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Port M, Barquinero JF, Endesfelder D, Moquet J, Oestreicher U, Terzoudi G, Trompier F, Vral A, Abe Y, Ainsbury L, Alkebsi L, Amundson S, Badie C, Baeyens A, Balajee A, Balázs K, Barnard S, Bassinet C, Beaton-Green L, Beinke C, Bobyk L, Brochard P, Brzoska K, Bucher M, Ciesielski B, Cuceu C, Discher M, D,Oca M, Domínguez I, Doucha-Senf S, Dumitrescu A, Duy P, Finot F, Garty G, Ghandhi S, Gregoire E, Goh V, Güçlü I, Hadjiiska L, Hargitai R, Hristova R, Ishii K, Kis E, Juniewicz M, Kriehuber R, Lacombe J, Lee Y, Lopez Riego M, Lumniczky K, Mai T, Maltar-Strmečki N, Marrale M, Martinez J, Marciniak A, Maznyk N, McKeever S, Meher P, Milanova M, Miura T, Gil OM, Montoro A, Domene MM, Mrozik A, Nakayama R, O’Brien G, Oskamp D, Ostheim P, Pajic J, Pastor N, Patrono C, Pujol-Canadell M, Rodriguez MP, Repin M, Romanyukha A, Rößler U, Sabatier L, Sakai A, Scherthan H, Schüle S, Seong K, Sevriukova O, Sholom S, Sommer S, Suto Y, Sypko T, Szatmári T, Takahashi-Sugai M, Takebayashi K, Testa A, Testard I, Tichy A, Triantopoulou S, Tsuyama N, Unverricht-Yeboah M, Valente M, Van Hoey O, Wilkins R, Wojcik A, Wojewodzka M, Younghyun L, Zafiropoulos D, Abend M. RENEB Inter-Laboratory Comparison 2021: Inter-Assay Comparison of Eight Dosimetry Assays. Radiat Res 2023; 199:535-555. [PMID: 37310880 PMCID: PMC10508307 DOI: 10.1667/rade-22-00207.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/10/2023] [Indexed: 06/15/2023]
Abstract
Tools for radiation exposure reconstruction are required to support the medical management of radiation victims in radiological or nuclear incidents. Different biological and physical dosimetry assays can be used for various exposure scenarios to estimate the dose of ionizing radiation a person has absorbed. Regular validation of the techniques through inter-laboratory comparisons (ILC) is essential to guarantee high quality results. In the current RENEB inter-laboratory comparison, the performance quality of established cytogenetic assays [dicentric chromosome assay (DCA), cytokinesis-block micronucleus assay (CBMN), stable chromosomal translocation assay (FISH) and premature chromosome condensation assay (PCC)] was tested in comparison to molecular biological assays [gamma-H2AX foci (gH2AX), gene expression (GE)] and physical dosimetry-based assays [electron paramagnetic resonance (EPR), optically or thermally stimulated luminescence (LUM)]. Three blinded coded samples (e.g., blood, enamel or mobiles) were exposed to 0, 1.2 or 3.5 Gy X-ray reference doses (240 kVp, 1 Gy/min). These doses roughly correspond to clinically relevant groups of unexposed to low exposed (0-1 Gy), moderately exposed (1-2 Gy, no severe acute health effects expected) and highly exposed individuals (>2 Gy, requiring early intensive medical care). In the frame of the current RENEB inter-laboratory comparison, samples were sent to 86 specialized teams in 46 organizations from 27 nations for dose estimation and identification of three clinically relevant groups. The time for sending early crude reports and more precise reports was documented for each laboratory and assay where possible. The quality of dose estimates was analyzed with three different levels of granularity, 1. by calculating the frequency of correctly reported clinically relevant dose categories, 2. by determining the number of dose estimates within the uncertainty intervals recommended for triage dosimetry (±0.5 Gy or ±1.0 Gy for doses <2.5 Gy or >2.5 Gy), and 3. by calculating the absolute difference (AD) of estimated doses relative to the reference doses. In total, 554 dose estimates were submitted within the 6-week period given before the exercise was closed. For samples processed with the highest priority, earliest dose estimates/categories were reported within 5-10 h of receipt for GE, gH2AX, LUM, EPR, 2-3 days for DCA, CBMN and within 6-7 days for the FISH assay. For the unirradiated control sample, the categorization in the correct clinically relevant group (0-1 Gy) as well as the allocation to the triage uncertainty interval was, with the exception of a few outliers, successfully performed for all assays. For the 3.5 Gy sample the percentage of correct classifications to the clinically relevant group (≥2 Gy) was between 89-100% for all assays, with the exception of gH2AX. For the 1.2 Gy sample, an exact allocation to the clinically relevant group was more difficult and 0-50% or 0-48% of the estimates were wrongly classified into the lowest or highest dose categories, respectively. For the irradiated samples, the correct allocation to the triage uncertainty intervals varied considerably between assays for the 1.2 Gy (29-76%) and 3.5 Gy (17-100%) samples. While a systematic shift towards higher doses was observed for the cytogenetic-based assays, extreme outliers exceeding the reference doses 2-6 fold were observed for EPR, FISH and GE assays. These outliers were related to a particular material examined (tooth enamel for EPR assay, reported as kerma in enamel, but when converted into the proper quantity, i.e. to kerma in air, expected dose estimates could be recalculated in most cases), the level of experience of the teams (FISH) and methodological uncertainties (GE). This was the first RENEB ILC where everything, from blood sampling to irradiation and shipment of the samples, was organized and realized at the same institution, for several biological and physical retrospective dosimetry assays. Almost all assays appeared comparably applicable for the identification of unexposed and highly exposed individuals and the allocation of medical relevant groups, with the latter requiring medical support for the acute radiation scenario simulated in this exercise. However, extreme outliers or a systematic shift of dose estimates have been observed for some assays. Possible reasons will be discussed in the assay specific papers of this special issue. In summary, this ILC clearly demonstrates the need to conduct regular exercises to identify research needs, but also to identify technical problems and to optimize the design of future ILCs.
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Affiliation(s)
- M. Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | | | | | - J. Moquet
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | | | - G. Terzoudi
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics Laboratory, Agia Paraskevi, Greece
| | - F. Trompier
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - A. Vral
- Ghent University, Radiobiology Research Unit, Gent, Belgium
| | - Y. Abe
- Department of Radiation Biology and Protection, Nagasaki University, Japan
| | - L. Ainsbury
- UK Health Security Agency and Office for Health Improvement and Disparities, Cytogenetics and Pathology Group, Oxfordshire, England
| | - L Alkebsi
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S.A. Amundson
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - C. Badie
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - A. Baeyens
- Ghent University, Radiobiology Research Unit, Gent, Belgium
| | - A.S. Balajee
- Cytogenetic Biodosimetry Laboratory, Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - K. Balázs
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - S. Barnard
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - C. Bassinet
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | | | - C. Beinke
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - L. Bobyk
- Institut de Recherche Biomédicale des Armées (IRBA), Bretigny Sur Orge, France
| | | | - K. Brzoska
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - M. Bucher
- Bundesamt für Strahlenschutz, Oberschleißheim, Germany
| | - B. Ciesielski
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - C. Cuceu
- Genevolution, Porcheville, France
| | - M. Discher
- Paris-Lodron-University of Salzburg, Department of Environment and Biodiversity, 5020 Salzburg, Austria
| | - M.C. D,Oca
- Università Degli Studi di Palermo, Dipartimento di Fisica e Chimica “Emilio Segrè,” Palermo, Italy
| | - I. Domínguez
- Universidad de Sevilla, Departamento de Biología Celular, Sevilla, Spain
| | | | - A. Dumitrescu
- National Institute of Public Health, Radiation Hygiene Laboratory, Bucharest, Romania
| | - P.N. Duy
- Dalat Nuclear Research Institute, Radiation Technlogy & Biotechnology Center, Dalat City, Vietnam
| | - F. Finot
- Genevolution, Porcheville, France
| | - G. Garty
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - S.A. Ghandhi
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - E. Gregoire
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - V.S.T. Goh
- Department of Radiobiology, Singapore Nuclear Research and Safety Initiative (SNRSI), National University of Singapore, Singapore
| | - I. Güçlü
- TENMAK, Nuclear Energy Research Institute, Technology Development and Nuclear Research Department, Türkey
| | - L. Hadjiiska
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - R. Hargitai
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - R. Hristova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - K. Ishii
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - E. Kis
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - M. Juniewicz
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - R. Kriehuber
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - J. Lacombe
- University of Arizona, Center for Applied Nanobioscience & Medicine, Phoenix, Arizona
| | - Y. Lee
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | | | - K. Lumniczky
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - T.T. Mai
- Dalat Nuclear Research Institute, Radiation Technlogy & Biotechnology Center, Dalat City, Vietnam
| | - N. Maltar-Strmečki
- Ruðer Boškovic Institute, Division of Physical Chemistry, Zagreb, Croatia
| | - M. Marrale
- Università Degli Studi di Palermo, Dipartimento di Fisica e Chimica “Emilio Segrè,” Palermo, Italy
| | - J.S. Martinez
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - A. Marciniak
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - N. Maznyk
- Radiation Cytogenetics Laboratory, S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - S.W.S. McKeever
- Radiation Dosimetry Laboratory, Oklahoma State University, Stillwater, Oklahoma
| | | | - M. Milanova
- University of Defense, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - T. Miura
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - O. Monteiro Gil
- Instituto Superior Técnico/ Campus Tecnológico e Nuclear, Lisbon, Portugal
| | - A. Montoro
- Servicio de Protección Radiológica. Laboratorio de Dosimetría Biológica, Valencia, Spain
| | - M. Moreno Domene
- Hospital General Universitario Gregorio Marañón, Laboratorio de dosimetría biológica, Madrid, Spain
| | - A. Mrozik
- Institute of Nuclear Physics, Polish Academy of Sciences, Krakow, Poland
| | - R. Nakayama
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - G. O’Brien
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - D. Oskamp
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - P. Ostheim
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - J. Pajic
- Serbian Institute of Occupational Health, Belgrade, Serbia
| | - N. Pastor
- Universidad de Sevilla, Departamento de Biología Celular, Sevilla, Spain
| | - C. Patrono
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Rome, Italy
| | | | - M.J. Prieto Rodriguez
- Hospital General Universitario Gregorio Marañón, Laboratorio de dosimetría biológica, Madrid, Spain
| | - M. Repin
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | | | - U. Rößler
- Bundesamt für Strahlenschutz, Oberschleißheim, Germany
| | | | - A. Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - H. Scherthan
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - S. Schüle
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - K.M. Seong
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | | | - S. Sholom
- Radiation Dosimetry Laboratory, Oklahoma State University, Stillwater, Oklahoma
| | - S. Sommer
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - Y. Suto
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - T. Sypko
- Radiation Cytogenetics Laboratory, S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - T. Szatmári
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - M. Takahashi-Sugai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - K. Takebayashi
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - A. Testa
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Rome, Italy
| | - I. Testard
- CEA-Saclay, Gif-sur-Yvette Cedex, France
| | - A. Tichy
- University of Defense, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - S. Triantopoulou
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics Laboratory, Agia Paraskevi, Greece
| | - N. Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - M. Unverricht-Yeboah
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - M. Valente
- CEA-Saclay, Gif-sur-Yvette Cedex, France
| | - O. Van Hoey
- Belgian Nuclear Research Center SCK CEN, Mol, Belgium
| | | | - A. Wojcik
- Stockholm University, Stockholm, Sweden
| | - M. Wojewodzka
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - Lee Younghyun
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - D. Zafiropoulos
- Laboratori Nazionali di Legnaro - Istituto Nazionale di Fisica Nucleare, Legnaro, Italy
| | - M. Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
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Barquinero JF, Abe Y, Aneva N, Endesfelder D, Georgieva D, Goh V, Gregoire E, Hristova R, Lee Y, Martínez JS, Meher PK, Miura T, Port M, Pujol-Canadell M, Prieto-Rodriguez MJ, Seong KM, Suto Y, Takebayashi K, Tsuyama N, Wojcik A, Yoon HJ, Abend M. RENEB Inter-Laboratory Comparison 2021: The FISH-Based Translocation Assay. Radiat Res 2023:492245. [PMID: 37057978 DOI: 10.1667/rade-22-00203.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/07/2023] [Indexed: 04/15/2023]
Abstract
Translocation analysis using fluorescence in situ hybridization (FISH) is the method of choice for dose assessment in case of chronic or past exposures to ionizing radiation. Although it is a widespread technique, unlike dicentrics, the number of FISH-based inter-laboratory comparisons is small. For this reason, although the current Running the European Network of Biological and Physical retrospective Dosimetry (RENEB) inter-laboratory comparison 2021 was designed as a fast response to a real emergency scenario, it was considered a good opportunity to perform an inter-laboratory comparison using the FISH technique to gain further experience. The Bundeswehr Institute of Radiobiology provided peripheral blood samples from one healthy human volunteer. Three test samples were irradiated with blinded doses of 0, 1.2, and 3.5 Gy, respectively. Samples were then sent to the seven participating laboratories. The FISH technique was applied according to the standard procedure of each laboratory. Both, the frequency of translocations and the estimated dose for each sample were sent to the coordinator using a special scoring sheet for FISH. All participants sent their results in due time. However, although it was initially requested to send the results based on the full analysis, evaluating 500 equivalent cells, most laboratories only sent the results based on triage, with a smaller number of analyzed cells. In the triage analysis, there was great heterogeneity in the number of equivalent cells scored. On the contrary, for the full analysis, this number was more homogeneous. For all three samples, one laboratory showed outlier yields compared to the other laboratories. Excluding these results, in the triage analysis, the frequency of translocations in sample no. 1 ranged from 0 to 0.013 translocations per cell, and for samples no. 2 and no. 3 the genomic mean frequency were 0.27 ± 0.03 and 1.47 ± 0.14, with a coefficient of variation of 0.29 and 0.23 respectively. Considering only results obtained in the triage analysis for sample no. 1, all laboratories, except one, classified this sample as the non-irradiated one. For sample no. 2, excluding the outlier value, the mean reported dose was 1.74 ± 0.16 Gy indicating a mean deviation of about 0.5 Gy to the delivered dose of 1.2 Gy. For sample no. 3 the mean dose estimated was 4.21 ± 0.21 Gy indicating a mean deviation of about 0.7 Gy to the delivered dose of 3.5 Gy. In the frame of RENEB, this is the second FISH-based inter-laboratory comparison. The whole exercise was planned as a response to an emergency, therefore, a triage analysis was requested for all the biomarkers except for FISH. Although a full analysis was initially requested for FISH, most of the laboratories reported only a triage-based result. The main reason is that it was not clearly stated what was required before starting the exercise. Results show that most of the laboratories successfully discriminated unexposed and irradiated samples from each other without any overlap. A good agreement in the observed frequencies of translocations was observed but there was a tendency to overestimate the delivered doses. Efforts to improve the harmonization of this technique and subsequent exercises to elucidate the reason for this trend should be promoted.
