1
|
Hatano T, Sengoku R, Nagayama H, Yanagisawa N, Yoritaka A, Suzuki K, Nishikawa N, Mukai Y, Nomura K, Yoshida N, Seki M, Matsukawa MK, Terashi H, Kimura K, Tashiro J, Hirano S, Murakami H, Joki H, Uchiyama T, Shimura H, Ogaki K, Fukae J, Tsuboi Y, Takahashi K, Yamamoto T, Kaida K, Ihara R, Kanemaru K, Kano O. Impact of Istradefylline on Levodopa Dose Escalation in Parkinson's Disease: ISTRA ADJUST PD Study, a Multicenter, Open-Label, Randomized, Parallel-Group Controlled Study. Neurol Ther 2024; 13:323-338. [PMID: 38227133 PMCID: PMC10951171 DOI: 10.1007/s40120-023-00574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024] Open
Abstract
INTRODUCTION A higher levodopa dose is a risk factor for motor complications in Parkinson's disease (PD). Istradefylline (IST) is used as adjunctive treatment to levodopa in PD patients with off episodes, but its impact on levodopa dose titration remains unclear. The objective of this study was to investigate the effect of IST on levodopa dose escalation in PD patients with wearing-off. METHODS This was a multicenter, open-label, randomized, parallel-group controlled study (ISTRA ADJUST PD) in which PD patients experiencing wearing-off (n = 114) who were receiving levodopa 300-400 mg/day were randomized to receive IST or no IST (control). Levodopa dose was escalated according to clinical severity. The primary endpoint was cumulative additional levodopa dose, and secondary endpoints were changes in symptom rating scales, motor activity determined by a wearable device, and safety outcomes. RESULTS The cumulative additional levodopa dose throughout 37 weeks and dose increase over 36 weeks were significantly lower in the IST group than in the control group (both p < 0.0001). The Movement Disorder Society Unified Parkinson's Disease Rating Scale Part I and device-evaluated motor activities improved significantly from baseline to 36 weeks in the IST group only (all p < 0.05). Other secondary endpoints were comparable between the groups. Adverse drug reactions (ADRs) occurred in 28.8% and 13.2% of patients in the IST and control groups, respectively, with no serious ADRs in either group. CONCLUSION IST treatment reduced levodopa dose escalation in PD patients, resulting in less cumulative levodopa use. Adjunctive IST may improve motor function more objectively than increased levodopa dose in patients with PD. TRIAL REGISTRATION Japan Registry of Clinical Trials: jRCTs031180248.
Collapse
Affiliation(s)
- Taku Hatano
- Department of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
| | - Renpei Sengoku
- Department of Neurology, Daisan Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Naotake Yanagisawa
- Medical Technology Innovation Center, Juntendo University and Juntendo Clinical Research and Trial Center, Tokyo, Japan
| | - Asako Yoritaka
- Department of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Noriko Nishikawa
- Department of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yohei Mukai
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kyoichi Nomura
- Department of Neurology, Higashimatsuyama Municipal Hospital, Saitama, Japan
| | - Norihito Yoshida
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Miho Kawabe Matsukawa
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroo Terashi
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, Yokohama, Japan
| | - Jun Tashiro
- Sapporo Parkinson MS Neurological Clinic, Sapporo, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hidetomo Murakami
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Neurology, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Tsuyoshi Uchiyama
- Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Hideki Shimura
- Department of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
- Department of Neurology, Juntendo University Koshigaya Hospital, Koshigaya, Japan
| | - Kotaro Ogaki
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Jiro Fukae
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | | | - Kenichi Kaida
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Ryoko Ihara
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazutomi Kanemaru
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University, Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
2
|
Nakazawa Y, Miyano M, Tsukamoto S, Kogai H, Yamamoto A, Iso K, Inoue S, Yamane Y, Yabe Y, Umihara H, Taguchi J, Akagi T, Yamaguchi A, Koga M, Toshimitsu K, Hirayama T, Mukai Y, Machinaga A. Delivery of a BET protein degrader via a CEACAM6-targeted antibody-drug conjugate inhibits tumour growth in pancreatic cancer models. Nat Commun 2024; 15:2192. [PMID: 38467634 PMCID: PMC10928091 DOI: 10.1038/s41467-024-46167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) has the worst prognosis of all cancers. To improve PDAC therapy, we establish screening systems based on organoid and co-culture technologies and find a payload of antibody-drug conjugate (ADC), a bromodomain and extra-terminal (BET) protein degrader named EBET. We select CEACAM6/CD66c as an ADC target and developed an antibody, #84.7, with minimal reactivity to CEACAM6-expressing normal cells. EBET-conjugated #84.7 (84-EBET) has lethal effects on various PDAC organoids and bystander efficacy on CEACAM6-negative PDAC cells and cancer-associated fibroblasts. In mouse studies, a single injection of 84-EBET induces marked tumor regression in various PDAC-patient-derived xenografts, with a decrease in the inflammatory phenotype of stromal cells and without significant body weight loss. Combination with standard chemotherapy or PD-1 antibody induces more profound and sustained regression without toxicity enhancement. Our preclinical evidence demonstrates potential efficacy by delivering BET protein degrader to PDAC and its microenvironment via CEACAM6-targeted ADC.
Collapse
Affiliation(s)
- Youya Nakazawa
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan.
| | - Masayuki Miyano
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
| | | | - Hiroyuki Kogai
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
| | | | - Kentaro Iso
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
| | - Satoshi Inoue
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
| | | | - Yuki Yabe
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
| | | | - Junichi Taguchi
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
| | - Tsuyoshi Akagi
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
- KAN Research Institute, Inc., Kobe, Japan
| | | | - Minaho Koga
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
| | | | | | | | - Akihito Machinaga
- Tsukuba Research Laboratory, Eisai Co., Ltd., Ibaraki, Japan
- KAN Research Institute, Inc., Kobe, Japan
| |
Collapse
|
3
|
Chaudhuri KR, Facheris MF, Bergmans B, Bergquist F, Criswell SR, Jia J, Kukreja P, Mukai Y, Spiegel AM, Gupta R, Bergmann L, Pahwa R. Improved Sleep Correlates with Improved Quality of Life and Motor Symptoms with Foslevodopa/Foscarbidopa. Mov Disord Clin Pract 2024. [PMID: 38465885 DOI: 10.1002/mdc3.14018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/29/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Foslevodopa/foscarbidopa is a subcutaneous infusion of levodopa/carbidopa prodrugs. OBJECTIVES Assess correlations between sleep and efficacy from interim data of a phase 3 trial of foslevodopa/foscarbidopa (NCT03781167). METHODS Pearson correlations between sleep (Parkinson's Disease Sleep Scale-2 [PDSS-2]) and quality of life (QoL; Parkinson's Disease Questionnaire-39), motor experiences of daily living (m-EDL; Movement Disorder Society-Unified Parkinson's Disease Scale Part II), and "Off"/"On" times were calculated for baseline and week 26 improvements. Regression analyses were adjusted for baseline PDSS-2 score. RESULTS Baseline sleep correlated moderately with QoL (r = 0.44, P < 0.001) and weakly with m-EDL (r = 0.28; P < 0.001). Sleep improvement weakly correlated with improved "Off" time (r = 0.37; P < 0.001) and QoL (r = 0.36; P < 0.001). Regression analyses demonstrated significant positive associations for improved sleep, "Off" time, QoL, and m-EDL. CONCLUSIONS Improved sleep with foslevodopa/foscarbidopa was associated with improved QoL and "Off" time.
Collapse
Affiliation(s)
- K Ray Chaudhuri
- Parkinson's Foundation International Centre of Excellence, King's College Hospital, London, UK
- King's College Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | | | - Bruno Bergmans
- Department of Neurology, AZ St-Jan Brugge-Oostende AV, Bruges, Belgium
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Filip Bergquist
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - Susan R Criswell
- Muhammad Ali Parkinson Center, Barrow Neurologic Institute, Phoenix, Arizona, USA
| | - Jia Jia
- AbbVie Inc., North Chicago, Illinois, USA
| | | | - Yohei Mukai
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | | | | | - Rajesh Pahwa
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| |
Collapse
|
4
|
Ito S, Kuromiya K, Sekai M, Sako H, Sai K, Morikawa R, Mukai Y, Ida Y, Anzai M, Ishikawa S, Kozawa K, Shirai T, Tanimura N, Sugie K, Ikenouchi J, Ogawa M, Naguro I, Ichijo H, Fujita Y. Accumulation of annexin A2 and S100A10 prevents apoptosis of apically delaminated, transformed epithelial cells. Proc Natl Acad Sci U S A 2023; 120:e2307118120. [PMID: 37844241 PMCID: PMC10614624 DOI: 10.1073/pnas.2307118120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
In various epithelial tissues, the epithelial monolayer acts as a barrier. To fulfill its function, the structural integrity of the epithelium is tightly controlled. When normal epithelial cells detach from the basal substratum and delaminate into the apical lumen, the apically extruded cells undergo apoptosis, which is termed anoikis. In contrast, transformed cells often become resistant to anoikis and able to survive and grow in the apical luminal space, leading to the formation of multilayered structures, which can be observed at the early stage of carcinogenesis. However, the underlying molecular mechanisms still remain elusive. In this study, we first demonstrate that S100A10 and ANXA2 (Annexin A2) accumulate in apically extruded, transformed cells in both various cell culture systems and murine epithelial tissues in vivo. ANXA2 acts upstream of S100A10 accumulation. Knockdown of ANXA2 promotes apoptosis of apically extruded RasV12-transformed cells and suppresses the formation of multilayered epithelia. In addition, the intracellular reactive oxygen species (ROS) are elevated in apically extruded RasV12 cells. Treatment with ROS scavenger Trolox reduces the occurrence of apoptosis of apically extruded ANXA2-knockdown RasV12 cells and restores the formation of multilayered epithelia. Furthermore, ROS-mediated p38MAPK activation is observed in apically delaminated RasV12 cells, and ANXA2 knockdown further enhances the p38MAPK activity. Moreover, the p38MAPK inhibitor promotes the formation of multilayered epithelia of ANXA2-knockdown RasV12 cells. These results indicate that accumulated ANXA2 diminishes the ROS-mediated p38MAPK activation in apically extruded transformed cells, thereby blocking the induction of apoptosis. Hence, ANXA2 can be a potential therapeutic target to prevent multilayered, precancerous lesions.
Collapse
Affiliation(s)
- Shoko Ito
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
- Eisai Co., Ltd., Kobe650-0047, Japan
| | - Keisuke Kuromiya
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
| | - Miho Sekai
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
- Eisai Co., Ltd., Kobe650-0047, Japan
| | - Hiroaki Sako
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
| | - Kazuhito Sai
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
| | - Riho Morikawa
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
- Eisai Co., Ltd., Kobe650-0047, Japan
| | - Yohei Mukai
- Protein Targeting Biologics, KAN Research Institute, Kobe650-0047, Japan
| | - Yoko Ida
- Protein Targeting Biologics, KAN Research Institute, Kobe650-0047, Japan
| | - Moe Anzai
- Protein Targeting Biologics, KAN Research Institute, Kobe650-0047, Japan
| | - Susumu Ishikawa
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo060-0815, Japan
| | - Kei Kozawa
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
| | - Takanobu Shirai
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo060-0815, Japan
| | - Nobuyuki Tanimura
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
| | - Kenta Sugie
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
- Eisai Co., Ltd., Kobe650-0047, Japan
| | - Junichi Ikenouchi
- Department of Biology, Faculty of Sciences, Kyushu University, Fukuoka819-0395, Japan
| | - Motoyuki Ogawa
- Laboratory of Cell Signaling, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo113-0033, Japan
| | - Isao Naguro
- Laboratory of Cell Signaling, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo113-0033, Japan
| | - Hidenori Ichijo
- Laboratory of Cell Signaling, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo113-0033, Japan
| | - Yasuyuki Fujita
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto606-8501, Japan
| |
Collapse
|
5
|
Nishikawa N, Iwaki H, Mukai Y, Takahashi Y. Classification of l-DOPA pharmacokinetics shapes and creating a predictive model. Parkinsonism Relat Disord 2023; 114:105798. [PMID: 37556972 DOI: 10.1016/j.parkreldis.2023.105798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND It is known that the pharmacokinetics (PK) of levodopa (LD) varies considerably. Difference in PK shapes is expected to affect drug efficacy and development of dyskinesia. In this study, the authors aimed to explore correlations between PK series data of LD and clinical characteristics and dyskinesia in patients with Parkinson's disease (PD). METHODS We studied 270 PD patients who underwent PK assessment after administration of LD/carbidopa (100/10 mg) in non-compartmental analysis. The patients were grouped according to similarities in time series data of blood LD concentration. Each group was analyzed with respect to clinical characteristics and PK parameters. We created a model to predict PK patterns based on these findings. RESULTS PD patients were divided into three groups by clustering analysis: blood LD concentration of the patients in Groups 1 (n = 129), 3 (n = 44) and 2 (n = 97) rose rapidly, relatively slowly and at an intermediate rate, respectively. There were no statistically significant differences in patient characteristics except age among the three groups (one-way ANOVA). Multivariate analysis showed that frequency of dyskinesias in Group 1 was significantly higher than that in Group 2. We successfully created a PK pattern prediction model based on body weight and blood LD concentration at 15 and 30 min after administration. CONCLUSIONS The PK series data of LD was classified into three patterns. The rapid absorption was associated with dyskinesias. Patients' PK patterns were successfully predicted based on their body weight and two-point LD concentration.
