institute of Tropical Medicine; Nagasaki University; Nagasaki Japan
| | - Yuji Shimizu
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
| | - Shimpei Sato
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mako Nagayoshi
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Koichiro Kadota
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Shinya Kawashiri
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mami Tamai
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Takahiro Maeda
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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24
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Koga T, Okada A, Fukuda T, Hidaka T, Ishii T, Ueki Y, Kodera T, Nakashima M, Takahashi Y, Honda S, Horai Y, Watanabe R, Okuno H, Aramaki T, Izumiyama T, Takai O, Miyashita T, Sato S, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Origuchi T, Nakamura H, Aoyagi K, Eguchi K, Kawakami A. Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity: A post hoc analysis of a nationwide cohort in Japan. PLoS One 2017; 12:e0175281. [PMID: 28505163 PMCID: PMC5432072 DOI: 10.1371/journal.pone.0175281] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 02/08/2017] [Accepted: 03/23/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice. Methods Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP. Results The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32 ± 0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64–299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03–3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95%CI 1.06–1.42). Conclusions ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs.
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Affiliation(s)
- Tomohiro Koga
- Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
- * E-mail:
| | - Akitomo Okada
- Japanese Red Cross Nagasaki Genbaku Hospital, Department of Rheumatology, Mori-machi 3–15, Nagasaki, Japan
| | - Takaaki Fukuda
- Kurume University Medical Center, Department of Rheumatology, Kokubun 155–1, Kurume, Japan
| | - Toshihiko Hidaka
- Zenjinkai Shimin-no-Mori Hospital, Shioji 2783–37, Miyazaki, Japan
| | - Tomonori Ishii
- Tohoku University Hospital, Department of Hematology and Rheumatology, Aoba-ku, seiryo 1–1, Sendai, Japan
| | - Yukitaka Ueki
- Sasebo Chuo Hospital, Rheumatic and Collagen Disease Center, Yamato 15, Sasebo, Japan
| | - Takao Kodera
- Tohoku Medical and Pharmaceutical University Hospital, Aoba-ku, komatsujima 4-4-1, Sendai, Japan
| | - Munetoshi Nakashima
- Japanese Red Cross Nagasaki Genbaku Hospital, Department of Rheumatology, Mori-machi 3–15, Nagasaki, Japan
- Kurume University Medical Center, Department of Rheumatology, Kokubun 155–1, Kurume, Japan
| | | | - Seiyo Honda
- Kurume University School of Medicine, asahi-machi 67, Kurume, Japan
| | - Yoshiro Horai
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
| | - Ryu Watanabe
- Tohoku University Hospital, Department of Hematology and Rheumatology, Aoba-ku, seiryo 1–1, Sendai, Japan
| | - Hiroshi Okuno
- Tohoku University Hospital, Department of Orthopaedic Surgery, Hirase 9–3, Sasebo, Japan
| | - Toshiyuki Aramaki
- Japanese Red Cross Nagasaki Genbaku Hospital, Department of Rheumatology, Mori-machi 3–15, Nagasaki, Japan
- Sasebo Chuo Hospital, Rheumatic and Collagen Disease Center, Yamato 15, Sasebo, Japan
| | - Tomomasa Izumiyama
- East Sendai Rheumatism and internal medicine Clinic, Miyagino, Nittahigashi 1-17-5, Sendai, Japan
| | - Osamu Takai
- Osaki Citizen Hospital, Furukawa-honami 3-8-1, Osaki, Japan
| | | | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-12-4, Nagasaki, Japan
| | - Naoki Iwamoto
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
| | - Kunihiro Ichinose
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
| | - Mami Tamai
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
| | - Tomoki Origuchi
- Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-12-4, Nagasaki, Japan
| | - Hideki Nakamura
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-12-4, Nagasaki, Japan
| | | | - Atsushi Kawakami
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan
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25
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Iwamoto N, Tsuji S, Takatani A, Shimizu T, Fukui S, Umeda M, Nishino A, Horai Y, Koga T, Kawashiri SY, Aramaki T, Ichinose K, Hirai Y, Tamai M, Nakamura H, Terada K, Origuchi T, Eguchi K, Ueki Y, Kawakami A. Efficacy and safety at 24 weeks of daily clinical use of tofacitinib in patients with rheumatoid arthritis. PLoS One 2017; 12:e0177057. [PMID: 28472115 PMCID: PMC5417647 DOI: 10.1371/journal.pone.0177057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/23/2017] [Indexed: 12/30/2022] Open
Abstract