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Affiliation(s)
- J-F Barquinero
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Y Abe
- Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University (ABDI), Nagasaki, Japan
| | - N Aneva
- National Centre of Radiobiology and Radiation Protection (NCRRP), Sofia, Bulgaria
| | - D Endesfelder
- Bundesamt für Strahlenschutz (BfS), Oberschleissheim, Germany
| | - D Georgieva
- National Centre of Radiobiology and Radiation Protection (NCRRP), Sofia, Bulgaria
| | - Vst Goh
- Singapore Nuclear Research and Safety Initiative (SNRSI), Singapore
| | - E Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay aux Roses, France
| | - R Hristova
- National Centre of Radiobiology and Radiation Protection (NCRRP), Sofia, Bulgaria
| | - Y Lee
- Korea Institute of Radiological & Medical Sciences, Laboratory of Biological Dosimetry (KIRAMS), Seoul, Korea
| | - J-S Martínez
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay aux Roses, France
| | - P-K Meher
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University (SU), Stockholm, Sweden
| | - T Miura
- Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine, Hirosaki University (IREM), Aomori, Japan
| | - M Port
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm (BIR), Munich, Germany
| | | | - M J Prieto-Rodriguez
- Hospital General Universitario Gregorio Marañón, Laboratorio de dosimetría biológica (SERMAS), Madrid, Spain
| | - K-M Seong
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay aux Roses, France
| | - Y Suto
- Biodosimetry Group, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - K Takebayashi
- Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine, Hirosaki University (IREM), Aomori, Japan
| | - N Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University (FMU), Fukushima, Japan
| | - A Wojcik
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University (SU), Stockholm, Sweden
| | - H-J Yoon
- Korea Institute of Radiological & Medical Sciences, Laboratory of Biological Dosimetry (KIRAMS), Seoul, Korea
| | - M Abend
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm (BIR), Munich, Germany
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Endesfelder D, Oestreicher U, Bucher M, Beinke C, Siebenwirth C, Ainsbury E, Moquet J, Gruel G, Gregoire E, Martinez JS, Vral A, Baeyens A, Valente M, Montoro A, Terzoudi G, Triantopoulou S, Pantelias A, Gil OM, Prieto MJ, Domene MM, Zafiropoulos D, Barquinero JF, Pujol-Canadell M, Lumniczky K, Hargitai R, Kis E, Testa A, Patrono C, Sommer S, Hristova R, Kostova N, Atanasova M, Sevriukova O, Domínguez I, Pastor N, Güçlü I, Pajic J, Sabatier L, Brochard P, Tichy A, Milanova M, Finot F, Petrenci CC, Wilkins RC, Beaton-Green LA, Seong KM, Lee Y, Lee YH, Balajee AS, Maznyk N, Sypko T, Pham ND, Tran TM, Miura T, Suto Y, Akiyamam M, Tsuyama N, Abe Y, Goh VST, Chua CEL, Abend M, Port M. RENEB Inter-Laboratory Comparison 2021: The Dicentric Chromosome Assay. Radiat Res 2023:492028. [PMID: 37018160 DOI: 10.1667/rade-22-00202.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/03/2023] [Indexed: 04/06/2023]
Abstract
After large-scale radiation accidents where many individuals are suspected to be exposed to ionizing radiation, biological and physical retrospective dosimetry assays are important tools to aid clinical decision making by categorizing individuals into unexposed/minimally, moderately or highly exposed groups. Quality-controlled inter-laboratory comparisons of simulated accident scenarios are regularly performed in the frame of the European legal association RENEB (Running the European Network of Biological and Physical retrospective Dosimetry) to optimize international networking and emergency readiness in case of large-scale radiation events. In total 33 laboratories from 22 countries around the world participated in the current RENEB inter-laboratory comparison 2021 for the dicentric chromosome assay. Blood was irradiated in vitro with X rays (240 kVp, 13 mA, ∼75 keV, 1 Gy/min) to simulate an acute, homogeneous whole-body exposure. Three blood samples (no. 1: 0 Gy, no. 2: 1.2 Gy, no. 3: 3.5 Gy) were sent to each participant and the task was to culture samples, to prepare slides and to assess radiation doses based on the observed dicentric yields from 50 manually or 150 semi-automatically scored metaphases (triage mode scoring). Approximately two-thirds of the participants applied calibration curves from irradiations with γ rays and about 1/3 from irradiations with X rays with varying energies. The categorization of the samples in clinically relevant groups corresponding to individuals that were unexposed/minimally (0-1 Gy), moderately (1-2 Gy) or highly exposed (>2 Gy) was successfully performed by all participants for sample no. 1 and no. 3 and by ≥74% for sample no. 2. However, while most participants estimated a dose of exactly 0 Gy for the sham-irradiated sample, the precise dose estimates of the samples irradiated with doses >0 Gy were systematically higher than the corresponding reference doses and showed a median deviation of 0.5 Gy (sample no. 2) and 0.95 Gy (sample no. 3) for manual scoring. By converting doses estimated based on γ-ray calibration curves to X-ray doses of a comparable mean photon energy as used in this exercise, the median deviation decreased to 0.27 Gy (sample no. 2) and 0.6 Gy (sample no. 3). The main aim of biological dosimetry in the case of a large-scale event is the categorization of individuals into clinically relevant groups, to aid clinical decision making. This task was successfully performed by all participants for the 0 Gy and 3.5 Gy samples and by 74% (manual scoring) and 80% (semi-automatic scoring) for the 1.2 Gy sample. Due to the accuracy of the dicentric chromosome assay and the high number of participating laboratories, a systematic shift of the dose estimates could be revealed. Differences in radiation quality (X ray vs. γ ray) between the test samples and the applied dose effect curves can partly explain the systematic shift. There might be several additional reasons for the observed bias (e.g., donor effects, transport, experimental conditions or the irradiation setup) and the analysis of these reasons provides great opportunities for future research. The participation of laboratories from countries around the world gave the opportunity to compare the results on an international level.
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Affiliation(s)
- D Endesfelder
- Bundesamt für Strahlenschutz, BfS, Oberschleissheim, Germany
| | - U Oestreicher
- Bundesamt für Strahlenschutz, BfS, Oberschleissheim, Germany
| | - M Bucher
- Bundesamt für Strahlenschutz, BfS, Oberschleissheim, Germany
| | - C Beinke
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - C Siebenwirth
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - E Ainsbury
- UK Health Security Agency, Radiation, Chemicals and Environmental Hazards Directorate, Chilton, Oxfordshire, United Kingdom
| | - J Moquet
- UK Health Security Agency, Radiation, Chemicals and Environmental Hazards Directorate, Chilton, Oxfordshire, United Kingdom
| | - G Gruel
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc Fontenay-aux-Roses 92262, France
| | - E Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc Fontenay-aux-Roses 92262, France
| | - J S Martinez
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc Fontenay-aux-Roses 92262, France
| | - A Vral
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - A Baeyens
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - M Valente
- Armed Forces Biomedical Research Institute, Department of Radiation Biological, Effects Brétigny-sur-Orge, France
| | - A Montoro
- Laboratorio de Dosimetría Biológica Servicio de Protección Radiológica Hospital Universitario Politécnico la Fe, Spain
| | - G Terzoudi
- National Centre for Scientific Research "Demokritos," Health Physics, Radiobiology & Cytogenetics Laboratory, Athens, Greece
| | - S Triantopoulou
- National Centre for Scientific Research "Demokritos," Health Physics, Radiobiology & Cytogenetics Laboratory, Athens, Greece
| | - A Pantelias
- National Centre for Scientific Research "Demokritos," Health Physics, Radiobiology & Cytogenetics Laboratory, Athens, Greece
| | - O Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico (IST), Universidade de Lisboa, Lisboa, Portugal
| | - M J Prieto
- Hospital General Universitario Gregorio Marañón; Servicio de Oncología Radioterápica; Laboratorio de dosimetría biológica, Madrid, Spain
| | - M M Domene
- Hospital General Universitario Gregorio Marañón; Servicio de Oncología Radioterápica; Laboratorio de dosimetría biológica, Madrid, Spain
| | - D Zafiropoulos
- Laboratori Nazionali di Legnaro - Istituto Nazionale di Fisica Nucleare, Legnaro, Italy
| | | | | | - K Lumniczky
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - R Hargitai
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - E Kis
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - A Testa
- Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile, Rome, Italy
| | - C Patrono
- Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile, Rome, Italy
| | - S Sommer
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - R Hristova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - N Kostova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - M Atanasova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - O Sevriukova
- Laboratori Nazionali di Legnaro - Istituto Nazionale di Fisica Nucleare, Legnaro, Italy
| | - I Domínguez
- Universidad de Sevilla, Departamento de Biología Celular, Facultad de Biología, Sevilla, Spain
| | - N Pastor
- Universidad de Sevilla, Departamento de Biología Celular, Facultad de Biología, Sevilla, Spain
| | - I Güçlü
- Nükleer Arş Ens. Yarımburgaz mah. Nükleer Arş yolu, Turkey
| | - J Pajic
- Serbian Institute of Occupational Health, Belgrade, Serbia
| | - L Sabatier
- PROCyTOX, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Fontenay-aux-Roses, France and Université Paris-Saclay, France
| | - P Brochard
- PROCyTOX, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Fontenay-aux-Roses, France and Université Paris-Saclay, France
| | - A Tichy
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - M Milanova
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - F Finot
- Genevolution, Porcheville, France
| | | | - R C Wilkins
- Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa, Canada
| | - L A Beaton-Green
- Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa, Canada
| | - K M Seong
- Lab of Biological Dosimetry, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - Y Lee
- Lab of Biological Dosimetry, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - Y H Lee
- Lab of Biological Dosimetry, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - A S Balajee
- Cytogenetic Biodosimetry Laboratory; Radiation Emergency Assistance Center/Training Site (REAC/TS); Oak Ridge Institute for Science and Education; Oak Ridge Associated Universities; Oak Ridge, Tennessee
| | - N Maznyk
- aa Radiation Cytogenetics Laboratory; S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - T Sypko
- aa Radiation Cytogenetics Laboratory; S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - N D Pham
- bb Biodosimetry Laboratory, Center for Radiation Technology & Biotechnology; Dalat Nuclear Research Institute; Dalat City, Vietnam
| | - T M Tran
- bb Biodosimetry Laboratory, Center for Radiation Technology & Biotechnology; Dalat Nuclear Research Institute; Dalat City, Vietnam
| | - T Miura
- cc Department of Risk Analysis and Biodosimetry Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - Y Suto
- dd National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Akiyamam
- dd National Institutes for Quantum Science and Technology, Chiba, Japan
| | - N Tsuyama
- ee Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Y Abe
- ff Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University, Japan
| | - V S T Goh
- ff Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University, Japan
| | - C E L Chua
- gg Department of Radiobiology, Singapore Nuclear Research and Safety Initiative (SNRSI), National University of Singapore, Singapore
| | - M Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - M Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
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Yonemori K, Fujiwara K, Hasegawa K, Yunokawa M, Ushijima K, Suzuki S, Shikama A, Minobe S, Usami T, Kim JW, Kim BG, Wang PH, Chang TC, Yamamoto K, Han S, McKenzie J, Barresi G, Miura T, Makker V, Kim Y. 177O Lenvatinib plus pembrolizumab versus treatment of physician’s choice in patients with previously treated advanced endometrial cancer: Study 309/KEYNOTE-775 Asian subgroup. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.213] [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: 12/05/2022] Open
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5
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Zhang Y, Li S, Uenaka T, Furuuchi K, Yonemori K, Shimizu T, Nishio S, Yunokawa M, Matsumoto K, Takehara K, Hasegawa K, Hirashima Y, Kato H, Otake Y, Miura T, Matsui J. Phase I Biomarker Analysis Results of MORAb-202 (Farletuzumab Ecteribulin) Effects on Vascular Remodeling and Immune Modulation in Patients With Ovarian Cancer. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01032-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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6
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Ebina K, Etani Y, Tsuboi H, Nagayama Y, Kashii M, Miyama A, Kunugiza Y, Hirao M, Okamura G, Noguchi T, Takami K, Goshima A, Miura T, Fukuda Y, Kurihara T, Okada S, Nakata K. Effects of prior osteoporosis treatment on the treatment response of romosozumab followed by denosumab in patients with postmenopausal osteoporosis. Osteoporos Int 2022; 33:1807-1813. [PMID: 35362725 DOI: 10.1007/s00198-022-06386-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/25/2022] [Indexed: 01/28/2023]
Abstract
UNLABELLED In patients with postmenopausal osteoporosis, prior osteoporosis treatment affected the bone mineral density increase of following treatment with 12 months of romosozumab, although it did not affect that of following treatment with 12 months of denosumab after romosozumab. PURPOSE To investigate the effects of prior osteoporosis treatment on the response to treatment with romosozumab (ROMO) followed by denosumab (DMAb) in patients with postmenopausal osteoporosis. METHODS In this prospective, observational, multicenter study, treatment-naïve patients (Naïve; n = 55) or patients previously treated with bisphosphonates (BP; n = 37), DMAb (DMAb; n = 45) or teriparatide (TPTD; n = 17) (mean age, 74.6 years; T-scores of the lumbar spine [LS] - 3.2 and total hip [TH] - 2.6) were switched to ROMO for 12 months, followed by DMAb for 12 months. Bone mineral density (BMD) and serum bone turnover markers were evaluated for 24 months. RESULTS A BMD increase was observed at 12 and 24 months in the following patients: Naïve (18.2% and 22.0%), BP (10.2% and 12.1%), DMAb (6.6% and 9.7%), and TPTD (10.8% and 15.0%) (P < 0.001 between the groups at both 12 and 24 months) in LS and Naïve (5.5% and 8.3%), BP (2.9% and 4.1%), DMAb (0.6% and 2.2%), and TPTD (4.3% and 5.4%) (P < 0.01 between the groups at 12 months and P < 0.001 at 24 months) in TH, respectively. The BMD increase in LS from 12 to 24 months was negatively associated with the levels of bone resorption marker at 24 months. Incidences of major fragility fractures for the respective groups were as follows: Naïve (5.5%), BP (16.2%), DMAb (11.1%), and TPTD (5.9%). CONCLUSIONS Previous treatment affected the BMD increase of following treatment with ROMO, although it did not affect that of following treatment with DMAb after ROMO.