Collapse
Affiliation(s)
- Noriko Nishikawa
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
| | | | - Yohei Mukai
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| |
Collapse
|
6
|
Mukai Y. [Idiopathic (Oral) and Tardive Dyskinesia: Pathogenesis, Epidemiology, and Treatment]. Brain Nerve 2023; 75:23-35. [PMID: 36574970 DOI: 10.11477/mf.1416202276] [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: 12/29/2022]
Abstract
Etymologically, dyskinesia is a combination of the prefix "dys-," which means 'abnormality' and the suffix "-kinesia," which means 'movement.' In a broad sense, dyskinesia indicates hyperkinetic involuntary movements. In a narrow sense, as a general term, dyskinesia refers to combinations of one or more of the following movements: chorea, dystonia, tremor, ballism, athetosis, tics, and myoclonus. In this article, we describe the pathogenesis, epidemiology, and treatment of idiopathic (oral) and tardive dyskinesia.
Collapse
Affiliation(s)
- Yohei Mukai
- Department of Neurology National Center Hospital, National Center of Neurology and Psychiatry
| |
Collapse
|
7
|
Kawai S, Sakamoto K, Takase S, Noma A, Kisanuki H, Nakashima H, Watanabe T, Sakemi T, Okabe K, Okahara A, Tokutome M, Matsuura H, Matsukawa R, Masuda S, Mukai Y. Prevalence and distribution of non-pulmonary vein atrial fibrillation triggers in real-world clinical settings. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.535] [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
Epidemiology of non-pulmonary vein (PV) triggers of atrial fibrillation (AF) is not fully known.
Purpose
This study aimed to clarify the prevalence and distribution of non-PV triggers in real-world clinical settings of AF catheter ablation.
Methods
One-thousand and twenty patients undergoing AF ablations were retrospectively analyzed (mean age 65 years old, 702 males (69%), 506 paroxysmal and 514 non-paroxysmal). Induction and observation of AF triggers were attempted using intravenous isoproterenol/adenosine triphosphate and repeated direct current cardioversion during AF in each session. Documentable non-PV AF triggers were characterized in the studied population. Premature atrial contractions that did not initiate AF were excluded.
Results
A hundred and twenty-six non-PV triggers were documented in 108 patients (10.6%). Non-PV trigger was documented in 6.3% of 1st session cases, whereas 30.9% of recurrent cases undergoing multiple sessions (p<0.0001). Left atrial (LA) posterior wall was the most prevalent site (N=34), followed by 30 intra-atrial septum (IAS), 29 superior vena cava (SVC), 13 crista terminalis, 7 right atrial (RA) free wall, 6 LA anterior wall, 3 coronary sinus (CS), 3 left atrial appendage, and 1 persistent left superior vena cava (LSVC). We classified those non-PV triggers into 4 groups; 43 LA, 33 thoracic veins (SVC, CS and LSVC), 30 IAS and 20 RA. Thoracic vein/RA origins were more prevalently detected in paroxysmal AF cases (57%) compared to non-paroxysmal AF (28%) (p<0.01). Conversely, LA origin was more prevalently detected in non-paroxysmal AF cases (48%) compared to paroxysmal AF (20%) (p<0.01).
Conclusions
Prevalence of non-PV trigger in cases undergoing multiple sessions is extremely high, suggesting a particular importance of non-PV trigger targeting in patients with recurrent AF undergoing 2nd or 3rd ablation sessions. Progressive nature of AF with newly generated AF triggers should be under consideration. Distributions of non-PV triggers are largely different between paroxysmal and non-paroxysmal AF. These findings may help ablation strategy regarding non-PV trigger targeting in practice.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- S Kawai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine , Fukuoka , Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine , Fukuoka , Japan
| | - A Noma
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Kisanuki
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Nakashima
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Watanabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Sakemi
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - K Okabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - A Okahara
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - M Tokutome
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Matsuura
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - R Matsukawa
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - S Masuda
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - Y Mukai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| |
Collapse
|
8
|
Okahara A, Kawai S, Tokutome M, Matsuura H, Noma A, Hara A, Nakashima H, Watanabe T, Sakemi T, Okabe K, Matsukawa R, Masuda S, Mukai Y. Catheter ablation of persistent atrial fibrillation with heart failure improves hemodynamic status without deteriorating renal function in the elderly. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.583] [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/Introduction
Atrial fibrillation (AF) and heart failure (HF) frequently coexist in the elderly people, leading to worse clinical outcomes. HF with preserved ejection fraction (HFpEF) is the most common form of HF in the elderly, particularly in women, associated with AF. Ablation of AF in younger patients with HF with reduced EF (HFrEF) has become an established treatment option. However, clinical impact of ablation for persistent AF accompanying with HF in the elderly remains unclear.
Purpose
This study aimed to evaluate the effect of catheter ablation of persistent AF with heart failure in the elderly.
Methods
Consecutive 70 patients who underwent catheter ablation of persistent AF accompanying with HF (NYHA class> II, mean LVEF 51.7%) in our institution were retrospectively analyzed with regards to their 1-year clinical outcomes, HF markers such as BNP, renal function and transthoracic echocardiographic findings. Patients were dichotomized by age of 75-year-old (31 elderly vs 39 younger subjects) and separately analyzed.
Results
Mean age of the studied population was 70.5 year-old; 79.6±3.8 in the elderly group and 63.2±8.5 in the younger group. The elderly patients were more frequently females (45% vs 21%). Longstanding persistent AF was observed in 32% in the elderly and 28% in the younger group. Circumferential pulmonary vein isolation (PVI) was performed in all patients, with additional ablations of liner lesions and/or non-PV foci as needed. PVI alone was observed in 54.8% in the elderly and 41% in the younger group. There were no serious complications associated with the procedure. During 1 year after ablation, recurrence of AF was observed in 15 patients [6/31 (19%) in the elderly, 9/39 (23%) in the younger]. Readmission due to HF was observed in only 1 patient in the elderly and 2 patients in the younger group (3% vs. 5%, respectively). Cardiovascular events were observed in 3 patients [2/31 (6%) in the elderly, 1/39 (3%) in the younger], but there was no death. The BNP level as well as the NYHA class significantly decreased at 1-year follow-up compared to baseline in the both groups (Figure A and B). There was no change in serum creatinine level in the both groups (Figure C). The left atrial dimension and the LA volume index decreased at 1-year follow-up in the both groups (Figure D and E). The LVEF improved only in the younger group (Figure F).
Conclusions
Ablation of persistent AF in the elderly with HF (mostly with preserved EF) was associated with hemodynamic and functional improvements without deteriorating renal function in a mid-term, which was mostly comparable to the results in the younger.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A Okahara
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - S Kawai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - M Tokutome
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Matsuura
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - A Noma
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - A Hara
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Nakashima
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Watanabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Sakemi
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - K Okabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - R Matsukawa
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - S Masuda
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - Y Mukai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| |
Collapse
|
9
|
Nishikawa N, Murata M, Hatano T, Mukai Y, Saitoh Y, Sakamoto T, Hanakawa T, Kamei Y, Tachimori H, Hatano K, Matsuda H, Taruno Y, Sawamoto N, Kajiyama Y, Ikenaka K, Kawabata K, Nakamura T, Iwaki H, Kadotani H, Sumi Y, Inoue Y, Hayashi T, Ikeuchi T, Shimo Y, Mochizuki H, Watanabe H, Hattori N, Takahashi Y, Takahashi R. Idiopathic rapid eye movement sleep behavior disorder in Japan: An observational study. Parkinsonism Relat Disord 2022; 103:129-135. [PMID: 36113390 DOI: 10.1016/j.parkreldis.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/12/2022] [Accepted: 08/10/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Idiopathic rapid eye movement sleep behavior disorder (iRBD) is one of the most specific prodromal symptoms of synucleinopathies, including Parkinson's disease (PD) and multiple system atrophy. The Japan Parkinson's Progression Markers Initiative (J-PPMI) was a prospective cohort study conducted in Japanese patients with iRBD to investigate biomarkers for prodromal synucleinopathies. We carried out an initial assessment of the J-PPMI study to reveal the factors correlated with dopamine transporter single-photon emission computed tomography (DaT) and 123I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy. METHODS This cross-sectional study was conducted in 108 patients with iRBD, selected from the J-PPMI study. We divided the patients into four groups based on the MIBG and DaT results. We also recorded the patients' demographics and clinical data. Following PD probability calculation, we examined the biomarkers associated with DaT and MIBG. RESULTS Ninety-five of the enrolled patients (88%) met the diagnostic criteria for prodromal PD based on the probability score. Only five patients had normal MIBG and DaT. We identified 29 cases with decreased DaT and MIBG, all of whom met the above diagnostic criteria. Both DaT and MIBG were significantly correlated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) score. CONCLUSION Both DaT and MIBG are important biomarkers for confirming synucleinopathies and/or staging disease progression. Although 95% of iRBD patients were consistent with the body-first subtype concept, alpha-synuclein pathologies of iRBD might have widespread systemic involvement rather than being confined to the lower brainstem, particularly in patients with reduced MoCA-J scores.
Collapse
Affiliation(s)
- Noriko Nishikawa
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Miho Murata
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yohei Mukai
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuji Saitoh
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takashi Sakamoto
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takashi Hanakawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuichi Kamei
- Department of Sleep-Wake Disorder, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Psychiatry, Kamisuwa Hospital, Nagano, Japan
| | - Hisateru Tachimori
- Department of Clinical Data Science, Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kenji Hatano
- Department of Clinical Data Science, Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yosuke Taruno
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobukatsu Sawamoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuta Kajiyama
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kensuke Ikenaka
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuya Kawabata
- Brain and Mind Research Centre, Nagoya University, Nagoya, Japan; Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiko Nakamura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | | | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan; Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Toshihiro Hayashi
- Department of Neurology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan; Department of Physiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hirohisa Watanabe
- Brain and Mind Research Centre, Nagoya University, Nagoya, Japan; Department of Neurology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | |
Collapse
|
10
|
Suzuki Y, Miyazaki T, Muto H, Kubara K, Mukai Y, Watari R, Sato S, Kondo K, Tsukumo SI, Yasutomo K, Ito M, Tsukahara K. Design and lyophilization of lipid nanoparticles for mRNA vaccine and its robust immune response in mice and nonhuman primates. Molecular Therapy - Nucleic Acids 2022; 30:226-240. [PMID: 36187052 PMCID: PMC9508692 DOI: 10.1016/j.omtn.2022.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022]
Abstract
mRNA and lipid nanoparticles have emerged as powerful systems for the preparation of vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The emergence of novel variants or the necessity of cold chain logistics for approved mRNA vaccines undermines the investigation of next-generation systems that could preserve both potency and stability. However, the correlation between lipid nanoparticle composition and activity is not fully explored. Here, we screened a panel of ionizable lipids in vivo and identified lead lipid nanoparticles with a branched-tail lipid structure. Buffer optimization allowed the determination of lyophilization conditions, where lipid nanoparticle-encapsulated mRNA encoding SARS-CoV-2 spike protein could induce robust immunogenicity in mice after 1 month of storage at 5°C and 25°C. Intramuscularly injected lipid nanoparticles distributed in conventional dendritic cells in mouse lymph nodes induced balanced T helper (Th) 1/Th2 responses against SARS-CoV-2 spike protein. In nonhuman primates, two doses of 10 or 100 μg of mRNA induced higher spike-specific binding geometric mean titers than those from a panel of SARS-CoV-2-convalescent human sera. Immunized sera broadly inhibited the viral entry receptor angiotensin-converting enzyme 2 (ACE2) from binding to the spike protein in all six strains tested, including variants of concern. These results could provide useful information for designing next-generation mRNA vaccines.