Objective We evaluated the efficacy and safety of tofacitinib in patients with rheumatoid arthritis (RA) in a real-world setting. Methods Seventy consecutive patients, for whom tofacitinib was initiated between November 2013 and May 2016, were enrolled. All patients fulfilled the 2010 ACR/EULAR classification criteria for RA. All patients received 5 mg of tofacitinib twice daily and were followed for 24 weeks. Clinical disease activity indicated by disease activity score (DAS)28-ESR, the simplified disease activity index, and the clinical disease activity index as well as adverse events (AEs) were evaluated. Statistical analysis was performed to determine which baseline variables influenced the efficacy of tofacitinib at 24 weeks. Results Fifty-eight patients (82.9%) continued tofacitinib at 24 weeks. Clinical disease activity rapidly and significantly decreased, and this efficacy continued throughout the 24 weeks: i.e., DAS28-ESR decreased from 5.04 ± 1.33 at baseline to 3.83 ± 1.11 at 4 weeks and 3.53 ± 1.17 at 24 weeks (P<0.0001, vs. baseline). 15 AEs including 5 herpes zoster infection occurred during tofacitinib treatment. The efficacy of tofacitinib was not changed in patients without concomitant use of methotrexate (MTX) or patients whose treatment with tocilizumab (TCZ) failed. Multivariable logistic analysis showed that the number of biologic DMARDs (bDMARDs) previously used was independently associated with achievement of DAS-low disease activity. Conclusions Our present study suggests that tofacitinib is effective in real-world settings even without concomitant MTX use or after switching from TCZ. Our results also suggest that its efficacy diminishes if started after use of multiple bDMARDs.
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Affiliation(s)
- Naoki Iwamoto
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- * E-mail:
| | - Sosuke Tsuji
- Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan
| | - Ayuko Takatani
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shoichi Fukui
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshiro Horai
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Departments of Community Medicine, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yasuko Hirai
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kaoru Terada
- Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan
| | - Tomoki Origuchi
- Department of Physical Therapy, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsumi Eguchi
- Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan
| | - Yukitaka Ueki
- Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Fukui S, Iwamoto N, Umeda M, Nishino A, Koga T, Kawashiri SY, Ichinose K, Tamai M, Nakamura H, Origuchi T, Kawakami A. P2_93 Renal Involvements in ANCA Associated Vasculitis. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Umeda M, Kawashiri SY, Nishino A, Koga T, Ichinose K, Michitsuji T, Shimizu T, Fukui S, Nakashima Y, Hirai Y, Iwamoto N, Aramaki T, Tamai M, Nakamura H, Origuchi T, Ueki Y, Kawakami A. Synovitis of sternoclavicular and peripheral joints can be detected by ultrasound in patients with SAPHO syndrome. Mod Rheumatol 2016; 27:881-885. [DOI: 10.1080/14397595.2016.1259971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
- Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan,
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
- Department of Community Medicine, and
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Toru Michitsuji
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Shoichi Fukui
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Yoshikazu Nakashima
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Yasuko Hirai
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | | | - Mami Tamai
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Tomoki Origuchi
- Department Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yukitaka Ueki
- Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan,
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
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Fukui S, Iwamoto N, Umeda M, Nishino A, Nakashima Y, Koga T, Kawashiri SY, Ichinose K, Hirai Y, Tamai M, Nakamura H, Origuchi T, Sato S, Kawakami A. Antineutrophilic cytoplasmic antibody-associated vasculitis with hypocomplementemia has a higher incidence of serious organ damage and a poor prognosis. Medicine (Baltimore) 2016; 95:e4871. [PMID: 27631255 PMCID: PMC5402598 DOI: 10.1097/md.0000000000004871] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