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Affiliation(s)
- K Ebina
- Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Y Etani
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - H Tsuboi
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - Y Nagayama
- Nagayama Rheumatology and Orthopaedic Clinic, 4-3-25 Hiokisounishi-machi, Higashi-ku, Sakai, 599-8114, Japan
| | - M Kashii
- Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka, 560-8565, Japan
| | - A Miyama
- Department of Orthopaedic Surgery, Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Y Kunugiza
- Department of Orthopaedic Surgery, Japan Community Health Care Organization, Hoshigaoka Medical Center, 4-8-1 Hoshigaoka, Hirakata, Osaka, 573-8511, Japan
| | - M Hirao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - G Okamura
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, 591-8025, Japan
| | - T Noguchi
- Department of Orthopaedic Surgery, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashi, Kawachinagano, Osaka, 586-8521, Japan
| | - K Takami
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - A Goshima
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - T Miura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Y Fukuda
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - T Kurihara
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - S Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - K Nakata
- Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
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7
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Nagai K, Fukuno S, Moriwaki R, Kuroda H, Omotani S, Miura T, Hatsuda Y, Myotoku M, Konishi H. Influence of concurrent and staggered dosing of semi-solid nutrients on the pharmacokinetics of orally administered carbamazepine in rats. Pharmazie 2022; 77:118-120. [PMID: 35459440 DOI: 10.1691/2022.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In the present study, we examined the effects of concurrent and staggered dosing of PG-soft ace-MP TM (PG), novel semi-solid enteral nutrients, on the pharmacokinetics of orally administered carbamazepine (CBZ) in rats due to the high possibility of drug interaction during the absorption process. The pharmacokinetic behavior of CBZ was considerably altered when administered concurrently with PG. The maximum serum CBZ concentration (Cmax) significantly decreased and the mean residence time (MRT) significantly increased. The elimination constant (ke) also significantly increased, but there were no significant changes in the area under the serum CBZ concentration versus time curve (AUC) and the time to reach Cmax (Tmax). However, these changes in the pharmacokinetic parameters were eliminated by waiting 20 min, the time interval equivalent to the Tmax described above, between CBZ administration and PG dosing. This study suggested that PG interferes with CBZ absorption from the digestive tract, although staggered administration of CBZ and PG prevented their interaction.
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Affiliation(s)
- K Nagai
- Laboratory of Clinical Pharmacy and Therapeutics, Osaka Ohtani University, Tondabayashi, Japan;,
| | - S Fukuno
- Laboratory of Clinical Pharmacy and Therapeutics, Osaka Ohtani University, Tondabayashi, Japan
| | - R Moriwaki
- Laboratory of Clinical Pharmacy and Therapeutics, Osaka Ohtani University, Tondabayashi, Japan
| | - H Kuroda
- Laboratory of Clinical Pharmacy and Therapeutics, Osaka Ohtani University, Tondabayashi, Japan
| | - S Omotani
- Laboratory of Practical Pharmacy and Pharmaceutical Care, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan
| | - T Miura
- Pharmaceutical Education Support Center, School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, Nishinomiya, Japan
| | - Y Hatsuda
- Laboratory of Practical Pharmacy and Pharmaceutical Care, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan
| | - M Myotoku
- Laboratory of Practical Pharmacy and Pharmaceutical Care, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan
| | - H Konishi
- Laboratory of Clinical Pharmacy and Therapeutics, Osaka Ohtani University, Tondabayashi, Japan
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8
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Katano S, Yano T, Ohori K, Kouzu H, Nagaoka R, Honma S, Shimomura K, Numazawa R, Koyama M, Nagano N, Fujito T, Nishikawa R, Hashimoto A, Katayose M, Miura T. Barthel Index score predicts mortality in elderly heart failure: a goal of comprehensive cardiac rehabilitation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Accurate prediction of mortality in heart failure (HF) patients is crucial for decision-making regarding HF therapies, but a strategy for the prediction of mortality in elderly HF patients has not been established. In addition, although favorable effects of comprehensive cardiac rehabilitation (CR) on clinical outcomes and functional status in HF patients have been demonstrated, a goal of comprehensive CR during hospitalization for reducing mortality remains unclear.
Aims
We examined whether assessment of basic activities of daily living (ADL) by the Barthel Index (BI), the most widely used tool for assessment of basic ADL, is useful for predicting all-cause mortality in elderly HF patients who received comprehensive CR.
Methods
This study was a single-center, retrospective and observational study. We retrospectively examined 413 HF patients aged ≥65 years (mean age, 78±7 years; 50% female) who were admitted to our institute for management of HF and received comprehensive CR during hospitalization. Functional status for performing basic ADL ability was assessed by the BI within 3 days before discharge. The clinical endpoint was all-cause death during the follow-up period.
Results
Of 413 HF patients, 116 patients (28%) died during a follow-up period of median 1.90-years (interquartile range, 1.20–3.23 years). Results of an adjusted dose-dependent association analysis showed that the hazard ratio (HR) of mortality increases in an almost linear fashion as the BI score decreases and that the BI score corresponding the hazard ratio of 1.0 is 85 (Figure A). To minimize the differences in potential confounding factors between patient with low BI (<85) and patients with high BI (≥85), inverse probability treatment weighting (IPTW) was calculated using propensity score. Kaplan-Meier survival curves, in which selection bias was minimized by use of IPTW for confounders, showed that patients with low BI (<85) had a higher mortality rate than did patients with high BI (≥85) (Figure B). In multivariate Cox regression analyses, low BI was independently associated with higher mortality after adjustment for predictors including brain natriuretic peptide and prior HF hospitalization (IPTW-adjusted HR, 1.75 [95% confidence interval, 1.03–2.98], p<0.001). Inclusion of the BI into the adjustment model improved the accuracy of prediction of mortality (continuous net reclassification improvement, 0.292, p=0.008; integrated discrimination improvement, 0.017, p=0.022).
Conclusion
A BI score of <85 at the time of discharge is associated with increased mortality independently of known prognostic markers, and achievement of functional status of a BI score ≥85 by comprehensive CR during hospitalization may contribute to a favorable outcome in elderly HF patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the Japan Society for the Promotion of Science
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Affiliation(s)
- S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation, Sapporo, Japan
| | - K Shimomura
- Hakodate Goryoukaku Hospital, Department of Rehabilitation, Hakodate, Japan
| | - R Numazawa
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Public Health, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Division of Health Care Administration and Management, Sapporo, Japan
| | - M Katayose
- Sapporo Medical University, Second Division of Physical Therapy, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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9
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Ogawa T, Kouzu H, Osanami A, Tatekoshi Y, Oshima H, Mizuno M, Kuno A, Fujita Y, Ino S, Shimizu M, Ohwada W, Sato T, Yano T, Tanno M, Miura T. Intracellular localization of AMP deaminase and its novel role in BCAA and lipid metabolism in diabetic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
A metabolomic study in the human heart suggested a pivotal role of amino acid (AA) metabolism in fatty acid oxidation, which is dysregulated in type 2 diabetes mellitus (T2DM) and heart failure. We previously reported that aberrant up-regulation of AMP deaminase 3 (AMPD3) impairs cardiac energetics in T2DM hearts, and AMPD3 was recently shown to be activated by fasting and to promote AA metabolism and fatty acid oxidation in skeletal muscle. A sodium glucose cotransporter 2 inhibitor (SGLT2i) has been shown to augment systemic AA metabolism, but its effect on cardiac AA metabolism remains unknown.
Purpose
We hypothesized that AMPD3 has a role in AA and lipid metabolism in cardiomyocytes and that the protective effect of an SGLT2i in diabetic hearts is mediated by modification of AA and lipid metabolism.
Methods and results
Proteomic analyses of AMPD3 immunoprecipitates in rat hearts revealed that AMPD3 interacted with the E1α and E2 components of the BCKDH complex, a rate-limiting enzyme of branched-chain AA (BCAA) catabolism. Immunoblotting using subcellular fractions revealed that BCKDH localized not only in the mitochondria matrix but also in the cytosol and endoplasmic reticulum (ER) and that AMPD3 interacted with BCKDH in the cytosol and ER. Despite comparable expression of BCKDH components and phosphorylation of E1α at Ser293, significant accumulation of BCAA was observed in T2DM rats (OLETF; 317±30 nmol/g) compared to that in control rats (LETO; 213±16 nmol/g), and the accumulation of BCAA was accompanied by up-regulation of AMPD3 in the cytosol and ER by 98% and 231%, respectively. In cardiomyocytes, disruption of BCAA catabolism by knockdown of BCKDH-E1α resulted in a 5.8-fold increase in AMPD3 at the transcriptional level and blunted lipid droplet biogenesis in response to a long-chain fatty acid challenge. Next, myocardial infarction (MI) was induced in LETO and OLETF pretreated with empagliflozin (10 mg/kg/day, 14 days) or a vehicle. Pathway analysis of cardiac metabolites revealed arginine biosynthesis and BCAA metabolism as the most significantly changed pathways with empagliflozin, with BCAA (791±187 nmol/g), glutamate, glutamine and urea being significantly increased. Empagliflozin restored myocardial ATP and survival after MI in OLETF to levels comparable to those in LETO. Electron microscopy showed a significantly higher prevalence of myocardium lipid droplets in OLETF, which was further increased by empagliflozin.
Conclusions
The results support the hypotheses that imbalance of extra-mitochondrial AMPD3-BCKDH interaction underlies dysregulated BCAA metabolism in T2DM hearts and that activation of cardiac AA metabolism by an SGLT2i normalizes fatty acid overload through sequestration into intracellular lipid droplets.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Boehringer Ingelheim
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Affiliation(s)
- T Ogawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Osanami
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - Y Tatekoshi
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - H Oshima
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Mizuno
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Kuno
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - Y Fujita
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - S Ino
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Shimizu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - W Ohwada
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Sato
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Tanno
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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Nagase C, Tanno M, Kouzu H, Miki T, Nishida J, Murakami N, Kokubu N, Nagano N, Nishikawa R, Yoshioka N, Tsuchida A, Kita H, Ohnishi H, Miura T. Is GLP-1 insufficiency a coronary risk factor? A multicenter observational study, BOREAS-CAD2. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and aim
Glucagon-like peptide-1 (GLP-1) regulates insulin secretion and also affords pleiotropic effects including protective effects on blood vessels. Multiple factors regulate GLP-1 secretion after meals, but a group of apparently healthy subjects showed blunted responses of GLP-1 secretion in our previous study. In this study, we examined the possibility that the reduced capacity of GLP-1 secretion is associated with increased extent of coronary artery stenosis in non-diabetic patients.
Methods and results
Non-diabetic patients who were admitted for coronary angiography without a history of coronary interventions were enrolled. Coronary artery stenosis was quantified by Gensini score (GS), and GS ≥10 was used as an outcome variable based on results of earlier studies indicating its predictive value for cardiovascular events. The patients (mean age, 66.5±8.8 years; 71% males, n=173) underwent oral 75 g-glucose tolerant tests for determination of glucose, insulin and active GLP-1 levels. The area under the curve of plasma active GLP-1 (AUC-GLP-1) was determined as an index of GLP-1 secretion capacity. AUC-GLP-1 was not correlated with fasting glucose, AUC-glucose, serum lipids, indices of insulin sensitivity or estimated glomerular filtration rate. In multivariate logistic regression analysis for GS ≥10, AUC-GLP-1 < median, age and hypertension were selected as explanatory variables, though fasting GLP-1 level was not selected.
Conclusion
The findings indicate significant association of reduced GLP-1 secretion capacity with increased extent of coronary artery stenosis in non-diabetic patients. A causal relationship between change in GLP-1 secretion capacity and coronary stenosis remains to be examined by a longitudinal study
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This study was supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp./MSD K.K.
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Affiliation(s)
- C Nagase
- Sapporo Medical University, Sapporo, Japan
| | - M Tanno
- Sapporo Medical University, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Sapporo, Japan
| | - T Miki
- Sapporo Medical University, Sapporo, Japan
| | - J Nishida
- Sapporo Medical University, Sapporo, Japan
| | - N Murakami
- Sapporo Medical University, Sapporo, Japan
| | - N Kokubu
- Sapporo Medical University, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Sapporo, Japan
| | | | - N Yoshioka
- Sapporo Circulation Hospital, Sapporo, Japan
| | | | - H Kita
- JCHO Hokushin Hospital, Sapporo, Japan
| | - H Ohnishi
- Sapporo Medical University, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Sapporo, Japan
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11
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Hatanaka N, Xu B, Yasugi M, Morino H, Tagishi H, Miura T, Shibata T, Yamasaki S. Chlorine dioxide is a more potent antiviral agent against SARS-CoV-2 than sodium hypochlorite. J Hosp Infect 2021; 118:20-26. [PMID: 34536532 PMCID: PMC8442261 DOI: 10.1016/j.jhin.2021.09.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND A new coronavirus (SARS-CoV-2) abruptly emerged in Wuhan, China, in 2019 and rapidly spread globally to cause the COVID-19 pandemic. AIM To examine the anti-SARS-CoV-2 activity of the potent disinfectant Cleverin, the major disinfecting component of which is chlorine dioxide (ClO2); and to compare the results with that of sodium hypochlorite in the presence or absence of 0.5% or 1.0% foetal bovine serum (FBS). METHODS Concentrated SARS-CoV-2 viruses were treated with various concentrations of ClO2 and sodium hypochlorite and 50% tissue culture infective dose was calcurated to evaluate the antiviral activity of each chemical. FINDINGS When SARS-CoV-2 viruses were treated with 0.8 ppm ClO2 or sodium hypochlorite, viral titre was decreased only by 1 log10 TCID50/mL in 3 min. However, the viral titre was decreased by more than 4 log10 TCID50/mL when treated with 80 ppm of each chemical for 10 s regardless of presence or absence of FBS. It should be emphasized that treatment with 24 ppm of ClO2 inactivated more than 99.99% SARS-CoV-2 within 10 s or 99.99% SARS-CoV-2 in 1 min in the presence of 0.5% or 1.0% FBS, respectively. By contrast, 24 ppm of sodium hypochlorite inactivated only 99% or 90% SARS-CoV-2 in 3 min under similar conditions. Notably, except for ClO2, the other components of Cleverin such as sodium chlorite, decaglycerol monolaurate, and silicone showed no significant antiviral activity. CONCLUSION Altogether, the results strongly suggest that although ClO2 and sodium hypochlorite are strong antiviral agents in absence of organic matter but in presence of organic matter, ClO2 is a more potent antiviral agent against SARS-CoV-2 than sodium hypochlorite.
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Affiliation(s)
- N Hatanaka
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan
| | - B Xu
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - M Yasugi
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan
| | - H Morino
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - H Tagishi
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - T Miura
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - T Shibata
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - S Yamasaki
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan.
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12
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Yoshimura A, Yamaguchi T, Kugita M, Kumamoto K, Shiogama K, Ogitsu N, Yoneda M, Miura T, Nagamura Y, Nagao S. High Levels of Dietary Lard or Sucrose May Aggravate Lysosomal Renal Injury in Non-Obese, Streptozotocin-Injected CD-1 Mice Provided Isocaloric Diets. J Nutr Sci Vitaminol (Tokyo) 2021; 67:243-248. [PMID: 34470999 DOI: 10.3177/jnsv.67.243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Daily fat and sugar intake has increased in Japan, while total energy intake has decreased. However, the number of type 2 diabetes mellitus patients has increased, and this often causes renal injury characterized by autophagic vacuoles. Although many studies with comparisons of high fat or sugar versus a normal macronutrient balanced diet have been reported, there are few studies that equalized calorie intake and body weights. In the current study, AIN93M diets (CONT group) with matching energy content with lard derived high saturated fat (LARD group), soybean oil derived unsaturated fat (SOY OIL group) and sucrose (SUCROSE group) were provided to compare their effects on renal morphology in streptozotocin-injected CD-1 mice without causing obesity. The number of renal tubular vacuoles was higher in SUCROSE and slightly higher in LARD compared with CONT mice, and was higher in LARD and SUCROSE compared with SOY OIL mice. Most of those vacuoles were LAMP1-positive, a marker of lysosomal autophagy. These results suggest that despite identical energy contents, diets with high sucrose or saturated fat compared to unsaturated fat may aggravate lysosomal renal injury in a non-obese, streptozotocin-induced model of diabetes mellitus.