Collapse
Affiliation(s)
- Yuta Suzuki
- hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
- Corresponding author. Yuta Suzuki, hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan.
| | - Takayuki Miyazaki
- hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| | - Hiroki Muto
- hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| | - Kenji Kubara
- hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| | - Yohei Mukai
- Drug Discovery Platform, KAN Research Institute, Inc., 6-8-2 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Ryuji Watari
- Medicine Development Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| | - Shinya Sato
- Medicine Development Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| | - Keita Kondo
- hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| | - Shin-ichi Tsukumo
- Department of Immunology and Parasitology, Graduate School of Medicine, Tokushima University, Tokushima 770-8503, Japan
| | - Koji Yasutomo
- Department of Immunology and Parasitology, Graduate School of Medicine, Tokushima University, Tokushima 770-8503, Japan
| | - Masashi Ito
- hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| | - Kappei Tsukahara
- hhc Data Creation Center, Tsukuba Research Laboratories, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan
| |
Collapse
|
11
|
Tsuru A, Matsui K, Kimura A, Yoshiike T, Otsuki R, Nagao K, Hazumi M, Utsumi T, Fukumizu M, Mukai Y, Takahashi Y, Sakamoto T, Kuriyama K. Sleep disturbance and health-related quality of life in Parkinson's disease: A clear correlation between health-related quality of life and subjective sleep quality. Parkinsonism Relat Disord 2022; 98:86-91. [PMID: 35526495 DOI: 10.1016/j.parkreldis.2022.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Comorbid insomnia and poor sleep quality in Parkinson's disease (PD) are associated with a poor health-related quality of life (HRQoL). However, the relationship between HRQoL and sleep measures obtained using polysomnography (PSG) remains unclear. We aimed to examine the association between various sleep measures and HRQoL in PD patients. METHODS We retrospectively included patients with PD who underwent PSG and responded to self-administered questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS The patients' (n = 120) mean age was 67.06 (SD = 8.77) years, and their mean Hoehn and Yahr stage was 2.25 (SD = 0.78). A higher PSQI score (worse subjective sleep quality) was correlated in PSG with shorter sleep latency, less N1 sleep, and more N2 sleep. Multiple regression analysis showed that the total PSQI score correlated with both physical and mental HRQoL (p < 0.001 in both cases). However, neither type of HRQoL studied correlated with objective sleep measures, including indicators of sleep architecture, sleep-disordered breathing, and sleep related movement disorders. CONCLUSION Despite the association between subjective sleep quality and HRQoL, the associations between objective measures and HRQoL were negligible. Objective sleep fragmentation may not be perceived as a sleep disturbance in patients with PD, and therefore may not adversely affect their subjective health, given the paradoxical correlation between PSQI score and sleep architecture.
Collapse
Affiliation(s)
- Ayumi Tsuru
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Kentaro Matsui
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Department of Psychiatry, Tokyo Women's Medical University, 8-1, Kawada, Shinjuku, Tokyo, 162-8666, Japan.
| | - Ayano Kimura
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Rei Otsuki
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Department of Psychiatry, Nihon University School of Medicine, 1-6, Kandasurugadai, Chiyoda, Tokyo, 101-8309, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Megumi Hazumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Michio Fukumizu
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Segawa Memorial Neurological Clinic for Children, Segawa Building F2, 2-8, Kandasurugadai, Chiyoda, Tokyo, 101-0062, Japan
| | - Yohei Mukai
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Takashi Sakamoto
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| |
Collapse
|
12
|
Mukai Y. PO-1355 The treatment strategy for cervical cancer; image-guided HDR-ICBT and IMRT using central shielding. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03319-9] [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: 10/18/2022]
|
13
|
Hatano T, Kano O, Sengoku R, Yoritaka A, Suzuki K, Nishikawa N, Mukai Y, Nomura K, Yoshida N, Seki M, Matsukawa MK, Terashi H, Kimura K, Tashiro J, Hirano S, Murakami H, Joki H, Uchiyama T, Shimura H, Ogaki K, Fukae J, Tsuboi Y, Takahashi K, Yamamoto T, Yanagisawa N, Nagayama H. Evaluating the impact of adjunctive istradefylline on the cumulative dose of levodopa-containing medications in Parkinson's disease: study protocol for the ISTRA ADJUST PD randomized, controlled study. BMC Neurol 2022; 22:71. [PMID: 35241003 PMCID: PMC8892732 DOI: 10.1186/s12883-022-02600-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Levodopa remains the most effective symptomatic treatment for Parkinson’s disease (PD) more than 50 years after its clinical introduction. However, the onset of motor complications can limit pharmacological intervention with levodopa, which can be a challenge when treating PD patients. Clinical data suggest using the lowest possible levodopa dose to balance the risk/benefit. Istradefylline, an adenosine A2A receptor antagonist indicated as an adjunctive treatment to levodopa-containing preparations in PD patients experiencing wearing off, is currently available in Japan and the US. Preclinical and preliminary clinical data suggested that adjunctive istradefylline may provide sustained antiparkinsonian benefits without a levodopa dose increase; however, available data on the impact of istradefylline on levodopa dose titration are limited. The ISTRA ADJUST PD study will evaluate the effect of adjunctive istradefylline on levodopa dosage titration in PD patients. Methods This 37-week, multicenter, randomized, open-label, parallel-group controlled study in PD patients aged 30–84 years who are experiencing the wearing-off phenomenon despite receiving levodopa-containing medications ≥ 3 times daily (daily dose 300–400 mg) began in February 2019 and will continue until February 2022. Enrollment is planned to attain 100 evaluable patients for the efficacy analyses. Patients will receive adjunctive istradefylline (20 mg/day, increasing to 40 mg/day) or the control in a 1:1 ratio, stratified by age, levodopa equivalent dose, and presence/absence of dyskinesia. During the study, the levodopa dose will be increased according to symptom severity. The primary study endpoint is the comparison of the cumulative additional dose of levodopa-containing medications during the treatment period between the adjunctive istradefylline and control groups. Secondary endpoints include changes in efficacy rating scales and safety outcomes. Discussion This study aims to clarify whether adjunctive istradefylline can reduce the cumulative additional dose of levodopa-containing medications in PD patients experiencing the wearing-off phenomenon, and lower the risk of levodopa-associated complications. It is anticipated that data from ISTRA ADJUST PD will help inform future clinical decision-making for patients with PD in the real-world setting. Trial registration Japan Registry of Clinical Trials, jRCTs031180248; registered 12 March 2019.
Collapse
Affiliation(s)
- Taku Hatano
- Department of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan.
| | - Osamu Kano
- Department of Neurology, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Renpei Sengoku
- Department of Neurology, Jikei University Daisan Hospital, 4-11-1 Izumihoncho, Komae, Tokyo, 201-0003, Japan
| | - Asako Yoritaka
- Department of Neurology, Juntendo University Koshigaya Hospital, 560 Fukuroyama, Koshigaya-shi, Saitama, 343-0032, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University Hospital, 880 Oaza Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Noriko Nishikawa
- Department of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan.,Department of Neurology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551, Japan
| | - Yohei Mukai
- Department of Neurology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551, Japan
| | - Kyoichi Nomura
- Department of Neurology, Saitama Medical Center, Kawagoe-shi, Saitama, 350-8550, Japan
| | - Norihito Yoshida
- Department of Neurology, Saitama Medical Center, Kawagoe-shi, Saitama, 350-8550, Japan
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Miho Kawabe Matsukawa
- Department of Neurology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Hiroo Terashi
- Department of Neurology, Tokyo Medical University Hospital, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama-shi, Kanagawa, 232-0024, Japan
| | - Jun Tashiro
- Sapporo Parkinson MS Neurological Clinic, Dai 27 Big Sapporo-kita Sky Building 12F, 7-6 Kita-7 jo Nishi-5 chome, Kita-ku, Sapporo-shi, Hokkaido, 060-0807, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Hidetomo Murakami
- Department of Neurology, The Jikei University Hospital, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Tsuyoshi Uchiyama
- Department of Neurology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-shi, Shizuoka, 430-8558, Japan
| | - Hideki Shimura
- Department of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo, 136-0075, Japan
| | - Kotaro Ogaki
- Department of Neurology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu-shi, Chiba, 279-0021, Japan
| | - Jiro Fukae
- Department of Neurology, Juntendo University Nerima Hospital, 3-1-10 Takano-dai, Nerima-ku, Tokyo, 177-8521, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Musashidai 2-6-1, Fuchu-shi, Tokyo, 183-0042, Japan
| | - Toshimasa Yamamoto
- Department of Neurology, Saitama Medical University Hospital, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Naotake Yanagisawa
- Medical Technology Innovation Center, Juntendo University and Juntendo Clinical Research and Trial Center, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroshi Nagayama
- Department of Neurology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| |
Collapse
|
14
|
Shigemoto Y, Matsuda H, Kimura Y, Chiba E, Ohnishi M, Nakaya M, Maikusa N, Ogawa M, Mukai Y, Takahashi Y, Sako K, Toyama H, Inui Y, Taki Y, Nagayama H, Ono K, Kono A, Sekiguchi K, Hirano S, Sato N. Voxel-based analysis of age and gender effects on striatal [ 123I] FP-CIT binding in healthy Japanese adults. Ann Nucl Med 2022; 36:460-467. [PMID: 35174441 DOI: 10.1007/s12149-022-01725-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/01/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although previous studies have investigated age and gender effects on striatal subregional dopamine transporter (DaT) binding, these studies were mostly based on a conventional regions of interest-based analysis. Here, we investigated age and gender effects on striatal DaT binding at the voxel level, using a multicenter database of [(123)I] N-omega-fluoropropyl-2beta-carbomethoxy-3beta-{4-iodophenyl}nortropane ([(123)I] FP-CIT)-single photon emission computed tomography (SPECT) scans in 256 healthy Japanese adults. METHODS We used the Southampton method to calculate the specific binding ratios (SBRs) of each subject's striatum and then converted the [123I] FP-CIT SPECT images to quantitative SBRs images. To investigate the effects of age and gender effects on striatal DaT binding, we performed a voxel-based analysis using statistical parametric mapping. Gender differences were also compared between young to middle-aged subjects and elderly subjects (age threshold: 60 years). RESULTS When all subjects were explored as a group, DaT binding throughout the striatum decreased with advancing age. Among all subjects, the females showed higher DaT binding in the bilateral caudate compared to the males. In the young to middle-aged subjects, the females showed higher DaT binding throughout the striatum (with a slight caudate predominance) versus the males. In the elderly, there were no gender differences in striatal DaT binding. CONCLUSION Our findings of striatal subregional age- and gender-related differences may provide useful information to construct a more detailed DaT database in healthy Japanese subjects.