A relationship between antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and complement has been shown, and complement has an important role in the pathogenesis of AAV. The clinical characteristics of AAV with hypocomplementemia still remain unclear.We conducted an observational study of 81 patients with AAV (median onset age 71 years; 58% female). Using medical records, we analyzed the patients' baseline variables, laboratory data, clinical symptoms, and therapeutic outcomes after treatments including episodes of relapses, initiation of dialysis, and death. We defined hypocomplementemia as the state in which at least one of the following was lower than the lower limit of the normal range: complement 3 (C3), complement 4 (C4), and total complement activity (CH50).Sixteen patients (20%) had hypocomplementemia at their diagnosis of AAV. Compared to the AAV patients without hypocomplementemia (n = 65), those with hypocomplementemia had significantly higher rates of the occurrence of skin lesions (8 [50%] vs. 8 [12%], P = 0.002), diffuse alveolar hemorrhage (DAH) (6 [38%] vs. 5 [8%], P = 0.006), and thrombotic microangiopathy (TMA) (3 [19%] vs. 0 [0%], P = 0.007). The AAV patients with hypocomplementemia had significantly lower platelet levels (16.5 × 10 vs. 24.9 × 10 cells/μL, P = 0.023) compared to those without hypocomplementemia. More positive immune complex deposits in renal biopsy specimens were seen in the AAV patients with hypocomplementemia than in those without hypocomplementemia (4 [80%] vs. 2 [18%], P = 0.036). Assessed by a log-rank test, hypocomplementemia at disease onset was significantly associated with death (P = 0.033).Hypocomplementemia in AAV at the disease onset was a risk factor for the serious organ damage, and a life prognostic factor. It is thus very important to pay attention to the levels of complement at the diagnosis of AAV.
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Affiliation(s)
| | | | | | | | | | | | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology
- Department of Public Health
| | | | | | - Mami Tamai
- Department of Immunology and Rheumatology
| | | | - Tomoki Origuchi
- Department of Immunology and Rheumatology
- Department of Rehabilitation Sciences, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Shuntaro Sato
- Nagasaki University Hospital Clinical Research Center, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology
- Correspondence: Dr. Atsushi Kawakami, Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1–7–1 Sakamoto, Nagasaki 852–8501, Japan (e-mail: )
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Ushigusa T, Ichinose K, Sato S, Michitsuji T, Shimizu T, Umeda M, Fukui S, Nishino A, Nakashima Y, Koga T, Kawashiri SY, Iwamoto N, Hirai Y, Tamai M, Nakamura H, Origuchi T, Kawakami A. Soluble α-klotho is a potential biomarker associated with neuropsychiatric systemic lupus erythematosus. Clin Immunol 2016; 165:29-34. [DOI: 10.1016/j.clim.2016.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 12/22/2022]
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Ichinose K, Ushigusa T, Nishino A, Nakashima Y, Suzuki T, Horai Y, Koga T, Kawashiri SY, Iwamoto N, Tamai M, Arima K, Nakamura H, Obata Y, Yamamoto K, Origuchi T, Nishino T, Kawakami A, Tsokos GC. Lupus Nephritis IgG Induction of Calcium/Calmodulin-Dependent Protein Kinase IV Expression in Podocytes and Alteration of Their Function. Arthritis Rheumatol 2016; 68:944-52. [PMID: 26636664 PMCID: PMC6103450 DOI: 10.1002/art.39499] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 10/29/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Kidney podocytes and their slit diaphragms prevent urinary protein loss. T cells from patients with systemic lupus erythematosus display increased expression of calcium/calmodulin-dependent protein kinase IV (CaMKIV). The present study was undertaken to investigate the role of CaMKIV in podocyte function in lupus nephritis (LN). METHODS We treated kidney podocytes with IgG derived from healthy individuals or patients with LN and then analyzed gene expression using a DNA microarray. The localization of IgG in podocytes was analyzed by immunofluorescence staining, with or without silencing of neonatal Fc receptor (FcRn). In addition, we silenced CAMK4 in podocytes and analyzed the expression of selected genes. We also examined the expression of CD86 in kidney podocytes from MRL/lpr, MRL/lpr.camkiv(-/-), and MRL/MPJ mice by in situ hybridization. RESULTS We found that exposure of podocytes to IgG resulted in entry of IgG into the cytoplasm. IgG entered podocytes via the FcRn because less IgG was found in the cytoplasm of podocytes treated with FcRn small interfering RNA. DNA microarray studies of podocytes exposed to LN-derived IgG revealed up-regulation of genes related to the activation of immune cells or podocyte damage. Interestingly, CD86 expression decreased after silencing CAMK4 in podocytes. Also, in situ hybridization experiments showed that the expression of CD86 was reduced in podocytes from MRL/lpr.camkiv(-/-) mice. CONCLUSION LN-derived IgG enters podocytes and up-regulates CAMK4, which is followed by increased expression of genes known to be linked to podocyte damage and T cell activation. Targeted inhibition of CAMK4 in podocytes may prove to be clinically useful in patients with LN.