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Affiliation(s)
- Aya Yoshimura
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University
| | - Tamio Yamaguchi
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science
| | - Masanori Kugita
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University
| | - Kanako Kumamoto
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University
| | - Kazuya Shiogama
- Division of Morphology and Cell Function, Faculty of Medical Technology, School of Health Sciences, Fujita Health University
| | - Naomichi Ogitsu
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science
| | - Misao Yoneda
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science
| | - Toshihiro Miura
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science
| | - Yoichi Nagamura
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science
| | - Shizuko Nagao
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University
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13
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Miyazaki S, Shimoji H, Suzuki R, Chinushi I, Takayanagi H, Yaguchi H, Miura T, Maekawa K. Expressions of conventional vitellogenin and vitellogenin-like A in worker brains are associated with a nursing task in a ponerine ant. Insect Mol Biol 2021; 30:113-121. [PMID: 33150669 DOI: 10.1111/imb.12682] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 06/11/2023]
Abstract
In eusocial insect colonies, non-reproductive workers often perform different tasks. Tasks of an individual worker are shifted depending on various factors, e.g., age and colony demography. Although a vitellogenin (Vg) gene play regulatory roles in both reproductive and non-reproductive division of labours in a honeybee, it has been shown that the insect Vg underwent multiple gene duplications and sub-functionalisation, especially in apical ant lineages. The regulatory roles of duplicated Vgs were suggested to change evolutionarily among ants, whereas such roles in phylogenetically basal ants remain unclear. Here, we examined the expression patterns of conventional Vg (CVg), Vg-like A, Vg-like B and Vg-like C, as well as Vg receptor, during the task shift in an age-dependent manner and under experimental manipulation of colony demography in a primitive ant Diacamma sp. Expressions of CVg and Vg-like A in a brain were associated with a nursing task. It is suggested that associations of brain expressions of these Vgs with worker tasks were acquired in the basal ant lineage, and that such Vg functions could have sub-functionalised in the derived ant lineage.
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Affiliation(s)
- S Miyazaki
- Graduate School of Agriculture, Tamagawa University, Tokyo, Japan
| | - H Shimoji
- Faculty of Environmental Earth Science, Hokkaido University, Sapporo, Japan
- School of Science and Technology, Kwansei Gakuin University, Sanda, Japan
| | - R Suzuki
- Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
| | - I Chinushi
- Graduate School of Agriculture, Tamagawa University, Tokyo, Japan
| | - H Takayanagi
- Faculty of Environmental Earth Science, Hokkaido University, Sapporo, Japan
| | - H Yaguchi
- School of Science and Technology, Kwansei Gakuin University, Sanda, Japan
- Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
| | - T Miura
- Faculty of Environmental Earth Science, Hokkaido University, Sapporo, Japan
- Misaki Marine Biological Station, School of Science, The University of Tokyo, Miura, Japan
| | - K Maekawa
- Faculty of Science, Academic Assembly, University of Toyama, Toyama, Japan
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14
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Katano S, Yano T, Tsukada T, Kouzu H, Honma S, Inoue T, Takamura Y, Nagaoka R, Ohori K, Koyama M, Nagano N, Nishikawa R, Hashimoto A, Katayose M, Miura T. Clinical determinants and prognostic impact of osteoporosis in patients with chronic heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3418] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite accumulating evidence of a close association between orthopedic fractures and chronic heart failure (CHF), the clinical risk factors of osteoporosis, defined as reduction in bone mineral densities (BMDs), in CHF patients have not been systematically analyzed. In addition, the impact of osteoporosis on prognosis of CHF remains unclear.
Aims
We aimed to clarify the prevalence, clinical risk factors, and prognostic impact of osteoporosis in CHF patients.
Methods
We retrospectively examined 303 CHF patients (75 years, [interquartile range (IQR), 66–82 years]; 41% female). BMDs at the lumber spine, femoral neck, and total femur were measured by dual-energy X-ray absorptiometry (DEXA), and osteoporosis was diagnosed when BMD at any of the three sites was less than 70% of Young Adult Mean.
Results
The prevalence of osteoporosis in the CHF patients was 40%. Patients with osteoporosis were older (79 [IQR, 74–86] vs. 72 [IQR, 62–80] years), included a large percentage of females, had slower gait speed and had lower body mass index (BMI). Loop diuretics and warfarin were used more frequently and direct oral anticoagulants (DOACs) were used less frequently in patients with osteoporosis than in patients without osteoporosis. Multivariate logistic regression analysis indicated that sex (odds ratio [OR] 5.07, 95% Confidence Interval [CI] 2.68–9.61, p<0.01), BMI (OR, 0.83; 95% CI, 0.75–0.91; p<0.01), gait speed (OR, 0.80; 95% CI, 0.70–0.92; p<0.01), loop diuretics use (OR, 2.52; 95% CI, 1.20–5.27; p=0.01) and no DOACs use (OR, 0.43; 95% CI, 0.19–0.96; p=0.04) were independently associated with osteoporosis. During the mean follow-up period of 290±254 days, 92 patients (30.4%) had adverse events. When patients with osteoporosis were divided into subgroups according to the number of sites with BMD of an osteoporosis level, Kaplan-Meier survival curves showed that the rate of adverse events (death and cardiovascular events) was higher in patients with osteoporotic BMD at two or more sites than in patients without osteoporosis (51% vs. 23%, p=0.03) (Figure). In multivariate Cox regression analyses, osteoporotic BMD at two or more sites was an independent predictor of adverse events after adjustment for age, sex, and NT-proBNP level (Hazard ratio, 1.74; 95% CI, 1.01–2.99; p=0.04).
Conclusion
The risk of osteoporosis may be increased in users of loop diuretics and may be decreased in users of DOACs in CHF patients. Extent of osteoporosis is a novel predictor of adverse events in CHF patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Japan Society for the Promotion of Science KAKENHI
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Affiliation(s)
- S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Tsukada
- Social Welfare Corporation, Hokkaido Social Work Association Obihiro Hospital, Cardiac Rehabilitation Center, Obihiro, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - S Honma
- Sapporo Cardiovascular Hospital, Department of Rehabilitation, Sapporo, Japan
| | - T Inoue
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - Y Takamura
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - R Nagaoka
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Public Health, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Division of Health Care Administration and Management, Sapporo, Japan
| | - M Katayose
- Sapporo Medical University, Second Division of Physical Therapy, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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15
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Nishikawa K, Nagae A, Miura T, Katoh T, Kanzaki Y, Abe N, Yokota D, Yanagisawa T, Senda K, Wakabayashi T, Oyama Y, Okina Y, Nakazawa S, Tsukada S, Kagoshima M. Impact of frailty on super elderly patients with peripheral artery disease from the I-PAD 3 year registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Unlike age, frailty is often not taken into account in treatment indications of Endovascular treatment (EVT). One of the reason is that there was little known the relationship between frailty and the outcome of EVT for super elderly patients with peripheral artery disease (PAD). We investigate impacts of frailty on the super elderly patient prognosis who underwent EVT.
Purpose
To investigate impacts of frailty on the super elderly patient prognosis who underwent EVT.
Methods
From August 2015 to July 2016, 335 consecutive patients who underwent EVT were enrolled in the I-PAD registry from 7 institutes in Nagano prefecture. Among them, we selected and analyzed 91 super elderly PAD patients (≥80 years-old) and divided them into two groups:those with moderate or higher frailty (Clinical Frailty Scale (CFS) ≥6, n=28) and those without (CFS ≤5, n=63). The primary endpoints were cardiovascular death and major adverse cardiovascular and limb events (MACLE), defined as a composite of cardiovascular death, myocardial infarction, stroke, admission for heart failure, major amputation and revascularization.
Results
The median follow-up period was 2.7 years. Freedom rate from cardiovascular death and MACLE were significantly lower among patients with moderate or higher frailty than among those without (47.0% vs. 58.0%, P=0.03; 39.1% vs. 68.5%, P<0.01).
Conclusion
The prognosis of super elderly patients with moderate or higher frailty is worse than those without.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano Municipal Hospital, Nagano, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | - Y Kanzaki
- Shinonoi General Hospital, Nagano, Japan
| | - N Abe
- Nagano Red Cross Hospital, Nagano, Japan
| | - D Yokota
- Iida Hospital, Department of Cardiovascular Medicine, Iida, Japan
| | - T Yanagisawa
- Saku Central Hospital, Department of Cardiovascular Medicine, Saku, Japan
| | - K Senda
- Aizawa Hospital, Matsumoto, Japan
| | | | - Y Oyama
- Japanese Red Cross Society Suwa Hospital, Suwa, Japan
| | - Y Okina
- Joetsu General Hospital, Joetsu, Japan
| | | | - S Tsukada
- Joetsu General Hospital, Joetsu, Japan
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16
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Igaki Y, Osanami A, Tanno M, Sato T, Ogawa T, Yano T, Kouzu H, Miura T. Inhibition of xanthine oxidase ameliorates functional and metabolic impairment in type 2 diabetic hearts under pressure overload. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
We recently reported that upregulated AMP deaminase (AMPD), via reduction in the tissue adenine nucleotide pool, contributes to exacerbation of diastolic dysfunction under pressure overload in OLETF, a rat model of obese type 2 diabetes (T2DM). Upregulated AMPD also possibly promotes xanthine oxidase (XO)-mediated ROS production, since AMPD deaminases AMP to IMP, which is further converted to inosine, providing substrates of XO, hypoxanthine and xanthine. Here, we examined the hypothesis that inhibition of XO ameliorates the pressure overload-induced diastolic dysfunction by suppression of ROS-mediated mitochondrial dysfunction and/or vascular dysfunction in T2DM rats.
Methods and results
Metabolomic analyses revealed that levels of xanthine and uric acid in the LV myocardium were significantly higher by 37% and 51%, respectively, in OLETF than in LETO, non-diabetic control rats, under the condition of phenylephrine-induced pressure overloading (200–230 mmHg). Myocardial XO activity in OLETF was 57.9% higher than that in LETO, which may be attributed to 31% higher level of inosine, a positive regulator of XO, in OLETF than in LETO. The activity of XO was significantly attenuated by administration of topiroxostat, an XO inhibitor at 0.5 mg/kg/day for 14 days. Pressure volume loop analyses showed that the pressure overloading resulted in significantly higher LVEDP in OLETF than in LETO (18.3±1.5 vs. 12.2±1.3 mmHg, p<0.05, n=7), though LVEDPs at baseline were comparable in OLETF and LETO (5.6±0.4 vs. 4.7±0.7 mmHg). Treatment with topiroxostat significantly suppressed the pressure overload-induced elevation of LVEDP in OLETF (18.3±1.5 vs. 11.3±1.1 mmHg, p<0.05) but not in LETO. Under the condition of pressure overloading, Ea/Ees, an index for ventricular-arterial coupling, was higher in OLETF than in LETO (2.3±0.3 vs. 1.6±0.3, p<0.05), and it was also improved by topiroxostat in OLETF (1.2±0.2, p<0.05). Myocardial ATP content was lower in OLETF than in LETO (2966±400 vs. 1818±171 nmol/g wet tissue, p<0.05), and treatment with topiroxostat significantly restored the ATP level (2629±307 nmol/g wet tissue). The LV myocardium of OLETF under pressure overload showed significantly higher level of malondialdehyde and 4-hydroxynonenal, an indicator of lipid peroxidation, than that of LETO. Measurement of oxygen consumption rate by Seahorse XFe96 Analyzer in mitochondria isolated from LV tissues revealed that state 3 respiration was significantly suppressed in OLETF by 43% compared to LETO, and it was restored by treatment with topiroxostat.
Conclusion
Both activity and substrates of XO are increased in T2DM hearts, in which upregulation of AMPD may play a role. Inhibition of XO ameliorates pressure overload-induced diastolic dysfunction and improves ventricular-arterial coupling in diabetic hearts, most likely through protection of mitochondrial function from ROS-mediated injury.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant-in-aid for Scientific Research (#26461132, #17K09584) from the Japanese Society for the Promotion of Science
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Affiliation(s)
- Y Igaki
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Osanami
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Tanno
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Sato
- Sapporo Medical University, Department of Cellular physiology and Signal Transduction, Sapporo, Japan
| | - T Ogawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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17
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Nagai K, Fukuno S, Miura T, Uchino Y, Sehara N, Konishi H. Reduced cytotoxicity in doxorubicin-exposed HepG2 cells pretreated with menthol due to upregulation of P-glycoprotein. Pharmazie 2020; 75:510-511. [PMID: 33305727 DOI: 10.1691/ph.2020.0448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The aim of the present study was to examine changes in the expression and activity of P-glycoprotein (P-gp) in human hepatocellular carcinoma HepG2 cells after exposure to menthol, and their relationship to the cytotoxicity of and apoptotic responses to doxorubicin (DOX), a substrate of P-gp, in the cells. The expression of P-gp in HepG2 cells was significantly increased by menthol treatment. Intracellular accumulation of DOX in HepG2 cells was significantly lower in the menthol-treated group than in the control group, but this phenomenon was abolished in the presence of verapamil. Decreased cell viability by DOX was significantly attenuated by 24-h menthol treatment prior to DOX exposure, which coincided with the changes in mRNA expression of Bcl-xl and caspase-3. These results demonstrate that menthol causes hepatocellular carcinoma cells to acquire resistance to DOX by increasing its efflux through the upregulation of P-gp.