Collapse
Affiliation(s)
- Yoko Shigemoto
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.,Drug Discovery and Cyclotron Research Center, Southern TOHOKU Research Institute for Neuroscience, Koriyama, 963-8052, Japan
| | - Hiroshi Matsuda
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan. .,Drug Discovery and Cyclotron Research Center, Southern TOHOKU Research Institute for Neuroscience, Koriyama, 963-8052, Japan. .,Southern TOHOKU Research Institute for Neuroscience, Shin-Otemachi Building 6F (621), 2-2-1, Otemachi, Chiyoda-ku, Tokyo, 199-0004, Japan.
| | - Yukio Kimura
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Emiko Chiba
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Masahiro Ohnishi
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Moto Nakaya
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Norihide Maikusa
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Masayo Ogawa
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Yohei Mukai
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuya Sako
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yoshitaka Inui
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Hiroshi Nagayama
- Department of Neurology, Graduate School of Medicine, Nippon Medical School Bunkyo-Ku, Tokyo, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan.,Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Atsushi Kono
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenji Sekiguchi
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| |
Collapse
|
15
|
Shiozawa S, Tsumiyama K, Miyazaki Y, Uto K, Sakurai K, Nakashima T, Matsuyama H, Doi A, Tarui M, Izumikawa M, Kimura M, Fujita Y, Satonaka C, Horiuchi T, Matsubara T, Oribe M, Yamane T, Kagawa H, Li QZ, Mizuno K, Mukai Y, Murakami K, Enya T, Tsukimoto S, Hakata Y, Miyazawa M, Shiozawa K. DOCK8-expressing T follicular helper cells newly generated beyond self-organized criticality cause systemic lupus erythematosus. iScience 2022; 25:103537. [PMID: 34977502 PMCID: PMC8689056 DOI: 10.1016/j.isci.2021.103537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/01/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
Pathogens including autoantigens all failed to induce systemic lupus erythematosus (SLE). We, instead, studied the integrity of host's immune response that recognized pathogen. By stimulating TCR with an antigen repeatedly to levels that surpass host's steady-state response, self-organized criticality, SLE was induced in mice normally not prone to autoimmunity, wherein T follicular helper (Tfh) cells expressing the guanine nucleotide exchange factor DOCK8 on the cell surface were newly generated. DOCK8+Tfh cells passed through TCR re-revision and induced varieties of autoantibody and lupus lesions. They existed in splenic red pulp and peripheral blood of active lupus patients, which subsequently declined after therapy. Autoantibodies and disease were healed by anti-DOCK8 antibody in the mice including SLE-model (NZBxNZW) F1 mice. Thus, DOCK8+Tfh cells generated after repeated TCR stimulation by immunogenic form of pathogen, either exogenous or endogenous, in combination with HLA to levels that surpass system's self-organized criticality, cause SLE. Autoimmunity seldom takes place under integrated steady-state immune response Repeated invasion by pathogen, such as measles virus, is not exceptional but routine in life DOCK8+Tfh is generated upon TCR overstimulation by pathogen beyond self-organized criticality Newly generated DOCK8+Tfh induces autoantibodies and SLE, i.e., autoimmunity
Collapse
Affiliation(s)
- Shunichi Shiozawa
- Institute for Rheumatic Diseases, 944-25 Fujita, Katoshi 673-1462, Japan.,Department of Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan.,Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan.,Department of Medicine, Rheumatology and Orthopedic Surgery, Matsubara Mayflower Hospital, 944-25 Fujita, Katoshi 673-1462, Japan
| | - Ken Tsumiyama
- Institute for Rheumatic Diseases, 944-25 Fujita, Katoshi 673-1462, Japan.,Department of Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan.,Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan.,Department of Medicine, Rheumatology and Orthopedic Surgery, Matsubara Mayflower Hospital, 944-25 Fujita, Katoshi 673-1462, Japan
| | - Yumi Miyazaki
- Department of Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan.,Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Kenichi Uto
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Keiichi Sakurai
- Institute for Rheumatic Diseases, 944-25 Fujita, Katoshi 673-1462, Japan.,Department of Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan
| | - Toshie Nakashima
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Hiroko Matsuyama
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Ai Doi
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Miho Tarui
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Manabu Izumikawa
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Mai Kimura
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Yuko Fujita
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Chisako Satonaka
- Division of Bioregulation, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Sumaku, Kobe 654-0142, Japan
| | - Takahiko Horiuchi
- Department of Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan
| | - Tsukasa Matsubara
- Department of Medicine, Rheumatology and Orthopedic Surgery, Matsubara Mayflower Hospital, 944-25 Fujita, Katoshi 673-1462, Japan
| | - Motohiro Oribe
- Oribe Clinic, 1-8-15 Higashi-Odori, Oita 870-0823, Japan
| | - Takashi Yamane
- Department of Rheumatology, Kakogawa City Hospital, 439 Honmachi, Kakogawa 675-8611, Japan
| | - Hidetoshi Kagawa
- Department of Medicine, Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji 670-8540, Japan
| | - Quan-Zhen Li
- Department of Immunology, University of Texas Southwestern Medical Center, 6001 Forest Park Road/ND 6.504, Dallas, TX 75390-8814, USA
| | - Keiko Mizuno
- Drug Discovery Platform, KAN Research Institute, Inc., 6-8-2 Minatojimaminamicho, Kobe 650-0047, Japan
| | - Yohei Mukai
- Drug Discovery Platform, KAN Research Institute, Inc., 6-8-2 Minatojimaminamicho, Kobe 650-0047, Japan
| | - Kazuhiro Murakami
- Tohoku Medical and Pharmaceutical University, 4-4-1 Komatsujima, Aobaku 981-8558, Japan
| | - Takuji Enya
- Department of Immunology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.,Department of Pediatrics, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Shota Tsukimoto
- Department of Immunology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.,Department of Anesthesiology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Yoshiyuki Hakata
- Department of Immunology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Masaaki Miyazawa
- Department of Immunology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.,Kindai University Anti-Aging Center, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan
| | - Kazuko Shiozawa
- Department of Medicine, Rheumatology and Orthopedic Surgery, Matsubara Mayflower Hospital, 944-25 Fujita, Katoshi 673-1462, Japan.,Rheumatology and Collagen Disease Center, Hyogo Prefectural Kakogawa Medical Center, 203 Kanno, Kakogawa 675-8555, Japan
| |
Collapse
|
16
|
Sugimoto H, Murai H, Hirai T, Hamaoka T, Mukai Y, Tokuhisa H, Usui S, Sakata K, Kawajiri M, Takamura M. Different contribution of sympathetic nerve activity to arterial velocity pulse index in hypertensive patients with and without diastolic dysfunction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2306] [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
Introduction
Left ventricular diastolic dysfunction (LVDD) is the main cause of heart failure with preserved ejection fraction (HFpEF). LVDD is related not only to arterial stiffness but also sympathetic nerve activity (SNA). Recent study demonstrated that increased muscle sympathetic nerve activity (MSNA) may be one of contributing factor for arterial stiffness. In clinical practice, Cardio-ankle vascular index (CAVI) provides a reproducible index of arterial stiffness, independent of blood pressure (BP). Recently, Arterial Velocity pulse Index (AVI), which is an index of arterial reflected waves, have been proposed as new index of arterial stiffness. We reported that AVI was associated with MSNA in hypertensive (HT) patients. However, it is still uncertain the effect of LVDD on the association between AVI and SNA in HT patients. Thus, we tested the hypothesis that AVI would be increased and related to MSNA in HT patients with LVDD.
Methods
Patients with essential HT subjects were included in this study. HT was diagnosed as systolic blood pressure (SBP) ≥140mmHg or diastolic blood pressure (DBP) ≥90mmHg. Patients with secondary HT was excluded. AVI was measured from left upper arm by NAS-1000 (Nihon Koden, Japan). CAVI was measured by VaSera VS-1500A (Fukuda Denshi, Japan). Transthoracic echocardiography was performed by trained sonographers. SNA was evaluated by direct recording of MSNA from peroneal nerves.
Results
25 HT patients were included (age 63±14 years, Male/Female 9/16). They were divided into two groups according to E/e' (no LVDD group, E/e' ≤9, N=12; LVDD group, E/e' >9, N=13). There were no significant differences between no LVDD and LVDD groups in age (63±9 vs 69±9 years p=0.205), body mass index (23±3 vs 24±4 p=0.355), BP (SBP 139±16 vs 144±20mmHg p=0.524, DBP 87±15 vs 78±14mmHg p=0.167). LV Ejection Fraction (EF) and Stroke Volume (SV) did not differ between two groups (EF 66±7 vs 69±6% p=0.471, SV 58±7 vs 62±14ml p=0.599). MSNA had tendency to increase in LVDD group compared to no LVDD group (MSNA 53±10 vs 44±12 bursts/100 heartbeats, p=0.052). Contrary to our hypothesis, AVI and CAVI did not differ between two groups (AVI 27±7 vs 29±7 p=0.398, CAVI 8.7±1.4 vs 8.6±1.4 p=0.894). However, a significant correlation was seen between AVI and MSNA in no LVDD group (r=0.57, p<0.05), but no correlation in LVDD group. There is no correlation between CAVI and MSNA in no LVDD and LVDD group. Significant relationship was observed between AVI and CAVI in LVDD group (r=0.61, p<0.05), but no relationship in no LVDD group.
Conclusion
AVI was significantly associated with MSNA in HT patients without LVDD, but not with LVDD. CAVI was related to AVI in HT patients with LVDD, but not without LVDD. MSNA was slightly increased in HT patients with LVDD compared to without LVDD. These results indicate that augmented SNA could contribute to the increase in arterial stiffness in HT patients without LVDD, however, this contribution might be attenuated in HT patients with LVDD.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - H Murai
- Kanazawa University, Kanazawa, Japan
| | - T Hirai
- Kanazawa University, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University, Kanazawa, Japan
| | | | - S Usui
- Kanazawa University, Kanazawa, Japan
| | - K Sakata
- Kanazawa University, Kanazawa, Japan
| | | | | |
Collapse
|
17
|
Mukai Y, Murai H, Hirai T, Sugimoto H, Hamaoka T, Tokuhisa H, Takamura M. Effect of pulmonary vein isolation on left atrial remodeling and muscle sympathetic nerve activity in patients with atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0422] [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
Catheter ablation (CA) for atrial fibrillation (AF) improves left ventricular function and induces left atrium reverse remodeling (LARR). CA is also associated with the modulation of ganglionated plexi in the left atrium (LA), including stretch-sensitive sympathetic and parasympathetic nerve mechanoreceptors. Increased filling pressure and enlargement of LA stimulate stretch-sensitive sympathetic nerve mechanoreceptors in heart failure, which contribute augmented sympathetic nerve activity. However, little is known about an effect of CA on the interaction between the changes of LARR and sympathetic nerve activity.
Purpose
To test the hypothesis that CA induce the reduction in sympathetic nerve activity in accordance with LARR in patients with atrial fibrillation.
Methods
This study was conducted as a retrospective, observational study. Twenty-eight AF patients (65.4±12.1 years old) were included in this study. We measured mean blood pressure (BP), heart rate (HR), brain natriuretic peptide (BNP), and direct recording of muscle sympathetic nerve activity (MSNA) using microneurography technique before and 12 weeks after CA. Echocardiogram was also performed to assess LARR and left ventricular function. To evaluate the interaction between LARR and MSNA, AF patients were divided into two groups by presence (LARR group; n=18) and absence (no LARR group; n=10) of LARR according to left atrium volume index (LAVi) following CA.
Results
No significant differences were observed at baseline in BP, MSNA and LAVi between two groups. BP did not change significantly after CA in both groups. HR significantly increased in the LARR group (63.1±5.7 vs 69.9±7.8, p<0.01) compared to no LARR group. CA significantly reduced MSNA in the LARR group (37.8±10.1 vs 24.9±8.8 bursts/min, p<0.01), but there was no significant change in the no LARR group. The septal E/e' ratio (11.3±3.8 vs 9.8±2.9, p<0.05), left ventricular end-systolic volume index (LVESVi) (24.4±11.9 vs 19.6±7.8 ml/m2, p<0.05) and Ln BNP (4.0±1.2 vs 3.3±1.0 log/pg/ml, p<0.05) were also significantly improved in the LARR group. On the other hand, in the no LARR group, there were no significancy in the changes of the septal E/e' ratio, LVESVi and Ln BNP. LVEF was not significantly changed in both two groups.
Conclusion
Our study shows CA reduced MSNA accompanied by LARR in AF patients. The reduction in MSNA, septal E/e' ratio, LVESVi and Ln BNP were all more pronounced in the LARR group compared to the no LARR group. These findings suggest that LARR is associated with the reduction in MSNA in AF patients, which was attributed to CA-induced modulation of stretch-sensitive sympathetic nerve mechanoreceptors.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- Y Mukai
- Kanazawa University Hospital, Kanazawa, Japan
| | - H Murai
- Kanazawa University Hospital, Kanazawa, Japan
| | - T Hirai
- Kanazawa University Hospital, Kanazawa, Japan
| | - H Sugimoto
- Kanazawa University Hospital, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University Hospital, Kanazawa, Japan
| | - H Tokuhisa
- Kanazawa University Hospital, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Kanazawa, Japan
| |
Collapse
|
18
|
Sugimoto H, Murai H, Hirai T, Hamaoka T, Mukai Y, Tokuhisa H, Usui S, Sakata K, Kawajiri M, Takamura M. Age differences in the association between arterial velocity pulse index and muscle sympathetic nerve activity in hypertensive patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2307] [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
Increased arterial stiffness characterize by aging. It is reported that age-related increases in muscle sympathetic nerve activity (MSNA) may be one of contributing factor for arterial stiffness. Arterial reflected wave was composed of SNA and aging. Increased arterial reflected wave partly plays an important role in blood pressure. Recently, we reported that arterial velocity pulse index (AVI), a novel index of arterial reflected waves, was associated with MSNA in hypertensive patients. It is still uncertain the effect of age on the association between AVI and SNA in hypertensive patients.