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Affiliation(s)
- Kunihiro Ichinose
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, and Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Takeshi Ushigusa
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ayako Nishino
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yosikazu Nakashima
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahisa Suzuki
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshiro Horai
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, and Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Shin-ya Kawashiri
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Iwamoto
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mami Tamai
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiko Arima
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideki Nakamura
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoko Obata
- Nagasaki University School of Medicine, Nagasaki, Japan
| | | | - Tomoki Origuchi
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Atsushi Kawakami
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - George C. Tsokos
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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Origuchi T, Fukui S, Umeda M, Nishino A, Nakashima Y, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Kawakami A. The Severity of Takayasu Arteritis Is Associated with the HLA-B52 Allele in Japanese Patients. TOHOKU J EXP MED 2016; 239:67-72. [DOI: 10.1620/tjem.239.67] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Tomoki Origuchi
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Shoichi Fukui
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Masataka Umeda
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Ayako Nishino
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Yoshikazu Nakashima
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Tomohiro Koga
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Shin-ya Kawashiri
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Naoki Iwamoto
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Kunihiro Ichinose
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Mami Tamai
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Hideki Nakamura
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Atsushi Kawakami
- Departments of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
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Kawashiri SY, Nishino A, Nakamura H, Origuchi T, Aoyagi K, Kawakami A. The stiff elastographic change of submandibular glands rapidly improves after the introduction of glucocorticoid treatment in patients with IgG4-related dacryoadenitis and sialoadenitis. Mod Rheumatol 2015; 26:463-4. [PMID: 26471698 DOI: 10.3109/14397595.2015.1088680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Shin-ya Kawashiri
- Department of Public Health
- Department of Immunology and Rheumatology, and
| | | | | | - Tomoki Origuchi
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Fukui S, Ichinose K, Tsuji S, Umeda M, Nishino A, Nakashima Y, Suzuki T, Horai Y, Koga T, Kawashiri SY, Iwamoto N, Hirai Y, Tamai M, Nakamura H, Sato S, Aramaki T, Iwanaga N, Izumi Y, Origuchi T, Migita K, Ueki Y, Kawakami A. Hypocholesterolemia predicts relapses in patients with Takayasu arteritis. Mod Rheumatol 2015; 26:415-420. [DOI: 10.3109/14397595.2015.1083148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Shoichi Fukui
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Sosuke Tsuji
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Yoshikazu Nakashima
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Takahisa Suzuki
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Yoshiro Horai
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
- Department of Public Health, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Yasuko Hirai
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Mami Tamai
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
| | - Shuntaro Sato
- Nagasaki University Hospital Clinical Research Center, Nagasaki, Japan,
| | - Toshiyuki Aramaki
- Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan,
| | - Nozomi Iwanaga
- Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Omura, Nagasaki, Japan, and
| | - Yasumori Izumi
- Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Omura, Nagasaki, Japan, and
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
- Department of Rehabilitation Sciences, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kiyoshi Migita
- Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Omura, Nagasaki, Japan, and
| | - Yukitaka Ueki
- Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan,
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan,
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Kawashiri SY, Nakamura H, Origuchi T, Aoyagi K, Kawakami A. A case of lacrimal sarcoidosis following interstitial pneumonia: imaging and management. ACTA ACUST UNITED AC 2015. [PMID: 26213195 DOI: 10.2177/jsci.38.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 60-year-old Japanese man developed a fever and dry cough. Although chest CT showed interstitial pneumonia, the primary disease was not revealed. The interstitial pneumonia was improved by treatment with oral prednisolone following methylprednisolone pulse therapy. After the discontinuation of prednisolone he developed swelling of the eyelids and polyarthralgia. Orbital magnetic resonance imaging showed enlargement of the bilateral lacrimal glands. (67)Gallium scintigraphy showed abnormal uptake of the bilateral lacrimal glands and pulmonary hilum. A lacrimal gland biopsy showed noncaseating granulomatous infiltration with occasional multinucleated giant cells consistent with sarcoidosis. His symptoms improved by treatment with oral prednisolone and triamcinolone injection into the lacrimal glands.