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Affiliation(s)
- K Nagai
- Laboratory of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan;,
| | - S Fukuno
- Laboratory of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan
| | - T Miura
- Pharmaceutical Education Support Center, School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, Nishinomiya, Japan
| | - Y Uchino
- Laboratory of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan
| | - N Sehara
- Laboratory of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan
| | - H Konishi
- Laboratory of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Japan
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18
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Miura T, Misa K, Yamamoto T. Subcutaneous Sweet syndrome mimicking cellulitis in a patient with myelodysplastic syndrome and subsequent secondary pulmonary alveolar proteinosis. Clin Exp Dermatol 2020; 45:763-764. [PMID: 32384176 DOI: 10.1111/ced.14279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/24/2020] [Accepted: 05/04/2020] [Indexed: 11/30/2022]
Affiliation(s)
- T Miura
- Departments of, Department of, Dermatology, Fukushima Medical University, Fukishama, Japan
| | - K Misa
- Department of, Respiratory Medicine, Fukushima Medical University, Fukishama, Japan
| | - T Yamamoto
- Departments of, Department of, Dermatology, Fukushima Medical University, Fukishama, Japan
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19
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Jang S, Suto Y, Liu J, Liu Q, Zuo Y, Duy PN, Miura T, Abe Y, Hamasaki K, Suzuki K, Kodama S. CORRIGENDUM TO: CAPABILITIES OF THE ARADOS-WG03 REGIONAL NETWORK FOR LARGE-SCALE RADIOLOGICAL AND NUCLEAR EMERGENCY SITUATIONS IN ASIA. Radiat Prot Dosimetry 2020; 188:270. [PMID: 32459335 DOI: 10.1093/rpd/ncaa079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/13/2020] [Accepted: 02/19/2020] [Indexed: 06/11/2023]
Affiliation(s)
- S Jang
- Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea
| | - Y Suto
- National Institute of Radiological Sciences (NIRS), National Institute for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - J Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Q Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Y Zuo
- China Institute of Radiation Protection (CIRP), China National Nuclear Corporation (CNNC), Taiyuen, China
| | - P N Duy
- Nuclear Research Institute (NRI), Viet Nam Atomic Energy Commission, VINATOM, Dalat, Viet Nam
| | - T Miura
- Hirosaki University, Hirosaki, Japan
| | - Y Abe
- Fukushima Medical University, Fukushima, Japan
| | - K Hamasaki
- Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - K Suzuki
- agasaki University, Nagasaki, Japan
| | - S Kodama
- Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea
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20
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Kobayashi M, Miura T, Miura K, Hiroyama N, Akashi K. Effect of a Moderate Carbohydrate-Restricted Diet on DPP-4 Inhibitor Action among Individuals with Type 2 Diabetes Mellitus: A 6-Month Intervention Study. J Nutr Sci Vitaminol (Tokyo) 2020; 66:114-118. [PMID: 32350172 DOI: 10.3177/jnsv.66.114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To decrease body weight and insulin resistance, a calorie-restricted diet-with minimal caloric intake required for daily activities-is the primary treatment strategy for patients with type 2 diabetes (T2D) in Japan. However, many patients cannot continue with this diet for long, because calorie restriction is difficult and nutritional balance is hard to understand. Carbohydrate-restricted diets are easier for patients than conventional calorie-restricted diet. In this study we aimed to elucidate the effects of a moderate carbohydrate-restricted diet on glucose metabolism and renal function in patients with T2D on dipeptidyl peptidase-4 (DPP-4) inhibitors. Nineteen outpatients with T2D continued on a moderate carbohydrate-restricted diet (targeting 50% of calories) for 6 mo. Meanwhile, 10 other outpatients with T2D on DPP-4 inhibitors had the conventional calorie-restricted diet using the food exchange table. No change in prescription drugs occurred for both groups during the study period. After the intervention, the carbohydrate content in dietary intake was lowered significantly from 56.8±8.3 to 46.8±10.1%, while the lipid concentration, primarily n-6 polyunsaturated fatty acids, was significantly increased. There was no significant change in protein intake. Hemoglobin A1c (HbA1c) fell from 7.22±0.74% to 6.95±0.72% (mean±SD). Furthermore, salt intake decreased significantly from 6.8±2.5 g prior to the intervention, to 5.7±1.9 g after the intervention. The estimated glomerular filtration rates (eGFR) decreased slightly, while serum creatinine levels did not change. These findings suggest that a moderate carbohydrate-restricted diet (50%) is effective in patients with T2D, without affecting kidney function.
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Affiliation(s)
- Masako Kobayashi
- Graduate School of Medical Sciences, Suzuka University of Medical Science
| | - Toshihiro Miura
- Department of Clinical Nutrition, Suzuka University of Medical Science
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Sato J, Shimizu T, Fujiwara Y, Yonemori K, Koyama T, Shimomura A, Tamura K, Iwasa S, Kondo S, Sudo K, Ikezawa H, Nomoto M, Nakajima R, Miura T, Yamamoto N. 17O A first-in-human phase I study of MORAb-202 in patients with folate receptor alpha-positive advanced solid tumors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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22
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SUGAWARA H, Moniwa N, Tanno M, Miki T, Kuno A, Yano T, Sato T, Kouzu H, Shibata S, Miura T. SUN-047 PROTECTION AFFORDED BY ANGIOTENSIN II RECEPTOR ACTIVATION AGAINST ACUTE KIDNEY INJURY IS ASSOCIATED WITH UPREGULATION OF TUBULAR AUTOPHAGY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Shibata S, Miura T, Sugawara H. SUN-046 ROLE OF NECROPTOSIS IN CONTRAST-INDUCED NEPHROPATHY IN A RAT MODEL OF CKD AND ITS MODIFICATION BY TOLVAPTAN. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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24
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Kouzu H, Oshima H, Miki T, Kuno A, Sato T, Yano T, Tanno M, Miura T. P207 Synergetic effect of amino acid and ketone metabolism underlies empagliflozin-mediated cardioprotection in the type 2 diabetic heart. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Boehringer Ingelheim
Background
Although emerging evidence has indicated that sodium glucose cotransporter 2 (SGLT2) inhibitors restore impaired cardiac energetics in type 2 diabetes mellitus (T2DM), the underlying molecular mechanisms have yet to be established. Augmented utilization of ketone is one proposed hypothesis, but depletion of succinyl-CoA triggered by the conversion of ketone back to acetyl-CoA by SCOT (succinyl-CoA:3-oxoacid CoA transferase) may hamper oxidative capacity of the tricarboxylic acid (TCA) cycle, which also requires succinyl-CoA. The recent finding that empagliflozin augments systemic amino acid metabolism in patients with T2DM led us to hypothesize that the anaplerotic effect of amino acid on the TCA cycle complements ketone oxidation.
Methods and Results
Myocardial infarction (MI) was induced in T2DM rats (OLETF) and control rats (LETO). Survival rate at 48 hours after MI was significantly lower in OLETF than in LETO (40% vs 84%), and empagliflozin treatment (10 mg/kg/day, 14 days) before MI improved the survival rate in OLETF to 70%. Metabolome analysis was performed using heart tissues from the non-infarct region 12 hours after MI. Using principal component analysis, data from 92 metabolites that were detected were compressed into 2 dimensions, and the first component (PC1) clearly separated empagliflozin-treated OLETF from non-treated LETO and OLETF. Analysis of factor loading of each metabolite for PC1 revealed that branched chain amino acids leucine, isoleucine and valine, the latter two of which can be oxidized to succynyl-CoA, and β-hydroxybutyrate were the top four metabolites that characterized empagliflozin treatment. Furthermore, in comparison to LETO, OLETF treated with empagliflozin showed 50% higher levels of glutamine and glutamate, both of which can replenish the TCA cycle at the level of α-ketoglutarate. In OLETF, empagliflozin significantly increased the TCA cycle intermediates citrate, cis-aconitate and malate by 74%, 119% and 59%, respectively. OLETF showed 86% higher lactate and 38% lower ATP than those in LETO, but levels of the metabolites were normalized by empagliflozin, suggesting improved glucose oxidation.
Conclusions
The present analyses showed that amino acid and ketone metabolism are metabolic pathways that are most affected by empagliflozin. Coordination of these "starvation-induced pathways" may underlie the favorable metabolic effect of empagliflozin in T2DM hearts.
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Affiliation(s)
- H Kouzu
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - H Oshima
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - T Miki
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - A Kuno
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - T Sato
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - M Tanno
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University School of Medicine, Sapporo, Japan
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Obase K, Matsumaru I, Nakaji S, Miura T, Eishi K. 41 Geometric change in valvular apparatus during tricuspid repair for severe tricuspid regurgitation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
For repairing severe tricuspid regurgitation (TR) with leaflet tethering, our team employs spiral suspension procedure, in which papillary muscles (PMs) are approximated and suspended towards annulus by suture in addition to annuloplasty.
Purpose
To visualize subtricuspid apparatus and investigate its geometric change by the procedure, comparing with annuloplasty alone.
Methods
11 patients who underwent spiral suspension and 10 patients who underwent annuloplasty alone were studied. Using 3D dataset derived from transesophgeal echocardiography with transgastric approach, the distances between the mid septal annulus (point C) and the anterior PM tip (point A) and posterior PM (point P) were calculated. Also, annular perimeter, leaflet surface area and tenting height were measured
Results
In all cases, PM tips could be visualized and identified for the measurements. By spiral suspension, the distance CA and tenting height were significantly reduced. On the other hand, by annuloplasty alone, CA and tenting height were likely to be increased but statistically not significant.
Conclusions
Spiral suspension ameliorated leaflet tethering with relocating PMs. Annuloplasty alone reduced leaflet surface area, which indicates increase of coaptation surface. Interestingly, PM tip- annulus distance and tenting height were possibly increased by annuloplasty. Further investigation is need in large number.
Result of measurements Annuloplasty alone Spiral suspension Pre-op Post-op Pre-op Post-op Annular perimeter, mm 120.9 ± 11.2 78.8 ± 5.1* 142.4 ± 18.2* 81.1 ± 6.4** Leaflet surface area, cm2 13.1 ± 3.1 5.6 ± 0.9* 19.3 ± 4.8* 5.8 ± 0.8** Tenting height, mm 2.8 ± 2.3 3.1 ± 1.2 7.0 ± 4.8* 2.9 ± 2.6** CA, mm 27.3 ± 3.9 29.1 ± 6.2 35.7 ± 6.9* 29.6 ± 5.2** CP, mm 33.1 ± 6.0 33.8 ± 9.4 38.5 ± 8.2 33.9 ± 6.1 *p < 0.05, vs Annuloplasty alone pre-op **p < 0.05, vs Spiral suspension pre-op
Abstract 41 Figure. Pre- and post-operative valve apparatus
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Affiliation(s)
- K Obase
- Nagasaki University Hospital, Cardiovascular Surgery, Nagasaki, Japan
| | - I Matsumaru
- Nagasaki University Hospital, Cardiovascular Surgery, Nagasaki, Japan
| | - S Nakaji
- Nagasaki University Hospital, Cardiovascular Surgery, Nagasaki, Japan
| | - T Miura
- Nagasaki University Hospital, Cardiovascular Surgery, Nagasaki, Japan
| | - K Eishi
- Nagasaki University Hospital, Cardiovascular Surgery, Nagasaki, Japan
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Igaki Y, Tanno M, Kouzu H, Tatekoshi Y, Yano T, Kuno A, Sato T, Miki T, Miura T. P121 Pressure overload-induced functional and metabolic impairments in type 2 diabetic hearts are ameliorated by inhibition of xanthine oxidase. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
SANWA KAGAKU KENKYUSHO Co., Ltd.
Background
We have recently demonstrated that AMP deaminase (AMPD) is upregulated in OLETF, obese type 2 diabetic (T2DM) rats, and that the upregulated AMPD contributes to depletion of myocardial ATP at the time of pressure overload, leading to diastolic dysfunction. On the other hand, AMPD promotes the formation of IMP from AMP, and IMP is in turn further converted to hypoxanthine and xanthine, substrates of xanthine oxidase (XO), which produces uric acid with ROS as a byproduct. Based on these findings, we tested the hypothesis that inhibition of XO ameliorates the pressure overload-induced diastolic dysfunction in T2DM rats.
Methods and results
Metabolomic analyses of the left ventricular myocardium revealed that levels of myocardial hypoxanthine and xanthine were significantly higher by 30% and 28%, respectively, in OLETF than in LETO, non-diabetic control rats, under the condition of pressure overloading (200-230 mmHg) induced by phenylephrine infusion. Myocardial XO activity in OLETF was 57.9% higher than that in LETO, and the activity was significantly attenuated by oral administration of topiroxostat, an XO inhibitor, at 0.1-0.5 mg/kg/day for 14 days in a dose-dependent manner. Pressure volume loop analyses showed that the pressure overloading induced by phenylephrine infusion resulted in significantly higher LVEDP in OLETF than in LETO (18.3 ± 1.5 vs. 12.2 ± 1.3 mmHg, p < 0.05, n = 7), though LVEDPs at baseline were comparable in OLETF and LETO (5.6 ± 0.4 vs. 4.7 ± 0.7 mmHg). Treatment with topiroxostat significantly suppressed the pressure overload-induced elevation of LVEDP in OLETF (18.3 ± 1.5 vs. 11.3 ± 1.1 mmHg, p < 0.05) but not in LETO. Tau, the time constant of LV pressure decay, was significantly prolonged to 14.7 ± 0.7 ms (p < 0.05) by pressure overloading in OLETF but not in LETO, though baseline Tau values were similar in LETO and OLETF (6.1 ± 0.2 vs. 8.0 ± 0.4 ms). The prolongation of Tau by pressure overloading in OLETF was significantly attenuated by treatment with topiroxostat. Ea/Ees, an index for ventricular-arterial coupling, was higher in OLETF than in LETO (2.3 ± 0.3 vs. 1.6 ± 0.3, p < 0.05) under the condition of pressure overloading, and it was also improved by topiroxostat in OLETF (1.2 ± 0.2, p < 0.05). Myocardial ATP content was lower in OLETF than in LETO under the condition of pressure overloading (2966 ± 400 vs. 1818 ± 171 nmol/g wet tissue, p < 0.05), but treatment with topiroxostat significantly restored the ATP level (2629 ± 307 nmo/g wet tissue). Conclusion: In T2DM hearts, not only XO activity but also XO substrates are upregulated and upregulated AMPD may be involved in the upregulation. Inhibition of XO ameliorates pressure overload-induced diastolic dysfunction and improves ventricular-arterial coupling most likely through augmented ATP preservation.
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Affiliation(s)
- Y Igaki
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Tanno
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - Y Tatekoshi
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Kuno
- Sapporo Medical University, Department of Pharmacology, Sapporo, Japan
| | - T Sato
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miki
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cadiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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27
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Jang S, Suto Y, Liu J, Liu Q, Zuo Y, Duy PN, Miura T, Abe Y, Hamasaki K, Suzuki K, Kodama S. CAPABILITIES OF THE ARADOS-WG03 REGIONAL NETWORK FOR LARGE-SCALE RADIOLOGICAL AND NUCLEAR EMERGENCY SITUATIONS IN ASIA. Radiat Prot Dosimetry 2019; 186:139-142. [PMID: 30576530 DOI: 10.1093/rpd/ncy279] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/27/2018] [Accepted: 12/02/2018] [Indexed: 06/09/2023]
Abstract
In 2015, the Asian Radiation Dosimetry Group established a regional network of biological dosimetry laboratories known as the ARADOS-WG03 (Working Group 03; Biological Dosimetry). A survey was conducted in 2017 to evaluate the capabilities and capacities of the participating laboratories for emergency preparedness and responses in large-scale nuclear and/or radiological incidents. The results of this survey were identified and assessed. The data provide important information on the current state of emergency cytogenetic biological dosimetry capabilities in the Asian region.