Method
Patients with essential HT and matched non-hypertensive control subjects were included in this study. HT was diagnosed as systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. AVI was measured from left upper arm by NAS-1000. SNA was evaluated by direct recording of muscle sympathetic nerve activity (MSNA) from peroneal nerves.
Results
45 HT patients and 46 control subjects were included. Age, SBP and DBP were significantly increased in HT group compared to control (Age 63±14 vs 42±16 years, p<0.001; SBP 144±16 vs 115±9 mmHg, p<0.001; DBP 80±14 vs 67±9 mmHg, p<0.001). MSNA and AVI were significantly increased in HT group compared to control (MSNA 34±10 vs 25±8 bursts/min, p<0.05; AVI 28±9 vs 17±5, p<0.05). AVI was significantly correlated with MSNA, age, and SBP in HT group. HT group was divided into two groups according to their age (group 1, age ≤63 N=21, group 2, age ≥64 N=26). AVI in group 1 showed correlation with MSNA (r=0.59, p<0.05), but no correlation was seen in group 2. However excluded SBP>160 mmHg subjects in group 2, significant correlation was clarified between AVI and MSNA (r=0.62, p<0.05).
Conclusion
The relationship between AVI and MSNA in HT patients is preserved regardless of aging, however, high blood pressure over 160mmHg might obscure its correlation. These results indicate that AVI is useful to estimate sympathetic nerve activity in high aging HT patient treated <160 blood pressure.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - H Murai
- Kanazawa University, Kanazawa, Japan
| | - T Hirai
- Kanazawa University, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University, Kanazawa, Japan
| | | | - S Usui
- Kanazawa University, Kanazawa, Japan
| | - K Sakata
- Kanazawa University, Kanazawa, Japan
| | | | | |
Collapse
|
19
|
Mukai Y. PO-1305 Radiation Therapy for Stage IVB Uterine Cervical Cancer with Supraclavicular Lymph Nodes Metastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07756-2] [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: 11/25/2022]
|
20
|
Kozawa K, Sekai M, Ohba K, Ito S, Sako H, Maruyama T, Kakeno M, Shirai T, Kuromiya K, Kamasaki T, Kohashi K, Tanaka S, Ishikawa S, Sato N, Asano S, Suzuki H, Tanimura N, Mukai Y, Gotoh N, Tanino M, Tanaka S, Natsuga K, Soga T, Nakamura T, Yabuta Y, Saitou M, Ito T, Matsuura K, Tsunoda M, Kikumori T, Iida T, Mizutani Y, Miyai Y, Kaibuchi K, Enomoto A, Fujita Y. The CD44/COL17A1 pathway promotes the formation of multilayered, transformed epithelia. Curr Biol 2021; 31:3086-3097.e7. [PMID: 34087104 DOI: 10.1016/j.cub.2021.04.078] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/30/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
At the early stage of cancer development, oncogenic mutations often cause multilayered epithelial structures. However, the underlying molecular mechanism still remains enigmatic. By performing a series of screenings targeting plasma membrane proteins, we have found that collagen XVII (COL17A1) and CD44 accumulate in RasV12-, Src-, or ErbB2-transformed epithelial cells. In addition, the expression of COL17A1 and CD44 is also regulated by cell density and upon apical cell extrusion. We further demonstrate that the expression of COL17A1 and CD44 is profoundly upregulated at the upper layers of multilayered, transformed epithelia in vitro and in vivo. The accumulated COL17A1 and CD44 suppress mitochondrial membrane potential and reactive oxygen species (ROS) production. The diminished intracellular ROS level then promotes resistance against ferroptosis-mediated cell death upon cell extrusion, thereby positively regulating the formation of multilayered structures. To further understand the functional role of COL17A1, we performed comprehensive metabolome analysis and compared intracellular metabolites between RasV12 and COL17A1-knockout RasV12 cells. The data imply that COL17A1 regulates the metabolic pathway from the GABA shunt to mitochondrial complex I through succinate, thereby suppressing the ROS production. Moreover, we demonstrate that CD44 regulates membrane accumulation of COL17A1 in multilayered structures. These results suggest that CD44 and COL17A1 are crucial regulators for the clonal expansion of transformed cells within multilayered epithelia, thus being potential targets for early diagnosis and preventive treatment for precancerous lesions.
Collapse
Affiliation(s)
- Kei Kozawa
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Cell Pharmacology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Miho Sekai
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; KAN Research Institute, Inc., Kobe, Japan
| | - Kenji Ohba
- KAN Research Institute, Inc., Kobe, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Shoko Ito
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; KAN Research Institute, Inc., Kobe, Japan
| | - Hiroaki Sako
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; KAN Research Institute, Inc., Kobe, Japan
| | - Takeshi Maruyama
- KAN Research Institute, Inc., Kobe, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Mai Kakeno
- KAN Research Institute, Inc., Kobe, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Takanobu Shirai
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Keisuke Kuromiya
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Tomoko Kamasaki
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Koki Kohashi
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Shinya Tanaka
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Susumu Ishikawa
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Nanami Sato
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | - Shota Asano
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hironori Suzuki
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobuyuki Tanimura
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan
| | | | - Noriko Gotoh
- Division of Cancer Cell Biology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Mishie Tanino
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan; Institute for Chemical Reaction Design and Discovery (WPI-ICReDD), Hokkaido University, Sapporo, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan; Institute for Chemical Reaction Design and Discovery (WPI-ICReDD), Hokkaido University, Sapporo, Japan
| | - Ken Natsuga
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tomoyoshi Soga
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
| | - Tomonori Nakamura
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan; Department of Anatomy and Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yukihiro Yabuta
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan; Department of Anatomy and Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitinori Saitou
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan; Department of Anatomy and Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Takahiro Ito
- Division of Cell Fate Dynamics and Therapeutics, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Kenkyo Matsuura
- Division of Cell Fate Dynamics and Therapeutics, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Makoto Tsunoda
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Toyone Kikumori
- Department of Breast and Endocrine Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tadashi Iida
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuyuki Mizutani
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuki Miyai
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kozo Kaibuchi
- Department of Cell Pharmacology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Institute for Comprehensive Medical Science (ICMS), Fujita Health University, Toyoake, Japan
| | - Atsushi Enomoto
- Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuyuki Fujita
- Department of Molecular Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Sapporo, Japan.
| |
Collapse
|
21
|
Shiozawa S, Tsumiyama K, Miyazaki Y, Uto K, Sakurai K, Nakashima T, Matsuyama H, Doi A, Tarui M, Izumikawa M, Kimura M, Satonaka C, Fujita Y, Horiuchi T, Matsubara T, Oribe M, Yamane T, Kagawa H, Li QZ, Mizuno K, Mukai Y, Murakami K, Enya T, Tsukimoto S, Hakata Y, Miyazawa M, Shiozawa K. DOCK8-expressing Tfh cells cause SLE: autoimmunity via repeated TCR stimulation by antigen to levels that surpass system’s self-organized criticality. The Journal of Immunology 2021. [DOI: 10.4049/jimmunol.206.supp.52.21] [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] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Abstract
INTRODUCTION: The cause of autoimmunity remains unclear. Candidate pathogens including autoantigens all failed to induce, exist in, or heal upon their removal the prototypical autoimmune disease, systemic lupus erythematosus (SLE). We here investigated, instead of antigen, the immune response of host that recognized antigen.
METHODS:
We test the integrity of host’s immune response by stimulating TCR maximally to levels that surpass the limit of host’s steady-state immune response, self-organized criticality, by an antigen.
RESULTS:
After repeated stimulation by any immunogenic antigen, SLE was induced in mice normally not prone to autoimmune disease, wherein a novel T follicular helper (Tfh) cell type expressing the guanine nucleotide exchange factor DOCK8 on the cell surface was newly generated via resuscitation from antigen-induced anergy. DOCK8+ Tfh cells passed through TCR revision at the periphery, and induced a variety of autoantibodies and the lesion characteristic of SLE. They existed in splenic red pulp and in the circulation of active patients with SLE, which subsequently declined after conventional therapy. Lupus lesions of mice and the classical (NZBxNZW) F1 model mice were mostly cured by anti-DOCK8 antibody.
CONCLUSION:
Thus, disruption of host’s steady-state immune response by repeated TCR stimulation by immunogenic pathogen, either exogenous or endogenous, results in generation of DOCK8-expressing Tfh cells that cause autoantibodies and SLE.
Collapse
Affiliation(s)
- Shunichi Shiozawa
- 1Institute for Rheumatic Diseases, Japan
- 2Kyushu University Beppu Hospital, Japan
- 3Matsubara Mayflower Hospital, Japan
- 4Kobe University Graduate School of Health Sciences, Japan
| | - Ken Tsumiyama
- 1Institute for Rheumatic Diseases, Japan
- 2Kyushu University Beppu Hospital, Japan
- 3Matsubara Mayflower Hospital, Japan
| | | | - Kenichi Uto
- 4Kobe University Graduate School of Health Sciences, Japan
| | - Keiichi Sakurai
- 1Institute for Rheumatic Diseases, Japan
- 2Kyushu University Beppu Hospital, Japan
| | | | | | - Ai Doi
- 4Kobe University Graduate School of Health Sciences, Japan
| | - Miho Tarui
- 4Kobe University Graduate School of Health Sciences, Japan
| | | | - Mai Kimura
- 4Kobe University Graduate School of Health Sciences, Japan
| | | | - Yoko Fujita
- 4Kobe University Graduate School of Health Sciences, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Lin CH, Tsai PI, Lin HY, Hattori N, Funayama M, Jeon B, Sato K, Abe K, Mukai Y, Takahashi Y, Li Y, Nishioka K, Yoshino H, Daida K, Chen ML, Cheng J, Huang CY, Tzeng SR, Wu YS, Lai HJ, Tsai HH, Yen RF, Lee NC, Lo WC, Hung YC, Chan CC, Ke YC, Chao CC, Hsieh ST, Farrer M, Wu RM. Mitochondrial UQCRC1 mutations cause autosomal dominant parkinsonism with polyneuropathy. Brain 2021; 143:3352-3373. [PMID: 33141179 PMCID: PMC7719032 DOI: 10.1093/brain/awaa279] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 02/24/2020] [Revised: 06/25/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease is a neurodegenerative disorder with a multifactorial aetiology. Nevertheless, the genetic predisposition in many families with multi-incidence disease remains unknown. This study aimed to identify novel genes that cause familial Parkinson's disease. Whole exome sequencing was performed in three affected members of the index family with a late-onset autosomal-dominant parkinsonism and polyneuropathy. We identified a novel heterozygous substitution c.941A>C (p.Tyr314Ser) in the mitochondrial ubiquinol-cytochrome c reductase core protein 1 (UQCRC1) gene, which co-segregates with disease within the family. Additional analysis of 699 unrelated Parkinson's disease probands with autosomal-dominant Parkinson's disease and 1934 patients with sporadic Parkinson's disease revealed another two variants in UQCRC1 in the probands with familial Parkinson's disease, c.931A>C (p.Ile311Leu) and an allele with concomitant splicing mutation (c.70-1G>A) and a frameshift insertion (c.73_74insG, p.Ala25Glyfs*27). All substitutions were absent in 1077 controls and the Taiwan Biobank exome database from healthy participants (n = 1517 exomes). We then assayed the pathogenicity of the identified rare variants using CRISPR/Cas9-based knock-in human dopaminergic SH-SY5Y cell lines, Drosophila and mouse models. Mutant UQCRC1 expression leads to neurite degeneration and mitochondrial respiratory chain dysfunction in SH-SY5Y cells. UQCRC1 p.Tyr314Ser knock-in Drosophila and mouse models exhibit age-dependent locomotor defects, dopaminergic neuronal loss, peripheral neuropathy, impaired respiratory chain complex III activity and aberrant mitochondrial ultrastructures in nigral neurons. Furthermore, intraperitoneal injection of levodopa could significantly improve the motor dysfunction in UQCRC1 p.Tyr314Ser mutant knock-in mice. Taken together, our in vitro and in vivo studies support the functional pathogenicity of rare UQCRC1 variants in familial parkinsonism. Our findings expand an additional link of mitochondrial complex III dysfunction in Parkinson's disease.