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Affiliation(s)
- Shin-ya Kawashiri
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences
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Fukui S, Iwamoto N, Tsuji S, Umeda M, Nishino A, Nakashima Y, Suzuki T, Horai Y, Koga T, Kawashiri SY, Ichinose K, Hirai Y, Tamai M, Nakamura H, Origuchi T, Kawakami A. RS3PE Syndrome with Iliopsoas Bursitis Distinguished from an Iliopsoas Abscess Using a CT-guided Puncture. Intern Med 2015; 54:1653-6. [PMID: 26134200 DOI: 10.2169/internalmedicine.54.4874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 55-year-old man was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Contrast-enhanced computed tomography for cancer screening showed a mass with low-density centers with an enhanced rim in the left iliopsoas muscle. We suspected an iliopsoas abscess and performed computed-tomography-guided puncture of the mass. Both Gram staining and the culture of the fluid were negative. We diagnosed the patient with RS3PE syndrome with iliopsoas bursitis and administered low-dose corticosteroids without antibiotics. The symptoms, including left hip pain, quickly disappeared following treatment. Clinicians should be aware that iliopsoas bursitis may resemble an iliopsoas abscess. As a result, it is important to make an accurate differential diagnosis.
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Affiliation(s)
- Shoichi Fukui
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Umeda M, Origuchi T, Fujikawa K, Koga T, Mizokami A, Nakashima Y, Suzuki T, Okada A, Kawashiri SY, Ichinose K, Tamai M, Yamasaki S, Nakamura H, Kawakami A, Eguchi K. Hemophagocytic syndrome and inflammatory myopathy with abundant macrophages in a patient with adult-onset Still's disease. Intern Med 2014; 53:2385-9. [PMID: 25318809 DOI: 10.2169/internalmedicine.53.1081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein describe a 71-year-old woman with adult-onset Still's disease (AOSD) who developed fever, myalgia, and pancytopenia. The bone marrow aspiration and muscle biopsy revealed hemophagocytic syndrome (HPS) and inflammatory myopathy with abundant macrophages (IMAM). Immunostained specimens were positive for expression of retinoic acid-inducible gene-I (RIG-I), which recognizes viral RNA in infiltrated mononuclear cells as well as muscle tissues. These findings suggest that RIG-I may be involved in induction of HPS and IMAM in AOSD.