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Affiliation(s)
- S Jang
- Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea
| | - Y Suto
- National Institute of Radiological Sciences (NIRS), National Institute for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - J Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Q Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Y Zuo
- China Institute of Radiation Protection (CIRP), China National Nuclear Corporation (CNNC), Taiyuen, China
| | - P N Duy
- Nuclear Research Institute (NRI), Viet Nam Atomic Energy Commission, VINATOM, Dalat, Viet Nam
| | - T Miura
- Hirosaki University, Hirosaki, Japan
| | - Y Abe
- Fukushima Medical University, Fukushima, Japan
| | - K Hamasaki
- Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - K Suzuki
- Nagasaki University, Nagasaki, Japan
| | - S Kodama
- Osaka Prefacture University, Osaka, Japan
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28
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Miura H, Watanabe A, Okugawa M, Miura T, Koganeya T. Plant inspection by using a ground vehicle and an aerial robot: lessons learned from plant disaster prevention challenge in world robot summit 2018. Adv Robot 2019. [DOI: 10.1080/01691864.2019.1690575] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- H. Miura
- Aichi Institute of Technology, Toyota-shi, Japan
| | - A. Watanabe
- Aichi Institute of Technology, Toyota-shi, Japan
| | - M. Okugawa
- Aichi Institute of Technology, Toyota-shi, Japan
| | - T. Miura
- Sanritz Automation Co. Ltd., Toyota-shi, Japan
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29
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Tanaka H, Toyoshima Y, Kawakatsu S, Kobayashi R, Yokota O, Terada S, Kuroda S, Miura T, Higuchi Y, Otsu H, Sanpei K, Otani K, Ikeuchi T, Onodera O, Kakita A, Takahashi H. Morphological characterisation of glial and neuronal tau pathology in globular glial tauopathy (Types II and III). Neuropathol Appl Neurobiol 2019; 46:344-358. [DOI: 10.1111/nan.12581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022]
Affiliation(s)
- H. Tanaka
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
| | - Y. Toyoshima
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
| | - S. Kawakatsu
- Department of Neuropsychiatry Aizu Medical Center Fukushima Medical University Aizu Fukushima Japan
| | - R. Kobayashi
- Department of Psychiatry Yamagata University School of Medicine Yamagata Japan
| | - O. Yokota
- Department of Psychiatry Kinoko Espoir Hospital Okayama Japan
| | - S. Terada
- Department of Neuropsychiatry Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - S. Kuroda
- Department of Psychiatry Zikei Institute of Psychiatry Okayama Japan
| | - T. Miura
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - Y. Higuchi
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - H. Otsu
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - K. Sanpei
- Department of Neurology Sado General Hospital Niigata Japan
| | - K. Otani
- Department of Psychiatry Yamagata University School of Medicine Yamagata Japan
| | - T. Ikeuchi
- Department of Molecular Genetics Brain Research Institute Niigata University Niigata Japan
| | - O. Onodera
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - A. Kakita
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
| | - H. Takahashi
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
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Yuki M, Kosugi K, Nishiguchi Y, Miura T, Fujisawa D, Uehara Y, Kawaguchi T, Izumi K, Takehana J, Matsumoto Y. Factors associated with economic burden among cancer patients with minor children: A cross-sectional web-based survey of an online cancer community. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz430.008] [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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31
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Miura T, Aoki T, Ohtsuka H, Aoki S, Hata T, Iseki M, Takadate T, Ariake K, Kawaguchi K, Masuda K, Ishida M, Mizuma M, Hayashi H, Nakagawa K, Morikawa T, Motoi F, Sasano H, Naitoh T, Kamei T, Unno M. Preoperative neutrophil‐to‐lymphocyte ratio (NLR) predicts recurrence after surgery in patient with pancreatic neuroendocrine neoplasm (PanNEN). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Usui Y, Kosugi K, Nishiguchi Y, Miura T, Fujisawa D, Uehara Y, Kawaguchi T, Izumi K, Takehana J, Matsumoto Y. Parenting experiences of cancer patients with minor children and their conversations about the possibility of death: A cross-sectional web-based survey for the online cancer community. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz430.001] [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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33
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Nagae A, Nishikawa K, Fujimori K, Katoh T, Miura T, Miyashita Y, Kashiwagi D, Senda K, Sakai T, Saigusa T, Ebisawa S, Motoki H, Okada A, Kuwahara K. P943The impact of diabetes on patients with frail after endovascular treatments: from I-PAD registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Diabetes mellitus (DM) is known to be one of the risks of arteriosclerosis. However, it is still unknown whether DM is a risk factor also in secondary prevention of frail patients after endovascular treatments (EVT)
Purpose
To investigate impact of diabetes on patients with frail after EVT.
Methods
From July 2015 to July 2016, 371 consecutive PAD patients who performed EVT were enrolled in I-PAD registry. We could conduct follow up survey 361 patients (446 lesions) and divided into 2 groups; with diabetes (185 patients, 226 lesions) or without diabetes (176 patients, 220 lesions) and analyzed. And among them,we selected 96 patients with frail and divided into 2 groups; with diabetes (49 patients, 70 lesions) or without diabetes (46 patients, 58 lesions) and analyzed. We defined frail patients as the patients with Clinical Frailty Scale 5 (mild frail) or higher. The primary end point was all-cause-death and major adverse limb events (MALE: TLR, TVR, major amputations) at 1 year.
Result
At 1 years in the patients group with diabetes, overall survival and freedom from MALE were significantly lower (81.7% vs 95.8% P<0.0001; 80.0% vs 94.6%, P<0.0001) than the group without diabetes.Among the patients with frail, between the patients group with diabetes and the group without, there is no significant differences in overall survival and freedom from MALE (88.2% vs 88.9% P=0.83; 80.7% vs 84.1%, P=0.55) at 5 years.
Conclusion
The prognosis of patients with diabetes after EVT was worse than the patient without. On the other hand, the prognosis of frail patients with diabetes after EVT was no difference with the frail patient without diabetes in this study.
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Affiliation(s)
- A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - K Nishikawa
- Shinshu University Hospital, Matsumoto, Japan
| | - K Fujimori
- Shinshu University Hospital, Matsumoto, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano municipal hospital, Cardiology, Nagano, Japan
| | - Y Miyashita
- Nagano Red Cross Hospital, Cardiology, Nagano, Japan
| | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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Fujimori K, Nagae A, Miura T, Katoh T, Hirabayashi M, Kashiwagi D, Yokota D, Yanagisawa T, Sakai T, Senda K, Saigusa T, Ebisawa S, Okada A, Motoki H, Kuwahara K. P942Impact of left ventricular ejection fraction in patients with critical limb ischemia: from I-PAD registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In patients with critical limb ischemia (CLI) it is known that malnutrition, low BMI, inflammation and so on are prognostic factors. But, it is unclear whether left ventricular ejection fraction (LVEF) affects prognosis of CLI patients. So we investigated that LVEF affects prognosis of CLI patients.
Methods
From July 2015 to July 2016, 371 consecutive peripheral artery disease patients who performed endovascular treatment (EVT) were enrolled in I-PAD registry. 179 of them were patients with CLI. We could conduct follow up survey about 126 (age 75.5±11.1, men 63.5%) and divided two groups according to their LVEF (group with LVEF≤40%, n=13, group without LVEF≤40%, n=113). The primary end point was major adverse limb events (MALE: TLR, TVR, major amputations) and secondary end point was all-cause death.
Results
The median follow-up period was 11.5±6.7 months. The 18 months MALE rate was significant higher in the group with low LVEF than group without low LVEF (76.9% vs 37.2% p<0.05). The 18months all-cause death tended to be higher in the group with low LVEF, however there was not statistical significance in the two groups (53.8% vs 24.8% p=0.09).
Conclusion
LVEF was associated with MALE in patients with CLI.
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Affiliation(s)
- K Fujimori
- Shinshu University Hospital, Matsumoto, Japan
| | - A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano municipal hospital, cardiology, Nagano, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | - M Hirabayashi
- Shinonoi General Hospital, cardiology, Matsumoto, Japan
| | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | - D Yokota
- Iida Hospital, cardiology, iida, Japan
| | | | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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35
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Shimizu A, Sonoda S, Setoyama K, Inoue K, Miura T, Anai R, Tsuda Y, Araki M, Otsuji Y. P6402Ischemic and bleeding events during dual antiplatelet therapy after second-generation drug-eluting stent implantation in hemodialysis patients: a propensity score-matched analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Dual-antiplatelet therapy (DAPT) after second-generation drug eluting stent (2-DES) implantation reduced the risk of stent thrombosis and subsequent ischemic events, with an increase in bleeding risk. Although chronic kidney disease patients have high ischemic and bleeding risk, little is known about both risks in hemodialysis patients after 2-DES implantation during DAPT.
Method
From July 2009 to March 2017, we retrospectively analyzed post-discharge major adverse cardiac and cerebrovascular events [MACCE: cardiac death, myocardial infarction, target vessel revascularization (TVR) and cerebral infarction] and bleeding events in 644 consecutive patients during DAPT after 2-DES implantation. We divided them into 2 groups [102 hemodialysis (HD) and 518 non-hemodialysis (Non-HD) patients, mean age, 71±10 years] after excluding 24 patients (lost to follow up and peritoneal dialysis). Follow-up period was 49±24 months. Median DAPT duration was 12 months. The primary endpoint was MACCE. The secondary endpoint was bleeding events according to the Bleeding Academic Research Consortium (BARC) type 2, 3, or 5. MACCE and bleeding events were compared between HD and Non-HD by using the propensity score-matching (PSM) method.
Results
Among the 620 eligible patients, the primary and secondary events occurred in 207 (33.3%) and 76 (12.3%) patients, respectively. The rates of unadjusted MACCE [HD vs Non-HD: 53.9% vs 29.3%; Hazard ratio (HR) 2.39, p<0.01] and bleeding events (HD vs Non-HD: 21.6% vs 10.4%; HR 2.50, p<0.01) were significantly higher in HD than Non-HD.
After 1-to-1 propensity score adjustment for baseline differences (hypertension, diabetes mellitus, low ejection fraction, low albumin, anemia, and high C-reactive protein), a total of 160 patients (80 HD vs 80 Non-HD) was created. The rate of MACCE [HD vs Non-HD: 52.5% vs 31.3%; adjusted HR 2.04, p<0.01] was significantly higher in HD than Non-HD. Regarding MACCE, cardiac death (HD vs Non-HD: 18.8% vs 8.8%; adjusted HR 2.65, p=0.03) and TVR (HD vs Non-HD: 15.0% vs 6.3%; adjusted HR 2.74, p=0.046) occurred significantly higher in HD. On the other hand, bleeding events did not exhibit significant differences though HD had a numerically higher event rate (HD vs Non-HD: 25.0% vs 16.3%; adjusted HR 1.68, p=0.15), indicating that the bleeding risk in HD would be strongly dependent on the patient's background.
Conclusions
As a result of PSM, HD was shown to contribute to ischemic risk rather than bleeding risk. Even in the 2-DES era, HD was an independent risk factor of cardiac death and TVR. Therefore, further study on the current regimen of DAPT would be necessary while balancing both ischemic and bleeding risk.
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Affiliation(s)
- A Shimizu
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - S Sonoda
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - K Setoyama
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - K Inoue
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - T Miura
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - R Anai
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - Y Tsuda
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - M Araki
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
| | - Y Otsuji
- University of Occupational and Environmental Health, cardiovascular medicine, Kitakyushu, Japan
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Nishigawa K, Nagae A, Miura T, Katoh T, Hirabayashi M, Miyashita Y, Kashiwagi D, Mochidome T, Sakai T, Senda K, Saigusa T, Ebisawa S, Okada A, Motoki H, Kuwahara K. P1957Impact of fraility on the super elderly patients with peripheral artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The current consensus is that frail patients have high risks of mortality. However, it remains unclear whether frailty is associated with mortality risks in super-elderly patients with peripheral artery disease (PAD).
Methods
The I-PAD registry was a prospective multicenter observational study involving 12 institutions in Nagano prefecture in Japan. From July 2015 to July 2016, the I-PAD registry enrolled 371 consecutive PAD patients who had undergone endovascular therapy (EVT). Among them, we selected and analysed 109 PAD patients who were >80 years old when they had undergone EVT and divided them into two groups: those with frailty (Clinical Frailty Scale≥5, n=47) and those without frailty (Clinical Frailty Scale≤4, n=62). The primary endpoints were overall survival and major adverse limb events (MALE), defined as a composite of all-cause death, major amputation and revascularization.
Results
The median follow-up period was 1.58±0.3 years. Overall, 109 patients with a mean age of 84.8±4.0 years, of whom 63.3% were men, were included. Overall survival and freedom from MALE were significantly lower among patients with frailty than among those without frailty (60.5% vs. 91.6%, P<0.001; 51.4% vs. 87.5%, P<0.001; respectively).
Conclusion
The prognosis of super-elderly patients with frailty is worse than that of patients without frailty.
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Affiliation(s)
- K Nishigawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano Municipal Hospital, Nagano, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | | | | | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | | | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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Fujimori K, Nagae A, Miura T, Katoh T, Hirabayashi M, Kashiwagi D, Yokota D, Yanagisawa T, Sakai T, Senda K, Saigusa T, Ebisawa S, Okada A, Motoki H, Kuwahara K. P936Impact of left ventricular ejection fraction in patients with peripheral artery disease: from I-PAD registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
In patients with peripheral artery disease (PAD) it is known that CVD is one of prognostic factors. But, it is unclear whether left ventricular ejection fraction (LVEF) affects prognosis of PAD patients. So we investigated that LVEF affects prognosis of PAD patients.
Methods
From July 2015 to July 2016, 371 consecutive PAD patients who performed endovascular treatment (EVT) were enrolled in I-PAD registry. We could conduct follow up survey about 337 (age 73.8±9.6, men 72.4%) patients and divided two groups according to their LVEF (group with LVEF≤40%, n=18, group without LVEF≤40%, n=319). The primary end point was major adverse limb events (MALE: TLR, TVR, major amputations) and secondary end point was all-cause death.
Results
The median follow-up period was 13.6±5.7 months. The 18 months MALE and all-cause death rate were significantly higher in the group with low LVEF than group without low LVEF (61.1% vs 21.6% p<0.001, 44.4% vs 11.6% p<0.001).
Conclusion
LVEF was significantly associated with MALE and all-cause death in patients with PAD.
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Affiliation(s)
- K Fujimori
- Shinshu University Hospital, Matsumoto, Japan
| | - A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano municipal hospital, cardiology, Nagano, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | - M Hirabayashi
- Shinonoi General Hospital, cardiology, Matsumoto, Japan
| | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | - D Yokota
- Iida Hospital, cardiology, iida, Japan
| | | | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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38
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Ohori K, Yano T, Katano S, Honma S, Shimomura K, Watanabe A, Ishigo T, Fujito T, Nagano N, Koyama M, Kouzu H, Hashimoto A, Miura T. P4537Impact of body composition analysis on prediction of short-term readmission events in heart failure: muscle wasting vs. obesity. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity, defined as higher body mass index (BMI), is associated with better prognosis in patients with chronic heart failure (CHF), though the presence of obesity is a risk factor of development of CHF (Obesity paradox). On the other hand, muscle wasting, i.e. reduction in skeletal muscle mass, is frequently observed in CHF, leading to lower exercise capacity and poor cardiovascular outcome.
Purpose
The aim of this study was to examine whether analysis of body composition improves prediction of short-term readmission rates in patients with CHF.