Collapse
Affiliation(s)
- Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-I Tsai
- Department of Biochemistry and Biophysics, University of California San Francisco, USA
| | - Han-Yi Lin
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Manabu Funayama
- Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Beomseok Jeon
- Department of Neurology, Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, Seoul, Korea
| | - Kota Sato
- Department of Neurology, Okayama University Medical School, Okayama, Japan
| | - Koji Abe
- Department of Neurology, Okayama University Medical School, Okayama, Japan
| | - Yohei Mukai
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Yuanzhe Li
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kenya Nishioka
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyo Yoshino
- Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kensuke Daida
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Meng-Ling Chen
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jay Cheng
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Yen Huang
- The first core laboratory, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shiou-Ru Tzeng
- Institute of Biochemistry and Molecular Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Sheng Wu
- Electron Microscope Laboratory of Tzong Jwo Jang, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Hsing-Jung Lai
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsin-Hsi Tsai
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ni-Chung Lee
- Department of Medical Genetics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Chun Lo
- Graduate Institute of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chien Hung
- Graduate Institute of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Chiang Chan
- Graduate Institute of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Ci Ke
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Chao Chao
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sung-Tsang Hsieh
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Matthew Farrer
- Department of Neurology, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Center for Applied Neurogenetics, University of British Columbia, Canada
| | - Ruey-Meei Wu
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
23
|
Mukai Y, Toyoda H, Miyama K, Takahashi Y. Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson's disease on levodopa-carbidopa intestinal gel infusion therapy. Clin Park Relat Disord 2020; 3:100079. [PMID: 34316657 PMCID: PMC8298846 DOI: 10.1016/j.prdoa.2020.100079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/20/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022] Open
Abstract
It is important to treat tube-related adverse events without endoscopy. All PEG-J tube kinks were resolved using tube manipulation with fluoroscopy. Use of an antispasmodic agent before PEG-J may have lowered success rate. Most tube-associated adverse events were clarified without endoscopy.
Introduction Tube-related adverse events (AEs) occur frequently in patients with Parkinson’s disease (PD) receiving levodopa-carbidopa intestinal gel therapy. Endoscopy has become evasive since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate methods that use the percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tubes without endoscopy. Methods We included 19 patients in this study. The contrast agent was injected into the PEG-J tube to clarify the AEs related to the use of the tube. When the kink of the PEG-J tube was found, it was pulled approximately 5–10 cm. When placing or replacing the PEG-J tube, the percutaneous endoscopic gastrostomy (PEG) tube was pushed into the gastrostomy hole to bring its tip closer to the pylorus before a new PEG-J tube was inserted into it. Results The mean patient age was 63.1 ± 9.9 years, while the mean duration of PD was 16.7 ± 6.3 years. Tube-related AEs included PEG-J tube kinks (32 events), connector failures (20 events), and PEG-J tube entanglements without/with bezoars (9 events/5 events). All PEG-J tube kinks were resolved by tube manipulation with a fluoroscopic guide. In 66 of 85 events (77.6%), the PEG-J tube was placed or replaced without endoscopy. We believe that the use of the antispasmodic agent just before PEG-J operation reduced this rate. Conclusion Our methods were able to resolve most AEs associated with PEG-J tube use without endoscopy.
Collapse
Affiliation(s)
- Yohei Mukai
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| | - Hiroyuki Toyoda
- Department of Surgery, National Center Hospital, National Center of Neurology and Psychiatry, Japan
| | - Kenji Miyama
- Department of Surgery, National Center Hospital, National Center of Neurology and Psychiatry, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| |
Collapse
|
24
|
Mukai Y, Hata M. Prognostic Significance Of Lymphocyte Ratio In Postoperative Radiation Therapy For Cholangiocarcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1913] [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: 11/17/2022]
|
25
|
Kawai S, Nagaoka K, Takase S, Sakamoto K, Ikuta H, Toyohara T, Okahara A, Tokutome M, Kuribayashi Y, Matsura H, Matsukawa R, Masuda S, Chishaki A, Tsutsui H, Mukai Y. Presence of low voltage area predicts atrial tachyarrhythmia inducibility with atrial burst pacing after pulmonary vein isolation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0595] [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
Induction of atrial fibrillation (AF)/atrial tachycardia (AT) by atrial burst pacing following ablation procedure may reflect the presence of residual substrates in the atria that maintain AF. However, the relation between the inducibility and left atrial low voltage area (LVA) has not been established.
Methods
Fifty-nine patients (65 years old, 43 males) with persistent AF who underwent pulmonary vein isolation (PVI)-based ablation were studied. All patients underwent left atrial voltage mapping during sinus rhythm and atrial burst pacing after PVI. Atrial burst pacing was performed with 30-beat at an amplitude of 10V from the ostium of the coronary sinus; increasing from 240 to 320 ppm in steps of 20 ppm or failure to 1:1 atrial capture. Inducibility was defined as AF/AT lasting more than 5 minutes following burst pacing. Left atrial LVA and other co-variates were analyzed with regard to burst pacing positivity.
Results
AF/AT was induced by burst pacing in 23 patients (39%). Univariate analysis revealed that past history of stroke, CHADS2 score and presence of left atrial LVA were significantly associated with the inducibility of AF/AT. Multivariate analysis revealed that only the presence of LVA was associated with the inducibility (OR 1.5: per 10% increase; p=0.04). We focused on the relationship between the extent of LVA and burst positivity. AF/AT inducibility increased as low voltage area increased, and it was as high as 72.7% when low voltage area was more than 20% (P<0.05). Interestingly, induced arrhythmia type was AT rather than AF when low voltage area was more than 20%.
Conclusions
Presence of left atrial LVA is an independent predictor of atrial tachyarrhythmia inducibility after PVI in patients with persistent AF. A large amount of low voltage area is related to AT inducibility rather than AF.
Extent of LVA and burst positivity
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- S Kawai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - H Ikuta
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - T Toyohara
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - A Okahara
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - M Tokutome
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - H Matsura
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - S Masuda
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Hospital, Health Sciences, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| |
Collapse
|
26
|
Mukai Y, Koike I, Hayashi Y, Sugiura M, Koizumi T, Mitsudo K, Hata M. PO-0786: Comparison of the intra-arterial and systemic chemoradiotherapy for gingival carcinoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00803-3] [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: 11/25/2022]
|
27
|
Matsukawa R, Ikuta H, Okahara A, Kawai S, Tokutome M, Matsuura H, Masuda S, Mukai Y. Early follow-up visit at outpatient care after discharge improves 2-year heart failure readmission rate and long-term prognosis in patients with decompensated heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1042] [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/Introduction
It has been reported that heart failure (HF) readmission has not declined even with current cardiology practice in the last 10 years. It has been also reported that HF readmission tends to occur shortly after discharge. This may be due to overwork and excessive salt intake after discharge. In other words, it is conceivable that patient factors are largely attributable, which should be intervene for better clinical outcomes.
Purpose
We hypothesized and investigated whether an early follow-up visit at outpatient care within 2 weeks after discharge affects the re-admission rate and prognosis in patients with decompensated HF.
Methods
We retrospectively investigated consecutive 407 hospitalized patients due to decompensated HF. After exclusion of 99 patients with in-hospital death, transfer to another hospital and readmission within 2 weeks after discharge, consecutive 308 out of 407 patients were investigated. Two-year clinical outcomes after discharge were collected and analyzed. An early follow-up was defined as an outpatient care visit within 2 weeks after discharge with the adjustment of drugs and/or the lifestyle guidance, if necessary. A setting of early follow-up in each patient was according to a physician's discretion.
Results
One hundred-twenty eight patients underwent early follow-up visits and other 180 patients were without it. An univariate analysis showed that the early follow-up was significantly associated with a lower HF readmission rate during 2 years (17.1% in the early follow-up group, 34.4% in the control group, p≤0.001, OR=0.397, 95% CI=0.230–0.685, Figure) and a 2-year composite adverse outcome (all cause death and HF readmission; 18.7% vs. 40.5%, p<0.001, OR=0.332, 95% CI=0.196–0.563, Figure). To exclude possible relationships of other co-variable factors, we performed a multivariate analysis about the association with HF readmission rate and the 2-year composite adverse outcome (co-variate factors as follows are included; factors of which p-value was less than 0.1 and general confounding factors). The multivariate analysis showed that the early follow-up was independently associated with HF readmission during 2 years (p=0.002, OR=0.376, 95% CI=0.197–0.716) and the 2-year composite outcome (p<0.001, OR=0.343, 95% CI=0.182–0.648). Finally, we characterized the practical interventions at outpatient care after discharge. Lifestyle guidance was done in all patients. However, medication adjustments were done in only 36.7% patients. Interestingly, whether or not a medication adjustment was done at the early follow-up visit was not associated with the HF readmissions (p=0.781).
Conclusions
The present study suggests that an early follow-up approach after discharge in decompensated HF patients may improve the long-term prognosis. These results were not dependent on whether a medication adjustment was performed or not. An early follow-up may help improve patient factors of HF worsening.
Main results
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
| | - H Ikuta
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - A Okahara
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - S Kawai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - M Tokutome
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - H Matsuura
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - S Masuda
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Y Mukai
- Fukuoka Red Cross Hospital, Fukuoka, Japan
| |
Collapse
|
28
|
Sugimoto H, Murai H, Hamaoka T, Mukai Y, Inoue O, Okabe Y, Tokuhisa H, Takashima S, Kato T, Usui S, Sakata K, Talamura M. Novel index of arterial reflected waves, Arterial Velocity pulse Index, relates to muscle sympathetic nerve activity independent of Arterial Pressure volume Index in patients with hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2720] [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: 11/13/2022] Open
Abstract
Abstract
Background
Arterial reflected wave is determined by not only atherosclerosis but also sympathetic nerve activity. Recently, Arterial Velocity pulse Index (AVI), which is an index of arterial reflected waves, and Arterial Pressure volume Index (API), which is an index of volume of a conductive blood vessel, have been proposed as new index of arterial stiffness. However, it is unclear whether API and AVI would be associated with muscle sympathetic nerve activity (MSNA) in hypertensive subjects.
Purpose
The purpose of this study was to evaluate the correlation between AVI, API and MSNA in hypertensive subjects.
Method
41 hypertensive patients and 40 non-hypertensive subjects were included in this study. We performed a cross-sectional, observational study. Hypertension (HT) was defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg or medical treatment for HT. AVI and API was measured by NAS-1000 (Nihon Koden, Japan). MSNA, central sympathetic outflow to peripheral muscle, was recorded directly from peroneal nerve. MSNA was expressed by burst frequency (bursts/minute) and burst incidence (bursts/100heartbeats). Blood pressure, heart rate and MSNA were recorded simultaneously.
Results
Age, systolic and diastolic pressure were significantly higher in hypertensive patients compared to control (40±15 vs 61±13 years, p<0.001; 142±16 vs 113±9 mmHg, p<0.001; 81±14 vs 67±9 mmHg, p<0.001). MSNA and AVI were significantly augmented in hypertensive patients compared to control (34±11 vs. 23±6 bursts/min, p<0.05; 26±7 vs. 16±4, p<0.05). AVI was correlated with MSNA in each group (hypertension: r=0.59, P<0.001, non-hypertension: r=0.51, p<0.001). However, no correlation was shown between API and MSNA in each group (hypertension: r=0.22, p=0.15, non-hypertension: r=0.07, p=0.63). Multiple regression analysis also showed MSNA was significantly related with AVI but was not with API.