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Affiliation(s)
- Masataka Umeda
- Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
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Tamai M, Kita J, Nakashima Y, Suzuki T, Horai Y, Okada A, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Arima K, Yamasaki S, Nakamura H, Origuchi T, Uetani M, Fukushima A, Aoyagi K, Eguchi K, Kawakami A. Combination of MRI-detected bone marrow oedema with 2010 rheumatoid arthritis classification criteria improves the diagnostic probability of early rheumatoid arthritis. Ann Rheum Dis 2014; 73:2219-20. [DOI: 10.1136/annrheumdis-2013-205074] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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38
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Horai Y, Koga T, Fujikawa K, Takatani A, Nishino A, Nakashima Y, Suzuki T, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Ida H, Kakugawa T, Sakamoto N, Ishimatsu Y, Mukae H, Hamaguchi Y, Fujimoto M, Kuwana M, Origuchi T, Kohno S, Kawakami A. Serum interferon-α is a useful biomarker in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis. Mod Rheumatol 2014; 25:85-9. [DOI: 10.3109/14397595.2014.900843] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yoshiro Horai
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Keita Fujikawa
- Department of Rheumatology, Isahaya Health Insurance General Hospital, Nagasaki, Japan
| | - Ayuko Takatani
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ayako Nishino
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshikazu Nakashima
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahisa Suzuki
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-ya Kawashiri
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Iwamoto
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kunihiro Ichinose
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mami Tamai
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideki Nakamura
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomoyuki Kakugawa
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noriho Sakamoto
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuji Ishimatsu
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yasuhito Hamaguchi
- Department of Dermatology, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
| | - Masataka Kuwana
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tomoki Origuchi
- Unit of Translational Medicine, Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shigeru Kohno
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Kawashiri SY, Kawakami A, Iwamoto N, Fujikawa K, Aramaki T, Tamai M, Yamasaki S, Nakamura H, Origuchi T, Ueki Y, Migita K, Mizokami A, Aoyagi K, Eguchi K. In rheumatoid arthritis patients treated with tocilizumab, the rate of clinical disease activity index (CDAI) remission at 24 weeks is superior in those with higher titers of IgM-rheumatoid factor at baseline. Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0409-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Iwamoto N, Kawakami A, Fujikawa K, Aramaki T, Kawashiri SY, Tamai M, Arima K, Ichinose K, Kamachi M, Yamasaki S, Nakamura H, Nakashima M, Mizokami A, Goto A, Fukuda T, Matsuoka N, Ueki Y, Tsukada T, Migita K, Shoumura F, Kawabe Y, Shibatomi K, Mine M, Ida H, Origuchi T, Aoyagi K, Eguchi K. Prediction of DAS28-ESR remission at 6 months by baseline variables in patients with rheumatoid arthritis treated with etanercept in Japanese population. Mod Rheumatol 2014. [DOI: 10.3109/s10165-009-0187-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Horai Y, Satoru O, Lapalme-Remis S, Sumiyoshi R, Nakashima Y, Suzuki T, Okada A, Kawashiri SY, Ichinose K, Tamai M, Yamasaki S, Nakamura H, Takeshima F, Origuchi T, Kawakami A. Takayasu arteritis developing during treatment of ulcerative colitis with infliximab. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0684-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Akazawa S, Ichinose K, Origuchi T, Kawashiri SY, Iwamoto N, Fujikawa K, Aramaki T, Kamachi M, Arima K, Tamai M, Nakamura H, Ida H, Kawakami A, Eguchi K. Successful treatment of chronic lupus myocarditis with prednisolone and mizoribine. Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0326-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kawashiri SY, Suzuki T, Okada A, Yamasaki S, Tamai M, Nakamura H, Origuchi T, Mizokami A, Uetani M, Aoyagi K, Eguchi K, Kawakami A. Musculoskeletal ultrasonography assists the diagnostic performance of the 2010 classification criteria for rheumatoid arthritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0628-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takahisa Suzuki
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Akitomo Okada
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Satoshi Yamasaki
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Mami Tamai
- Center for Health and Community Medicine, Nagasaki University,
Nagasaki, Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Tomoki Origuchi
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences,
Nagasaki, Japan
| | - Akinari Mizokami
- Department of Internal Medicine, Nagasaki Municipal Hospital,
Omura, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences,
Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences,
Nagasaki, Japan
| | - Katsumi Eguchi
- Department of Internal Medicine, Sasebo City General Hospital,
Sasebo, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