Methods
We retrospectively analyzed data for 167 consecutive HF patients who were admitted to our institute for management of HF and received a Dual-energy X-ray absorptiometry (DEXA) scan. Muscle wasting was defined as DEXA-measured appendicular skeletal muscle mass index <7.0 kg/m2 in male and <5.4 kg/m2 in female according to the Asian Working Group for Sarcopenia criteria. Obesity was defined according to the criteria by the use of DEXA-measured percent body fat mass: >25% in male, >30% in female. The primary endpoint was readmission due to cardiac events including worsening heart failure, arrhythmia, and cardiopulmonary arrest during a 180-days follow-up period after discharge.
Results
The mean age of the patients was 74±13 years and 46% of them were male. The mean BMI was 21.8±3.8 kg/m2. Forty-seven percent of the patients were classified as NYHA functional class III. The most frequent etiology of HF was cardiomyopathy (30%), followed by ischemic heart disease (27%) and valvular heart disease (27%). The prevalence of muscle wasting and that of obesity were 69% and 59%, respectively. Patients with muscle wasting had lower BMI level, higher prevalence of NYHA functional class III and diabetes mellitus compared with those without muscle wasting. On the other hand, patients with obesity had higher prevalence of hypertension and dyslipidemia, higher level of BMI, fasting plasma insulin and triglyceride, and lower level of HDL-cholesterol compared with those without obesity. During the follow-up period, 34 patients (19%) were re-hospitalized due to cardiac events. Kaplan-Meier survival curves showed that patients with obesity had a significantly lower readmission rate during a 180-days follow-up period than did the patients without obesity (14.3% vs. 29.0%, Log-Rank test, p<0.01). There was no difference in readmission rates between patients with and without muscle wasting (20.0% vs. 21.2%, p=0.88). In multivariate Cox regression analyses adjusted for age, sex, diabetes, and renal function, obesity was independently associated with lower readmission rates (hazard ratio 0.45, 95% confidence interval 0.22–0.93). However, the association between obesity and readmission rate was lost after the adjustment for NT-proBNP levels.
Conclusion
Body composition analysis by DEXA enables to find CHF patients with increased fat mass who have lower risk of short-term readmission.
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Affiliation(s)
- K Ohori
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - S Katano
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - S Honma
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - K Shimomura
- Sapporo Medical University, Division of Rehabilitation, Sapporo, Japan
| | - A Watanabe
- Sapporo Medical University, Division of Nursing, Sapporo, Japan
| | - T Ishigo
- Sapporo Medical University, Division of Hospital Pharmacy, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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Saigusa T, Miura T, Taki M, Kobayashi M, Kanai M, Okuma Y, Yanagisawa T, Hashizume N, Otagiri K, Shoin K, Kato T, Ebisawa S, Motoki H, Kuwahara K. P2696Clinical characteristics of late catch-up phenomenon after implantation of 2nd generation drug eluting stent. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Late catch-up phenomenon (LCU) of 1st generation drug eluting stent (DES) has been increasing yearly despite the rate of restenosis in 1 year has reduced compared with bare metal stent (BMS). 2nd generation DES was more improved than 1st generation DES and suggested more benefits about clinical outcome.
Purpose
To investigate the incidence and predictor of LCU after implantation of 2nd generation DES and to evaluate the association between LCU phenomenon and adverse events.
Methods
Between August 2012 and July 2013, a total of 1665 consecutive patients (1956 lesions with elective/urgent PCI) were enrolled in SHINANO 5 years Registry (a prospective observational multicenter cohort study) from 13 institutions in Nagano, Japan. 711 patients that were treated with 2nd generation DES and 576 patients with BMS were selected. Exclusion criterias were cases of 1st DES, only POBA, only aspiration and chronic total occulusion.
Results
There were significant difference about patients background between BMS and 2nd generation DES groups. Those groups were matched with propensity score. After matching, 822 patients (BMS group 411 patients, 2nd generation group 411 patients) were analyzed. The rates of 2nd DES and BMS restenosis 5 years after initial PCI were 9.2% and 8.5% (p=0.572), those of LCU were 2.6% and 5.6% (p=0.043) by 1 year landmark analysis. Cox proportional hazards analysis revealed that the DES in-stent restenosis (ISR) lesion and higher HbA1c were independent predictors for LCU from 1year to 5year (HR 5.304, p=0.009, HR 1.254, p=0.015), but 2nd generation DES was not. Kaplan Meier curve showed no association between LCU phenomenon and all cause death (p=0.446). Cox regression analysis showed LCU was not independent predictor for all cause death (p=0.414).
Conclusions
Implantation to DES-ISR lesion with 2nd generation DES was associated with higher LCU. Despite of more complex lesions with 2nd generation DES, there were no differences of LCU incidence between 2nd generation DES and BMS.
Acknowledgement/Funding
None
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Affiliation(s)
- T Saigusa
- Shinshu University School of Medicine, Department of Cardiovascular Medicine, Matsumoto, Japan
| | - T Miura
- Nagano municipal hospital, Nagano, Japan
| | - M Taki
- Shinshu Ueda medical center, Ueda, Japan
| | - M Kobayashi
- Matsumoto Kyoritsu Hospital, Matsumoto, Japan
| | - M Kanai
- Nagano red cross hospital, Nagano, Japan
| | - Y Okuma
- Suwa red cross hospital, suwa, Japan
| | | | | | | | - K Shoin
- Aizawa Hospital, Matsumoto, Japan
| | - T Kato
- Shinshu University School of Medicine, Department of Cardiovascular Medicine, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University School of Medicine, Department of Cardiovascular Medicine, Matsumoto, Japan
| | - H Motoki
- Shinshu University School of Medicine, Department of Cardiovascular Medicine, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University School of Medicine, Department of Cardiovascular Medicine, Matsumoto, Japan
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40
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Shimomura K, Katano S, Yano T, Ohori K, Honma S, Watanabe A, Ishigo T, Fujito T, Nagano N, Koyama M, Kouzu H, Hashimoto A, Miura T. P1538Low energy intake predicts readmission of elderly heart failure patients independently of nutritional status. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Malnutrition is frequently present and closely associated with poor clinical outcomes in elderly heart failure (HF) patients. Our previous study showed that low energy intake (EI) is associated with worse functional status in elderly HF inpatients after cardiac rehabilitation, but significance of EI in prediction of hospital readmission has not been elucidated fully.
Purpose
We examined whether low EI is a predictor of readmission for cardiac events in elderly HF patients.
Methods
We retrospectively retrieved data for 298 HF patients aged ≥65 years (median age of 77 years, interquartile range [IQR]: 71 - 82, female: 53%) who admitted to our institute for diagnosis and treatment of HF. Medical records were reviewed with regard to demography, medical history, comorbidities, medications, laboratory data, echocardiograms, functional status, nutritional status and total energy intake. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF) and total EI per day were calculated at discharge by a registered dietitian and a trained physical therapist. The primary endpoint was readmission due to cardiovascular events including worsening HF, arrhythmia, angina pectoris and myocardial infarction during a 1-year follow-up period.
Results
The median period of follow-up was 235 days (IQR: 78–365 days). The 1-year readmission rate for cardiovascular events was 54.4%. The cutoff values of MNA-SF score and EI, calculated by ROC curve analysis to predict the primary endpoint, were 7 points (area under the curve [AUC]: 0.59, sensitivity: 0.65, specificity: 0.50) and 31.8 kcal/kg/day (AUC: 0.59, sensitivity: 0.83, specificity: 0.35), respectively. Patients with low MNF-SF score (≤7) or low EI (≤31.8 kcal/kg/day) had significantly higher readmission rate during a 1-year follow-up period than did the patients with high MNF-SF score or EI (MNA-SF: 60.7% vs. 45.6%, p<0.01, EI: 60.4% vs. 36.8%, p<0.01), respectively. When patients were classified into four groups using cutoff values of MNA-SF score and EI, 1-year readmission rate was significantly higher in patients with low EI than in those with high EI regardless of MNF-SF scores. In multivariate Cox proportional hazard analyses adjusted for known prognostic factors in addition to age and gender, hazard ratios (HR) were significantly higher in patients with high MNA-SF score and low EI (adjusted HR: 2.81, 95% confidential interval [CI]: 1.15 - 9.32, p=0.02) and low MNA-SF score (≤7) and low EI (adjusted HR: 4.16, 95% CI: 1.72 - 13.72, p<0.01) than those with high MNA-SF score and high EI.
Kaplan-Meier curves of readmission rates
Conclusions
Low energy intake is a nutritional status-independent predictor of 1-year readmission rate in elderly HF patients.
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Affiliation(s)
- K Shimomura
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - S Katano
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - T Yano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Ohori
- Hokkaido Cardiovascular Hospital, Department of Cardiology, Sapporo, Japan
| | - S Honma
- Sapporo Medical University Hospital, Division of Rehabilitation, Sapporo, Japan
| | - A Watanabe
- Sapporo Medical University Hospital, Division of Nursing, Sapporo, Japan
| | - T Ishigo
- Sapporo Medical University Hospital, Department of Hospital Pharmacy, Sapporo, Japan
| | - T Fujito
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - N Nagano
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - M Koyama
- Sapporo Medical University School of Medicine, Department of Public Health, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Hashimoto
- Sapporo Medical University School of Medicine, Division of Health Care Administration and Management, Sapporo, Japan
| | - T Miura
- Sapporo Medical University School of Medicine, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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Setoyama K, Inoue K, Miura T, Shimizu A, Anai R, Sanuki Y, Tsuda Y, Araki M, Sonoda S, Otsuji Y. P3590Impact of right ventricular branch slow flow phenomenon post percutaneous coronary intervention for acute coronary syndrome to predict sustained right ventricular dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although Right Ventricular dysfunction (RVD) is one of the predictor of poor prognosis, it is believed that ischemic RVD after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) restores quickly. Because right ventricular perfusion has more ischemic preconditioning compared with left ventricle, due to their complex perfusion system. However, little is known about the time courses of RVD after ACS-PCI andtheir prognosis. We evaluated the relationship between right ventricular branch slow flow phenomenon (RVB-SF) post ACS-PCI in right coronary artery (RCA) and RVD at 6–8 months follow-up.
Method
We retrospectively analyzed consecutive 82 patients who underwent PCI for ACS in proximal or mid portion of RCA from August 2011 to March 2018 in our institution. Finally, both baseline and follow-up data were obtained from 70 patients. We analyzed TIMI frame count (TFC) to confirm the presence of RVB-SF (TFC ≥40 frame) after PCI. We also analyzed right ventricular fractional area change (RVFAC) at baseline and follow-up using echocardiography to detect sustained RVD (RVFAC ≤35%).
Result
We divided the patients into two groups (RVB-SF: 36 patients, RVB non-SF: 34 patients). Patient clinical characteristics were similar in both groups (sex, age, risk factors, medication, onset to balloon time, left ventricular stroke volume, max creatine kinase). Baseline RVFAC and follow-up RVFAC was significantly smaller in RVB-SF than in RVB non-SF, respectively. (27.1±1.7% vs. 38.3±1.8%, 31.4±1.0% vs. 48.7±1.1%, P<0.0001). However, ΔRVFAC (follow-up RVFAC – baseline RVFAC) was similar between groups. The size of inferior vena cava and systolic pulmonary artery pressure at follow-up were similar in both groups (12.1±0.6 mm vs. 11.7±0.7 mm, P=0.67, 25.7±1.5 mmHg vs. 25.2±1.5 mmHg, P=0.82). In RVB non-SF, 10 patients (29.4%) were diagnosed clinical RVAMI. However, follow-up RVFAC were similar and preserved in both groups (RVAMI: 48.1±1.3%, non-RVAMI: 49.9±1.9%, P=0.85). In RVB-SF, 19 patients (52.7%) were diagnosed clinical RVAMI. Follow-up RVFAC did not improved significantly in both groups (RVAMI: 30.4±1.4% vs. non-RVAMI: 32.6±1.5%, P=0.70). Multivariate analysis showed RVB-SF was the only independent predictor of sustained RVD at 6–8 months follow-up after ACS-PCI.
Conclusion
RVB-SF findings after ACS-PCI for RCA could predict sustained RVD at mid-term follow-up, which may indicate future prolonged RVD.
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Affiliation(s)
- K Setoyama
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - K Inoue
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - T Miura
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - A Shimizu
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - R Anai
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - Y Sanuki
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - Y Tsuda
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - M Araki
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - S Sonoda
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
| | - Y Otsuji
- University of Occupational and Environmental Health, The Second Department of Internal Medicine, Kitakyushu, Japan
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42
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Fujita Y, Yano T, Abe K, Nagano N, Kamiyama N, Fujito T, Mochizuki A, Koyama M, Kouzu H, Muranaka A, Naganara D, Tanno M, Miki T, Miura T. P6453Activation of necroptotic pathway by downregulated caspase-8 expression is associated with progression of left ventricular remodeling in nonischemic dilated cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Necroptosis, a form of programmed necrosis, has been suggested to be involved in the pathogenesis of various pathological conditions including heart failure. Protein expression of caspase-8, an endogenous inhibitor of necroptosis, is reported to be downregulated in human failing hearts, but its clinical significance remains unclear.
Methods
Endomyocardial biopsy specimens were obtained from patients with nonischemic dilated cardiomyopathy (n=57, 56.2±14.5 years old, 70% male). The area stained with antibodies against caspase-8 and phospho-MLKL-Ser358 was calculated using an image analyzer, and fibrotic and cardiomyocyte areas were determined by Masson's Trichrome staining. Using a level of median caspase-8 expression (6.04% of the area of the myocardium with caspase-8 signal), patients were classified into a high caspase-8 expression group (H-cas8) and a low caspase-8 expression group (L-cas8).
Results
Caspase-8 signals were detected in cytoplasm and intercalated disks of cardiomyocytes. Patients in the L-cas8 group was younger (51.3±13.1 vs. 61.2±14.3 years old) and had larger left ventricular end-diastolic volume (LVEDV: 174±49 vs. 131±41 ml), larger left ventricular end-systolic volume (LVESV: 123±51 vs. 87±39 ml), and higher ratio of mitral peak velocity of early filling to late diastolic filling (E/A: 1.94±1.48 vs. 1.12±0.66) compared with the H-cas8 group. Caspase-8 expression level was positively correlated with age (r=0.34, p=0.01) and negatively correlated with LVEDV (r=−0.47, p<0.01), LVESV (r=−0.40, p<0.01), and E/A (r=−0.39, p<0.01) in simple linear regression analysis. The extent of myocardial fibrosis was not correlated with caspase-8 expression level. Multiple regression analysis indicated that LVEDV, LVESV, and E/A were independent explanatory factors of caspase-8 expression level after adjusting age and sex. Phospho-MLKL signals, an index of activation of necroptotic pathway, were frequently observed in cytoplasm, intercalated disks, and nuclei in the L-cas8 group but not in the H-cas8 group.
Conclusion
Lower caspase-8 expression in cardiomyocytes was associated with increased phosphorylation of MLKL and larger left ventricular volume, suggesting that downregulated caspase-8 may contribute to progression of myocardial remodeling via activation of MLKL in human dilated cardiomyopathy.