Conclusion
Our finding showed that AVI relates to MSNA independent of API in patients with hypertension. It suggested that Novel index of arterial reflected waves, AVI, is helpful to estimate augmented SNA in hypertensive subjects regardless of volume of a conductive blood vessel.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
| | - H Murai
- Kanazawa University, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University, Kanazawa, Japan
| | - O Inoue
- Kanazawa University, Kanazawa, Japan
| | - Y Okabe
- Kanazawa University, Kanazawa, Japan
| | | | | | - T Kato
- Kanazawa University, Kanazawa, Japan
| | - S Usui
- Kanazawa University, Kanazawa, Japan
| | - K Sakata
- Kanazawa University, Kanazawa, Japan
| | | |
Collapse
|
29
|
Nishikawa N, Iwaki H, Shiraishi T, Mukai Y, Takahashi Y, Hattori N. Female, Aging, Low ratio of DCI or lower body weight increases AUC4hr of levodopa in patients with Parkinson's disease. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.225] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
30
|
Shiraishi T, Nishikawa N, Mukai Y, Takahashi Y. High levodopa plasma concentration after oral administration predicts levodopa-induced dyskinesia in Parkinson's disease. Parkinsonism Relat Disord 2020; 75:80-84. [PMID: 32497995 DOI: 10.1016/j.parkreldis.2020.05.022] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION In patients with Parkinson's disease (PD), pulsatile dopaminergic stimulation may be a primary cause of levodopa-induced dyskinesia (LID). We aimed to investigate the correlation between levodopa pharmacokinetics (PK) and LID in PD. METHODS We retrospectively reviewed the consecutive series of 255 PD patients without LID who underwent PK assessments with 100 mg levodopa. The type of peripheral decarboxylase inhibitor used in the PK assessments was determined by the usual prescription of the formulations of levodopa (10 mg carbidopa [n = 185] and 25 mg benserazide [n = 70]). RESULTS During a median follow-up of 32 months (IQR, 16-49 months), 73 patients (29%) developed LID. Compared with patients who did not develop LID (PD-LID-), those who developed LID (PD-LID+) were younger (p = 0.003) and had significantly higher maximum levodopa concentration (Cmax) (p = 0.002) and area under the curve (p < 0.001), LEDD (p < 0.001), and improvement of motor symptoms (p = 0.009). In the multivariate Cox proportional hazards models, Cmax and AUC were associated with incident LID (Hazard Ratio [HR] 1.11, 95% confidence interval [CI] 1.03-1.19 and HR 1.13, 95% CI 1.03-1.24, respectively). In addition, younger age, benserazide use, LEDD, and MAOBI use were associated with incident LID. CONCLUSION High levodopa plasma concentration after oral administration was associated with incident LID in patients with PD.
Collapse
Affiliation(s)
- Tomotaka Shiraishi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi-cho, Kodaira-shi, Tokyo, 187-8551, Japan
| | - Noriko Nishikawa
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi-cho, Kodaira-shi, Tokyo, 187-8551, Japan.
| | - Yohei Mukai
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi-cho, Kodaira-shi, Tokyo, 187-8551, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi-cho, Kodaira-shi, Tokyo, 187-8551, Japan
| |
Collapse
|
31
|
Hamaoka T, Murai H, Sugimoto H, Mukai Y, Okabe Y, Tokuhisa H, Inoue O, Takashima S, Kato T, Usui S, Furusho H, Takamura M. 1417Effect of sodium glucose cotransporter 2 inhibitor on sympathetic nerve activity in type 2 diabetes mellitus patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Diabetes mellitus (DM) is a well-known risk factor for cardiovascular diseases. Augmented sympathetic nerve activity plays an important role in the progressive worsening disease severity. Most of anti-diabetic drugs were demonstrated to not only decrease blood glucose, but also increase sympathetic nerve activity. Recently, it has been reported that sodium glucose cotransporter 2 (SGLT2) inhibitor has beneficial effects on cardiovascular events in spite of the decrease in blood glucose in type 2 DM patients. The underlying mechanisms remain speculative; however, it is assumed that SGLT2 inhibitor would improve sympathetic nerve activity in type 2 DM patients.
Purpose
The purpose of this study was to evaluate the effect of SGLT2 inhibitor on sympathetic nerve activity in type 2 DM patients.
Methods
This study was designed as the prospective single-arm study. Type2 DM patients whose HbA1c >7.0% with at least one atherosclerotic risk factors (Hypertension, obesity, smoking history, aging ...) were included. Patients who had renal failure (eGFR<45ml/min/1.73m2) or high age patients (>80 years old) were excluded. We measured blood glucose, HbA1c and blood insulin concentration at baseline and 12 weeks after treatment of dapagliflozin (5mg/day). Muscle sympathetic nerve activity (MSNA) was applied to scrutinize accurate sympathetic nerve activity in type 2 DM patients. Also, baroreflex sensitivity was calculated by examining the relationship between MSNA and beat to beat diastolic blood pressure.
Results
Eleven type2 DM patients were included in this study. Body mass index, blood pressure, HbA1c and blood insulin concentration tended to decrease at 12weeks after dapagliflozin (body mass index: 27.2±6.3 vs. 24.9±3.2 kg/m2. systolic blood pressure: 121±12.3 vs. 118±13.6 mmHg. diastolic blood pressure: 74.3±6.3 vs. 72.5±7.6 mmHg. HbA1c: 7.6±0.3 vs. 7.2±0.7%. insulin: 9.7±7.2 vs. 8.8±5.1 μU/ml). Dapagliflozin significantly decrease MSNA and heart rate compared to baseline (46.7±7.5 vs. 38.6±6.9 bursts/minute, P<0.05. Heart rate: 80.6±8.5 vs. 72.8±7.4 beats per minute, P<0.05). However, there is no interaction between the reduction in MSNA and baroreflex sensitivity or insulin resistance.
12 weeks administration decreased MSNA
Conclusion
Our data demonstrated that dapagliflozin significantly decreased MSNA and HR beyond the lowering effect of blood glucose in type2 DM patients. These results indicate the favorable effect of SGLT2 inhibitor might be, in part, attributed to the improvement in sympathetic nerve activity.
Collapse
Affiliation(s)
- T Hamaoka
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - H Murai
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - H Sugimoto
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - Y Okabe
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - H Tokuhisa
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - O Inoue
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - S Takashima
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - T Kato
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - S Usui
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - H Furusho
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| |
Collapse
|
32
|
Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Yakabe D, Ikeda S, Chishaki A, Tsutsui H. P3764Morphological mechanisms of atrial functional mitral regurgitation in patients with atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0615] [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
Atrial functional mitral regurgitation (AFMR) occurs in patients with atrial fibrillation. However, morphological mechanisms of AFMR are poorly understood.
Purpose
The purpose of this study was to examine the morphological characteristics in patients with AFMR.
Methods
Among consecutive 795 patients undergoing initial radiofrequency catheter ablation (RFCA) at our hospital, twenty-five patients with persistent AF accompanied by AFMR (≥ moderate) before RFCA (AFMR group) were studied. Age-matched 25 patients with persistent AF without MR were defined as a control group.
Results
Left ventricular ejection fraction (LVEF) was lower and left atrium volume index was larger in the AFMR group (Table). Mitral valve annulus diameter and length of anterior mitral leaflet (AML) were similar between groups, whereas length of posterior mitral leaflet (PML) was significantly shorter in the AFMR group. Smaller tethering angle of AML (γ in the figure) and shorter tethering height were significantly associated with the occurrence of AFMR, which were different from morphology of functional mitral regurgitation in patients with dilated LV. Multiple regression analysis revealed that less tenting height (p<0.05) and LA dilatation toward the posterior (p<0.01) were significantly related to AFMR.
Echocardiographic parameters AFMR (n=25) Control (n=25) P value Age, y 69±8 66±10 NS Male, n (%) 9 (36) 20 (80) P=0.001 LVEF,% 60±9 67±6 P=0.004 LAD, mm 44±5 41±7 NS LAVI, ml/m2 56±17 41±13 P<0.001 MV diameter, mm 3.9±0.4 3.8±0.5 NS α angle, ° 34±9 35±7 NS β angle, ° 48±9 50±8 NS γ angle, ° 32±5 37±5 P=0.0005 AML length, mm 3.0±0.5 3.0±0.5 NS PML length, mm 2.1±0.1 2.4±0.1 P=0.03 Tenting height, mm 1.5±0.1 1.8±0.1 P=0.02 D, mm 0.8±0.3 0.5±0.3 P=0.001 LVEF: left ventricular ejection fraction; LAD: left atrial diameter; LAVI: left atrial volume index; AML: anterior mitral leaflet; PML: posterior mitral leaftlet.
Conclusions
AFMR occurs in patients with unique morphological features, such as less tethering height and LA dilatation toward the posterior.
Collapse
Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - D Yakabe
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| |
Collapse
|
33
|
Takahashi N, Mukai Y, Okumura K. 457Efficacy and safety of uninterrupted periprocedural edoxaban in patients undergoing catheter ablation for atrial fibrillation: Prospective KYU-RABLE study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0116] [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/Introduction
Catheter ablation (CA) has been established as a first-line therapy in the treatment of non-valvular atrial fibrillation (NVAF), and uninterrupted direct oral anticoagulants (DOACs) have become mainstream for the management of periprocedural thromboembolic events. Since 2014, edoxaban has been used for anticoagulation therapy for AF in Japan. However, evidence for uninterrupted use of edoxaban during the periprocedural period of CA in NVAF patients is limited.
Purpose
KYU-RABLE is a prospective, multicenter, single-arm interventional study, conducted in 23 institutions in Japan to evaluate the efficacy and safety of uninterrupted periprocedural oral edoxaban in patients undergoing CA. The plasma concentration of edoxaban and its relation with plasma coagulative biomarker levels during the periprocedural period were also evaluated.
Methods
A total of 537 Japanese NVAF patients were enrolled in Japan from December 2017 to September 2018. Edoxaban 60mg (30 mg in patients indicated for dose adjustment) was administered once daily in the morning for at least 4 weeks before CA and continued for at least 4 weeks after CA. On the day of CA, edoxaban was administered immediately after confirmation of hemostat. The primary endpoint was the composite incidence of thromboembolism and major bleeding events during 4 weeks from the procedural day. Plasma concentration of edoxaban and plasma levels of coagulative biomarkers including D-dimer, soluble fibrin monomer complex (SFMC) and prothrombin fragment 1+2 (F1+2) were also measured.
Results
Among the total 513 patients who underwent CA, 75.2% had radiofrequency CA and 23.0% had cryoballoon CA. The majority of CA patients (65%) received edoxaban 60mg/day, while others (35%) received 30mg/day. As for the primary endpoint, one major bleeding (cardiac tamponade) event was observed and no thromboembolism occurred. Clinically relevant non-major bleeding events occurred in six patients (1.2%), the most were puncture site hemorrhage. The plasma concentration of edoxaban at CA was dependent upon the duration from last administration of edoxaban before CA. However, plasma levels of coagulative biomarkers (D-dimer, SFMC, F1+2) were maintained within appropriate range during the periprocedural period, irrespective of the edoxaban concentration. We also report changes of plasma levels of coagulative biomarkers in sub group analyses by CHADS2 scores and types of AF.
Conclusion
The KYU-RABLE study demonstrated the first evidence of the efficacy and safety of uninterrupted periprocedural edoxaban administered once daily on the morning for NVAF patients underwent CA. Edoxaban treatment was associated with a low risk of periprocedural bleeding and thromboembolic complications. Furthermore, these low event risks were considered to be associated with the maintained plasma level of coagulative biomarkers, regardless of the change in edoxaban plasma concentration.
Acknowledgement/Funding
Daiichi Sankyo Co. Ltd.
Collapse
Affiliation(s)
- N Takahashi
- Oita University Faculty of Medicine, Oita, Japan
| | - Y Mukai
- Kyushu University, Cardiovascular Medicine, Fukuoka, Japan
| | - K Okumura
- Saiseikai Kumamoto Hospital Cardiovascular Center, Division of Cardiology, Kumamoto, Japan
| |
Collapse
|
34
|
Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Ikeda S, Chishaki A, Tsutsui H. P1025Clinical predictors for the improvement of left ventricular ejection fraction and prognosis after catheter ablation of atrial fibrillation in patients with systolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0616] [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
Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) and clinical outcomes in patients with left ventricular systolic dysfunction (LVSD). However, predictors of the improvement of LV function and clinical outcomes by CA were poorly understood.
Purpose
We examined the efficacy of CA in AF patients with LVSD and predictive factors associated with clinical outcomes.
Method
Among consecutive 795 patients undergone initial RFCA at our hospital, we studied 51 patients with LVSD (LVEF ≤50%). Improved LVEF more then 5% at 1-year after CA was classified as “responder” to CA. We analyzed clinical variables and echocardiographic parameters before and after the CAs.
Results
In the responder group, LVEF was significantly improved 1-year after catheter ablation compared with the non-responder group. (ΔLVEF 22±12% vs. −1±4%, p<0.001). The responder group was significantly younger, had more non-paroxysmal AF, smaller LV systolic diameter and lower plasma BNP level before CA (Table). Late gadolinium enhancement (LGE)-positive rate in cardiovascular magnetic resonance imaging (CMR) before CA was higher in the non-responder group than in the responder group (100% [6/6] vs. 38% [5/13], p<0.005). After CAs of AF, event-free survival from hospitalization for heart failure was significantly higher in the responder group (Figure) with less AF recurrence (27% vs. 47%, p=0.04) than in the non-responder group.