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Ichinose K, Origuchi T, Tashiro N, Kawashiri SY, Iwamoto N, Fujikawa K, Aramaki T, Arima K, Tamai M, Yamasaki S, Nakamura H, Moriuchi H, Kawakami A. An elderly patient with chronic active Epstein–Barr virus infection with mixed cryoglobulinemia and review of the literature. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0731-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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45
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Origuchi T, Iwamoto N, Kawashiri SY, Fujikawa K, Aramaki T, Tamai M, Arima K, Nakamura H, Yamasaki S, Ida H, Kawakami A, Ueki Y, Matsuoka N, Nakashima M, Mizokami A, Kawabe Y, Mine M, Fukuda T, Eguchi K. Reduction in serum levels of substance P in patients with rheumatoid arthritis by etanercept, a tumor necrosis factor inhibitor. Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0384-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Tomoki Origuchi
- Department of Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8520, Japan
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Shin-ya Kawashiri
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Keita Fujikawa
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Toshiyuki Aramaki
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kazuhiko Arima
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Satoshi Yamasaki
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Hiroaki Ida
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Yukitaka Ueki
- Sasebo Central Hospital,
15 Yamato-cho, Sasebo 857-1195, Japan
| | - Naoki Matsuoka
- Nagasaki Medical Hospital of Rheumatology,
1-21 Aburaya-machi, Nagasaki 850-0832, Japan
| | | | - Akinari Mizokami
- Nagasaki Municipal Hospital,
6-39 Shinchi-machi, Nagasaki 850-8555, Japan
| | - Yojiro Kawabe
- Ureshino National Hospital,
2436 Geshuku-hei, Ureshino 843-0393, Japan
| | - Masanobu Mine
- Suga Orthopedic Hospital,
332 Ono-machi, Isahaya 854-0034,, Japan
| | - Takaaki Fukuda
- Kurume University Medical Center,
155-1 Kokubu-cho, Kurume 839-0863, Japan
| | - Katsumi Eguchi
- Sasebo Municipal Hospital,
9-3 Hirase-machi, Sasebo 857-8511, Japan
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Kawashiri SY, Tamai M, Yamasaki S, Nakamura H, Kakugawa T, Sakamoto N, Ishimatsu Y, Kawakami A. A case of Sjögren syndrome with pulmonary amyloidosis complicating microscopic polyangiitis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0443-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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47
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Kawashiri SY, Nishino A, Sueyoshi E, Okada A, Koga T, Yamasaki S, Nakamura H, Origuchi T, Kawakami A. A patient with systemic lupus erythematosus who developed massive small intestinal hemorrhaging during treatment for chronic lupus peritonitis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0499-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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48
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Origuchi T, Arima K, Kawashiri SY, Tamai M, Yamasaki S, Nakamura H, Tsukada T, Aramaki T, Furuyama M, Miyashita T, Kawabe Y, Iwanaga N, Terada K, Ueki Y, Fukuda T, Eguchi K, Kawakami A. High serum matrix metalloproteinase 3 is characteristic of patients with paraneoplastic remitting seronegative symmetrical synovitis with pitting edema syndrome. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0556-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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49
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Horai Y, Isomoto E, Koga T, Okada A, Kawashiri SY, Tamai M, Yamasaki S, Nakamura H, Origuchi T, Hamaguchi Y, Fujimoto M, Kuwana M, Kawakami A. Early diagnosis and treatment for remission of clinically amyopathic dermatomyositis complicated by rapid progress interstitial lung disease: a report of two cases. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0637-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yoshiro Horai
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Eriko Isomoto
- The Japanese Red Cross Nagasaki Genbaku Hospital,
Morimachi 3-15, Nagasaki 852-8511, Japan
| | - Tomohiro Koga
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Akitomo Okada
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Shin-ya Kawashiri
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Mami Tamai
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Satoshi Yamasaki
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Hideki Nakamura
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Tomoki Origuchi
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Nagasaki University School of Health Sciences,
Nagasaki, Japan
| | - Yasuhito Hamaguchi
- Department of Dermatology, Graduate School of Medical Science, Kanazawa University,
13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Graduate School of Medical Science, Kanazawa University,
13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
| | - Masataka Kuwana
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine,
35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Atsushi Kawakami
- Unit of Translational Medicine, Department of Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University,
1-7-1 Sakamoto, Nagasaki 852-8501, Japan
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Kita J, Tamai M, Arima K, Kawashiri SY, Horai Y, Iwamoto N, Okada A, Koga T, Nakashima Y, Suzuki T, Yamasaki S, Nakamura H, Origuchi T, Ida H, Aoyagi K, Uetani M, Eguchi K, Kawakami A. Significant improvement in MRI-proven bone edema is associated with protection from structural damage in very early RA patients managed using the tight control approach. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0646-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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