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Affiliation(s)
- Y Fujita
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - T Yano
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - K Abe
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - N Nagano
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - N Kamiyama
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - T Fujito
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - A Mochizuki
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - M Koyama
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - H Kouzu
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - A Muranaka
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - D Naganara
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - M Tanno
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - T Miki
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - T Miura
- Sapporo Medical University School of Medicine, Hokkaido, Japan
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Abe K, Yano T, Sato T, Kouzu H, Kuno A, Tanno M, Miki T, Miura T. P6273Inhibitory phosphorylation of RIP1 at Ser320 induces nuclear translocation of TFEB, leading to suppression of necroptosis in cardiomyocytes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Necroptosis, a form of programmed necrosis, has been shown to contribute to the pathogenesis of various diseases including ischemia/reperfusion injury and heart failure. We recently reported that necroptotic signals suppresses autophagy in cardiomyocytes and that rapamycin, an mTORC1 inhibitor, not only promotes autophagy but also protect the cells from necroptosis.
Purpose
We examined the mechanism by which rapamycin suppresses necroptosis of cardiomyocytes, focusing on regulation of RIP1 activity and autophagic flux.
Methods and results
In H9c2 cardiomyoblasts, necroptosis was induced by treatment with TNF and z-VAD-fmk (zVAD) for 24 h, and cell death was determined by LDH release (as % of total). The treatment with TNF/zVAD increased LDH release from 3.4±1.3% to 46.1±2.3%, and LDH release was suppressed by necrostatin-1 (5.9±0.9%), a RIP1 inhibitor, and by rapamycin (23.5±1.4%). The protective effect of rapamycin was mimicked by Ku-0063794, an mTORC1/2 inhibitor. TNF/zVAD induced RIP1-RIP3 complex formation, together with suppression of TNF-induced RIP1 cleavage, which was mitigated by rapamycin. In addition, rapamycin not only suppressed TNF/zVAD-induced phosphorylation of RIP1-Ser166, an index of RIP1 activation, but also increased phosphorylation of RIP1-Ser320, an inhibitory phosphorylation site. In cells transfected with RIP1-S320A, which lack Ser320 for inhibitory phosphorylation, rapamycin failed to suppress TNF/zVAD-induced RIP1-RIP3 binding and cell death. Immunoblot analyses showed that TNF/zVAD significantly increased level of LC3-II. The accumulation of LC3-II protein was not further increased by bafilomycin A1 (100 nM), an inhibitor of lysosomal protein degradation, indicating that accumulation of LC3-II by TNF/zVAD reflected suppression of autophagic flux. Inhibition of RIP1 by necrostatin-1 attenuated TNF/zVAD-induced accumulation of LC3 II. The restoration of autophagic flux in TNF/zVAD-treated cells by necrostatin-1 was confirmed by monitoring tandem RFP-GFP-LC3 transfected cells; necrostatin-1 increased a ratio of RFP-LC3-puncta (autolysosomes) to RFP-GFP-LC3-puncta (autophagosomes) in TNF/zVAD-treated cells. In addition, necrostatin-1 and rapamycin induced nuclear translocation of TFEB, a regulator of lysosome biogenesis, which was associated with upregulation of MCOLN1 mRNA, a downstream target of TFEB. Restoration of autophagic flux in TNF/zVAD-treated cells by necrostatin-1 was inhibited by siRNA-mediated knockdown of TFEB.
Conclusion
Activation of TFEB by inhibitiory phosphorylation of RIP1-Ser320 is a primary mechanism of cytoprotection afforded by mTORC1 inhibition against necroptosis.
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Affiliation(s)
- K Abe
- Sapporo Medical University, Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Yano
- Sapporo Medical University, Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Sato
- Sapporo Medical University, Cell Physiology and Signal Transduction, Sapporo, Japan
| | - H Kouzu
- Sapporo Medical University, Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - A Kuno
- Sapporo Medical University, Pharmacology, Sapporo, Japan
| | - M Tanno
- Sapporo Medical University, Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miki
- Sapporo Medical University, Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Miura
- Sapporo Medical University, Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
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Yamanouchi K, Tsujiguchi T, Shiroma Y, Suzuki T, Tamakuma Y, Yamaguchi M, Sakamoto Y, Hegedűs M, Iwaoka K, Hosoda M, Kashiwakura I, Miura T, Tokonami S. COMPARISON OF BACTERIAL FLORA IN RIVER SEDIMENTS FROM FUKUSHIMA AND AOMORI PREFECTURES BY 16S RDNA SEQUENCE ANALYSIS. Radiat Prot Dosimetry 2019; 184:504-509. [PMID: 31038686 DOI: 10.1093/rpd/ncz114] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Monitoring of radioactive materials has been reported in rivers and soil in Fukushima post the Fukushima Daiichi Nuclear Power Plant accident in March 2011. However, there are few reports on the influence of this event on bacteria in forest soils and rivers. Therefore, through amplicon sequencing of 16S rDNA we compared the bacterial flora in river sediment soils from Fukushima prefecture and from an area not exposed to radioactive contamination, Aomori prefecture. The bacterial composition in the Aomori prefecture soil and Fukushima soil were found to be very similar at the phylum level. However, Fukushima soil had significantly fewer Bacteroidetes than the Aomori soil (p = 0.014), while the content of Firmicutes and Latescibacteria (WS3) was significantly higher (p = 0.001, 0.013 respectively). However, no increase in the content of radioactive-resistant bacteria was observed. In future studies, it is necessary to standardise the conditions for soil collection to assess its content of radioactive substances.
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Affiliation(s)
- K Yamanouchi
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - T Tsujiguchi
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Y Shiroma
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - T Suzuki
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Y Tamakuma
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - M Yamaguchi
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Y Sakamoto
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - M Hegedűs
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - K Iwaoka
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - M Hosoda
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - I Kashiwakura
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - T Miura
- Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - S Tokonami
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
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Matsunami M, Nozawa M, Suzuki R, Toga K, Masuoka Y, Yamaguchi K, Maekawa K, Shigenobu S, Miura T. Caste-specific microRNA expression in termites: insights into soldier differentiation. Insect Mol Biol 2019; 28:86-98. [PMID: 30126008 DOI: 10.1111/imb.12530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Eusocial insects have polyphenic caste systems in which each caste exhibits characteristic morphology and behaviour. In insects, caste systems arose independently in different lineages, such as Isoptera and Hymenoptera. Although partial molecular mechanisms for the development of eusociality in termites have been clarified by the functional analysis of genes and hormones, the contribution of microRNAs (miRNAs) to caste differentiation is unknown. To understand the role of miRNAs in termite caste polyphenism, we performed small RNA sequencing in a subterranean termite (Reticulitermes speratus) and identified the miRNAs that were specifically expressed in the soldier and worker castes. Of the 550 miRNAs annotated in the R. speratus genome, 74 were conserved in insects and 174 were conserved in other termite species. We found that eight miRNAs (mir-1, mir-125, mir-133, mir-2765, mir-87a and three termite-specific miRNAs) are differentially expressed (DE) in soldiers and workers of R. speratus. This differential expression was experimentally verified for five miRNAs by real-time quantitative PCR. Further, four of the eight DE miRNAs in soldier and worker termite castes were also differentially expressed in hymenopteran castes. The finding that Isoptera and Hymenoptera shared several DE miRNAs amongst castes suggests that these miRNAs evolved independently in these phylogenetically distinct lineages.
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Affiliation(s)
- M Matsunami
- Laboratory of Ecological Genetics, Graduate School of Environmental Science, Hokkaido University, Sapporo, Japan
- Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Japan
| | - M Nozawa
- Department of Biological Sciences, Tokyo Metropolitan University, Hachioji, Japan
| | - R Suzuki
- Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
| | - K Toga
- Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
- Department of Biosciences, College of Humanities and Sciences, Nihon University, Tokyo, Japan
| | - Y Masuoka
- Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
- Institute of Agrobiological Sciences, National Agriculture and Food Research Organization, Tsukuba, Ibaraki, Japan
| | - K Yamaguchi
- Functional Genomics Facility, National Institute for Basic Biology, Okazaki, Japan
| | - K Maekawa
- Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
| | - S Shigenobu
- Functional Genomics Facility, National Institute for Basic Biology, Okazaki, Japan
| | - T Miura
- Laboratory of Ecological Genetics, Graduate School of Environmental Science, Hokkaido University, Sapporo, Japan
- Misaki Marine Biological Station, University of Tokyo, Miura, Kanagawa, Japan
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Miura T, Mori T, Ito T, Kikuchi N, Kato Y, Yamamoto T. Lupus erythematosus profundus in a patient with dermatomyositis. Clin Exp Dermatol 2018; 44:e47-e48. [PMID: 30593680 DOI: 10.1111/ced.13893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 11/27/2022]
Affiliation(s)
- T Miura
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - T Mori
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - T Ito
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - N Kikuchi
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Y Kato
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - T Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
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Tanaka H, Yamashita T, Yoneda M, Takagi S, Miura T. Characteristics of bone strength and metabolism in type 2 diabetic model Tsumura, Suzuki, Obese Diabetes mice. Bone Rep 2018; 9:74-83. [PMID: 30094297 PMCID: PMC6073051 DOI: 10.1016/j.bonr.2018.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 07/13/2018] [Accepted: 07/19/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is a metabolic disease characterized by hyperglycemia, hyperinsulinemia, and complications such as obesity and osteoporosis. The Tsumura, Suzuki, Obese Diabetes (TSOD) mouse is an animal model of spontaneous obese T2DM. However, bone metabolism in TSOD mice is yet to be investigated. The objective of the present study was to investigate the effects of T2DM on bone mass, metabolism, microstructure, and strength in TSOD mice. METHODS We determined the following parameters in TSOD mice and Tsumura, Suzuki, Non-obesity (TSNO) mice (as controls): serum glucose levels; serum insulin levels; bone mass; bone microstructure; bone metabolic markers; and bone strength. We also performed the oral glucose tolerance test and examined histological sections of the femur. We compared these data between both groups at pre-diabetic (10 weeks) and established (20 weeks) diabetic conditions. RESULTS Bone strength, such as extrinsic mechanical properties, increased with age in the TSOD mice and intrinsic material properties decreased at both 10 weeks and 20 weeks. Bone resorption marker levels in TSOD mice were significantly higher than those in the control mice at both ages, but there was no significant difference in bone formation markers between the groups. Bone mass in TSOD mice was lower than that in controls at both ages. The trabecular bone volume at the femoral greater trochanter increased with age in the TSOD mice. The femoral mid-diaphysis in TSOD mice was more slender and thicker than that in TSNO mice at both ages. CONCLUSIONS Bone mass of the femur was lower in TSOD mice than in TSNO mice because hyperinsulinemia during pre-diabetic and established diabetic conditions enhanced bone resorption due to high bone turnover. In addition, our data suggest that the bone mass of the femur was significantly reduced as a result of chronic hyperglycemia during established diabetic conditions in TSOD mice. We suggest that bone strength in the femur deteriorated due to the reduction of bone mass and because the femoral mid-diaphysis was more slender in TSOD mice.
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Key Words
- BMC, bone mineral content
- BMD, bone mineral density
- Bone mass
- Bone metabolism
- Bone microstructure
- Bone strength
- CSMI, cross-sectional moment inertia
- OCN, osteocalcin
- OGTT, oral glucose tolerance test
- PBS, phosphate-buffered saline
- T1DM, type 1 diabetes mellitus
- T2DM, type 2 diabetes mellitus
- TRAcP5b, tartrate-resistant acid phosphatase 5b
- TSNO, Tsumura, Suzuki, non-obesity
- TSOD, Tsumura, Suzuki, Obese Diabetes
- Tsumura, Suzuki, Obese Diabetes mice
- Type 2 diabetes mellitus
- micro-CT, micro-computed tomography
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Affiliation(s)
- Hiroaki Tanaka
- Graduate School of Health Science Suzuka University of Medical Science, 1001-1 Kishioka, Suzuka, Mie 510-0293, Japan
| | - Takenori Yamashita
- Department of Radiological Technology, Faculty of Health Science, Suzuka University of Medical Science, 1001-1 Kishioka, Suzuka, Mie 510-0293, Japan
| | - Misao Yoneda
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science, 1001-1 Kishioka, Suzuka, Mie 510-0293, Japan
| | - Satoshi Takagi
- Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, 1230 Miyakoda, Kitaku, Hamamatsu, Shizuoka, 431-2102, Japan
| | - Toshihiro Miura
- Graduate School of Health Science Suzuka University of Medical Science, 1001-1 Kishioka, Suzuka, Mie 510-0293, Japan
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Miura T, Ishikawa M, Mori T, Hanami Y, Ohtsuka M, Yamamoto T. Huge Squamous Cell Carcinoma Arising on Severe Hidradenitis Suppurativa. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Yoshida T, Miura T, Sakamoto Y, Morohashi H, Fujita H, Sato K, Hakamada K. Phase II study of surgery after S-1 + oxaliplatin +bevacizumab therapy for unresectable rectal cancer by organ-preserved TME. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.149] [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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50
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Tanaka H, Miura T, Yamashita T, Yoneda M, Takagi S. Characteristics of Bone Strength and Metabolism in Type 2 Diabetic Model Nagoya Shibata Yasuda Mice. Biol Pharm Bull 2018; 41:1567-1573. [PMID: 30012927 DOI: 10.1248/bpb.b18-00275] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We evaluated the suitability of Nagoya Shibata Yasuda (NSY) mice as an animal model for examining the influence of a glucose metabolism disorder on bone integrity, using Institute of Cancer Research (ICR) mice as controls. We selected six NSY and ICR mice each that were matched for weight, and measured serum glucose levels, serum insulin levels, and conducted an oral glucose tolerance test. Histological sections of the femurs of both mouse lines were prepared, and the bone strength, mass, and microstructure of the femur were compared, along with bone metabolism. Serum glucose levels were significantly higher in the NSY mice than in the control mice, but body weight and serum insulin levels did not differ between the groups. Bone mass, microstructure, and strength of the femur, and bone metabolism were lower in the NSY mice than in the control mice. In the cortical bone of the femur in the NSY mice, several parts were not stained with eosin, demonstrating a strong negative correlation between serum glucose levels and bone mineral density; however, there was a negative correlation between serum glucose levels and bone metabolic markers. The bone turnover rate in the NSY mice was decreased by hyperglycemia, resulting in a thinner and shorter femur, reduced cortical and trabecular areas, and lower bone mass compared to those of the control mice. Collectively, these results suggest deteriorated bone strength of the femur in NSY mice, serving as a useful model for studying the link between glucose metabolism and bone integrity.
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Affiliation(s)
- Hiroaki Tanaka
- Graduate School of Health Science, Suzuka University of Medical Science
| | - Toshihiro Miura
- Graduate School of Health Science, Suzuka University of Medical Science
| | - Takenori Yamashita
- Department of Radiological Technology, Faculty of Health Science, Suzuka University of Medical Science
| | - Misao Yoneda
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science
| | - Satoshi Takagi
- Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University
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