Baseline characteristics Responder (N=35) Non-Responder (N=16) P value Age, y 62±11 69±8 p<0.01 Male, n (%) 26 (74) 13 (76) NS Non-pAF 26 (74) 4 (24) p<0.01 LAD, mm 48±7 48±8 NS LAVI, ml/m2 54±17 58±20 NS LVDd, mm 54±7 58±10 NS LVDs, mm 43±7 48±10 p=0.05 EF, % 37±8 38±8 NS BNP (pg/ml) 278±225 684±848 p<0.05
Conclusion
Younger age, absence of LV dilatation, lower plasma BNP, or absence of LGE may well predict favorable clinical outcomes after CA in patients with LVSD.
Collapse
Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| |
Collapse
|
35
|
Mukai Y, Matsuyama R, Koike I, Kumamoto T, Kaizu H, Homma Y, Endo I, Hata M. Outcome of Postoperative Radiation Therapy for Cholangiocarcinoma and Analysis of Dose-Volume Histogram of Remnant Liver. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1981] [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: 10/26/2022]
|
36
|
Mukai Y, Koike I, Miyagui E, Hata M. EP-1480 Radiation therapy for Uterine Cervical Cancer with lung metastases including oligometastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31900-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
37
|
Mukai Y, Nishikawa N, Takahashi Y, Murata M. [Complications and troubleshooting at the initial introduction of Levodopa-carbidopa continuous infusion gel therapy: A single-center study]. Rinsho Shinkeigaku 2019; 59:177-184. [PMID: 30930364 DOI: 10.5692/clinicalneurol.cn-001243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Levodopa-carbidopa intestinal gel (LCIG) therapy has been established as a device-aided treatment for advanced Parkinson's disease. We retrospectively investigated the issues related to LCIG therapy in patients with Parkinson's disease at our hospital from March 2014 to July 2018. The subjects were 18 patients including nine men and nine women. The mean duration of PD symptoms and motor fluctuation was 14.5 ± 5.9 and 7.2 ± 4.5 years, respectively. The mean age at initiation of LCIG was 60.1 ± 9.4 years and the mean treatment period was 21.1 ± 19.5 months. One hundred and sixteen LCIG-associated issues were observed, including pain at the gastrostomy site (23 cases), hypergranulation tissue (14 cases), skin redness and/or erosions (11 cases), cutaneous infections at the gastrostomy site (eight cases), percutaneous endoscopic gastrojejunostomy (PEG-J) tube occlusion in the gastrointestinal tract (19 cases), irremovable PEG-J tube (13 cases), dislocation of the PEG-J tube (six cases), and breakage of the connector (eight cases). The majority of these issues were easily diagnosed and could be managed by neurologists who are familiar with LCIG therapy.
Collapse
Affiliation(s)
- Yohei Mukai
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| | - Noriko Nishikawa
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| | - Miho Murata
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| |
Collapse
|
38
|
Mukai Y, Furusawa Y, Morimoto Y, Hama Y, Kawazoe T, Saitoh Y, Sakamoto T, Takahashi Y, Murata M. Lidocaine injections and neck corset wearing improve dropped head syndrome in Parkinson's disease and related disorders. Clin Park Relat Disord 2019; 1:82-85. [PMID: 34316606 PMCID: PMC8288613 DOI: 10.1016/j.prdoa.2019.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/15/2019] [Accepted: 10/20/2019] [Indexed: 10/27/2022] Open
|
39
|
Mukai Y, Takahashi Y, Murata M. [Questionnaire survey of Scans Without Evidence of Dopaminergic Deficit (SWEDD) in Japan]. Rinsho Shinkeigaku 2018; 58:549-555. [PMID: 30175806 DOI: 10.5692/clinicalneurol.cn-001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We conducted a questionnaire survey to collect epidemiological information on patients with Scans Without Evidence of Dopaminergic Deficit (SWEDD). We sent questionnaires to 4,970 neurology specialists in Japan in July 2015 and received responses from 933 of them. The total number of patients reported to have Parkinson's disease was 39,532, which included 237 cases of SWEDD in patients (111 males, 125 females, and 1 case without a gender description). The disease duration in patients with SWEDD was short; 127 cases (53.6%) had a duration less than 3 years, and 78 cases (32.9%) had a duration of 3 years or more but less than 7 years. By age, 59 cases (24.9%) occurred in individuals in their 60s, and 106 cases (44.7%) occurred in individuals in their 70s. Sixty-three neurologists stated that they performed dopamine transporter single photon emission computed tomography (DaT SPECT) on almost all patients with Parkinson's disease. They treated a total of 3,600 patients with Parkinson's disease which included 107 cases of SWEDD; therefore, approximately 3.0% of Parkinson's patients were estimated have SWEDD. The causes of SWEDD were unknown (101 cases), essential tremor (22 cases), vascular Parkinsonism (14 cases), and drug-induced Parkinsonism (14 cases). The majority of neurologists had doubts about the diagnosis of Parkinson's disease prior to confirming the diagnosis using DaT SPECT for reasons such as: normal findings on meta-iodobenzylguanidine (MIBG) myocardial scintigraphy, poor responses to anti-Parkinson drugs, lack of true akinesia, unchanged symptoms, and atypical symptoms. Two hundred and nineteen cases included reports on treatment paradigms following the SWEDD diagnosis. Of those cases, patients in 159 cases were maintained on the same treatment following diagnosis.
Collapse
Affiliation(s)
- Yohei Mukai
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| | - Miho Murata
- Department of Neurology, National Center Hospital, Parkinson's Disease & Movement Disorders Center, National Center of Neurology and Psychiatry, Japan
| |
Collapse
|
40
|
Akiyama Y, Matoba T, Uwatoku T, Mukai Y, Hayashidani S, Ooi K, Tsutsui H. P5532Biodegradable polymer drug-eluting stents are associated with better coronary endothelial function in stented vessels compared with non-target vessels in patients after coronary stenting. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Akiyama
- Kyushu University Graduate School of Medical Sciences, Cardiology, Fukuoka, Japan
| | - T Matoba
- Kyushu University Graduate School of Medical Sciences, Cardiology, Fukuoka, Japan
| | - T Uwatoku
- Kyushu University Hospital, Cardiology, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Hospital, Cardiology, Fukuoka, Japan
| | - S Hayashidani
- Kyushu University Hospital, Cardiology, Fukuoka, Japan
| | - K Ooi
- Kyushu University Hospital, Cardiology, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiology, Fukuoka, Japan
| |
Collapse
|
41
|
Kawai S, Mukai Y, Yakabe D, Nagaoka K, Chishaki A, Tsutsui H. P2880Circumferential conduction delay within the pulmonary veins (PV) rather than the PV-LA conduction delay has a key role in the onset of atrial fibrillation - A quantitative analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Kawai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - D Yakabe
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - K Nagaoka
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| |
Collapse
|
42
|
Yoshitaka O, Murai H, Tokuhisa H, Hamaoka T, Mukai Y, Sugimoto H, Takamura M. P2763Increased renal 123I-metaiodobenzylguanidine scintigraphy wash out rate accompanied by muscle sympathetic nerve activity in left ventricular dysfunction patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- O Yoshitaka
- Kanazawa University Hospital, Cardiology, Kanazawa, Japan
| | - H Murai
- Kanazawa University Hospital, Cardiology, Kanazawa, Japan
| | - H Tokuhisa
- Kanazawa University Hospital, Cardiology, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University Hospital, Cardiology, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University Hospital, Cardiology, Kanazawa, Japan
| | - H Sugimoto
- Kanazawa University Hospital, Cardiology, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Cardiology, Kanazawa, Japan
| |
Collapse
|
43
|
Mukai Y, Hata M, Koike I, Miyagi E, Inoue T. EP-1517: Outcome of Radiation therapy for locally advanced vulvar carcinoma: Analysis of inguinal lymph node. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31826-7] [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: 10/14/2022]
|
44
|
Matsuda H, Murata M, Mukai Y, Sako K, Ono H, Toyama H, Inui Y, Taki Y, Shimomura H, Nagayama H, Tateno A, Ono K, Murakami H, Kono A, Hirano S, Kuwabara S, Maikusa N, Ogawa M, Imabayashi E, Sato N, Takano H, Hatazawa J, Takahashi R. Japanese multicenter database of healthy controls for [ 123I]FP-CIT SPECT. Eur J Nucl Med Mol Imaging 2018; 45:1405-1416. [PMID: 29478082 PMCID: PMC5993845 DOI: 10.1007/s00259-018-3976-5] [Citation(s) in RCA: 46] [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: 11/08/2017] [Accepted: 02/12/2018] [Indexed: 10/30/2022]
Abstract
PURPOSE The aim of this multicenter trial was to generate a [123I]FP-CIT SPECT database of healthy controls from the common SPECT systems available in Japan. METHODS This study included 510 sets of SPECT data from 256 healthy controls (116 men and 140 women; age range, 30-83 years) acquired from eight different centers. Images were reconstructed without attenuation or scatter correction (NOACNOSC), with only attenuation correction using the Chang method (ChangACNOSC) or X-ray CT (CTACNOSC), and with both scatter and attenuation correction using the Chang method (ChangACSC) or X-ray CT (CTACSC). These SPECT images were analyzed using the Southampton method. The outcome measure was the specific binding ratio (SBR) in the striatum. These striatal SBRs were calibrated from prior experiments using a striatal phantom. RESULTS The original SBRs gradually decreased in the order of ChangACSC, CTACSC, ChangACNOSC, CTACNOSC, and NOACNOSC. The SBRs for NOACNOSC were 46% lower than those for ChangACSC. In contrast, the calibrated SBRs were almost equal under no scatter correction (NOSC) conditions. A significant effect of age was found, with an SBR decline rate of 6.3% per decade. In the 30-39 age group, SBRs were 12.2% higher in women than in men, but this increase declined with age and was absent in the 70-79 age group. CONCLUSIONS This study provided a large-scale quantitative database of [123I]FP-CIT SPECT scans from different scanners in healthy controls across a wide age range and with balanced sex representation. The phantom calibration effectively harmonizes SPECT data from different SPECT systems under NOSC conditions. The data collected in this study may serve as a reference database.
Collapse
Affiliation(s)
- Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
| | - Miho Murata
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yohei Mukai
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuya Sako
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Hidetoshi Ono
- Department of Radiology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yoshitaka Inui
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Hideo Shimomura
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Hiroshi Nagayama
- Department of Neurology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Amane Tateno
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Kenjiro Ono
- Department of Neurology, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Hidetomo Murakami
- Department of Neurology, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Atsushi Kono
- Department of Radiology, Kobe University, Kobe, Japan.,Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | | | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Masayo Ogawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Etsuko Imabayashi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Harumasa Takano
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Jun Hatazawa
- Department of Nuclear Medicine, Osaka University, Osaka, Japan
| | | |
Collapse
|
45
|
Mukai Y, Miyazaki M, Mukai T, Tasaki A, Yuji T, Murata M. The pharmacokinetics of patients with Parkinson’s disease receiving levodopa-carbidopa intestinal gel infusion therapy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
46
|
Tasaki A, Mukai Y, Takahashi Y, Murata M. Evaluation of osteoporosis in parkinsonian syndrome. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Sakamoto T, Mukai Y, Murata M, Takahashi Y. Sensory trick in cervical dystonia. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
48
|
Hata M, Koike I, Miyagi E, Numazaki R, Asai-Sato M, Kaizu H, Mukai Y, Takano S, Ito E, Sugiura M, Inoue T. Safety and Efficacy of Radiation Therapy for Very Elderly Patients Aged 80 Years or Older with Uterine Cervical Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
49
|
Hamaoka T, Murai H, Sugimoto H, Mukai Y, Okabe Y, Inoue O, Tokuhisa H, Kusayama T, Takashima S, Kato T, Usui S, Furusho H, Takata S, Takamura M, Kaneko S. P1570The relationship between arousal index, oxygen desaturation during sleep and daytime muscle sympathetic nerve activity in obstructive sleep apnea syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1570] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
50
|
Kawai S, Mukai Y, Inoue S, Chishaki A, Tsutsui H. 58Location and coupling interval of ectopic beats have key roles in the onset of atrial fibrillation from the pulmonary veins. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S. Kawai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - Y. Mukai
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - S. Inoue
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - A. Chishaki
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | - H. Tsutsui
- Kyushu University Hospital, cardiology, Fukuoka, Japan
| | | |
Collapse
|