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Kaneko S, Nukui Y, Arashiro T, Aiso Y, Sugii M, Hadano Y, Nagata K, Taki R, Ueda K, Hanada S, Suzaki S, Harada N, Yamaguchi Y, Nakanishi H, Kurosaki M, Nagasawa M, Izumi N. Clinical validation of an immunochromatographic SARS-Cov-2 IgM/IgG antibody assay with Japanese cohort. J Med Virol 2020; 93:569-572. [PMID: 32720704 DOI: 10.1002/jmv.26363] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 06/24/2020] [Revised: 07/05/2020] [Accepted: 07/18/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has become a major health threat. To overcome COVID-19, appropriate diagnosis methods are urgently needed. The aim of this study was to clinically evaluate the colloidal gold immunochromatography assay for SARS-Cov-2 IgM/IgG antibody (Ab). METHODS Patients confirmed COVID-19 (n = 51) were recruited prospectively from the Musashino Red Cross hospital and Tokyo Medical and Dental University Medical Hospital, between March and May 2020. And the analytical specificity was assessed with serum samples of patients without COVID-19 (n = 100) collected between August to September 2019 before SARS-CoV-2 was first reported in China. RESULTS Among COVID-19 patients, a total of 87 serum samples were tested for SARS-Cov-2 IgM/IgG Ab assay. IgM was detected 71.0 %, 86.9 %, and 83.3 % at day8-14, 15-28, >29 after symptom onset and IgG was detected in 81.6 %, 87.0 %, and 94.4 %, respectively. The sensitivity of IgM and IgG Ab after day8 assay was significantly higher than before day7, respectively (p=0.0016, 0.0003). There were no positive results in 100 serum samples from patients without COVID-19. CONCLUSION The SARS-Cov-2 IgM/IgG Ab assay had 79.7% / 86.1% sensitivity (the 8 days after from onset) and 100% specificity in this population.
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Affiliation(s)
- Shun Kaneko
- Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Yoko Nukui
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Takeshi Arashiro
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Yoshibumi Aiso
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Maya Sugii
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Yoshiro Hadano
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Kaoru Nagata
- Department of General Medicine, Musashino Red Cross Hospital, Tokyo, Japan
| | - Reiko Taki
- Department of Pulmonary Medicine, Musashino Red Cross Hospital, Tokyo, Japan
| | - Ken Ueda
- Department of General Medicine, Musashino Red Cross Hospital, Tokyo, Japan
| | - Satoko Hanada
- Department of Pulmonary Medicine, Musashino Red Cross Hospital, Tokyo, Japan
| | - Shinichiro Suzaki
- Department of Emergency and Intensive Care, Musashino Red Cross Hospital, Tokyo, Japan
| | - Naoshige Harada
- Department of Emergency and Intensive Care, Musashino Red Cross Hospital, Tokyo, Japan
| | - Yoshimi Yamaguchi
- Division of Clinical Laboratory, Musashino Red Cross Hospital, Tokyo, Japan
| | - Hiroyuki Nakanishi
- Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Masayuki Kurosaki
- Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Masayuki Nagasawa
- Division of Infection Control and Prevention, Musashino Red Cross Hospital, Tokyo, Japan
| | - Namiki Izumi
- Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
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Nukui Y, Chino T, Tani C, Sonobe K, Aiso Y, Tohda S, Koike R, Saito R. Molecular epidemiologic and clinical analysis of Helicobacter cinaedi bacteremia in Japan. Helicobacter 2020; 25:e12675. [PMID: 31755167 DOI: 10.1111/hel.12675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 09/02/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Helicobacter cinaedi is an important pathogen that causes bloodstream infections. Owing to the challenges in its culture and identification, its clinical and bacterial characteristics remain unknown. Our study aimed to investigate the molecular epidemiology and antimicrobial susceptibility of H cinaedi. MATERIALS AND METHODS From 2003 to 2016, we analyzed 16 non-repetitive H cinaedi strains, isolated from blood, at the medical hospital of Tokyo Medical and Dental University. Multilocus sequence typing was performed to analyze the genetic relationship across the different isolates. The minimum inhibitory concentrations (MIC) of antibiotics were determined by the agar dilution method. RESULTS The median age of subjects in this study was 61 years (range, 18-84 years). The most common risk factors included the use of steroids (75.0%) and immunosuppressant drugs (37.5%). In addition, the most common symptoms of H cinaedi bacteremia included colitis (37.5%) and cellulitis (31.3%). The infection recurred in three of seven cases (42.8%) that underwent antibiotic therapy for <10 days. The strains were classified into five sequence types (ST), of which, ST 10 (43.8%) and ST 4 (31.3%) were predominant. The MIC90 values of amoxicillin, gentamycin, imipenem, ciprofloxacin, and clarithromycin were 4, 0.5, 0.25, 64, and 128 mg/L, respectively. CONCLUSIONS Since there is no recommended guideline yet for the choice or duration of antibiotic therapy and antimicrobial break points, our results suggested, for the first time, that prolonged antibiotic therapy, except with ciprofloxacin and clarithromycin, would be required to ensure resolution of symptoms and prevention of recurrence.
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Affiliation(s)
- Yoko Nukui
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Chino
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chihiro Tani
- Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazunari Sonobe
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshibumi Aiso
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shuji Tohda
- Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryuji Koike
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Saito
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Molecular Microbiology, Tokyo Medical and Dental University, Tokyo, Japan
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Saito R, Usui Y, Ayibieke A, Nakajima J, Prah I, Sonobe K, Aiso Y, Ito S, Itsui Y, Hadano Y, Nukui Y, Koike R, Tohda S. Hypervirulent clade 2, ribotype 019/sequence type 67 Clostridioides difficile strain from Japan. Gut Pathog 2019; 11:54. [PMID: 31700548 PMCID: PMC6827173 DOI: 10.1186/s13099-019-0336-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/25/2019] [Indexed: 12/12/2022] Open
Abstract
Background Clostridioides difficile ribotype (RT) 019/sequence type (ST) 67 strains belong to a hypervirulent lineage closely related to RT027/ST1; however, limited data are available for hypervirulent clade 2 lineages in Japan. Herein, we report the draft genome of a C. difficile strain B18-123 belonging to clade 2, RT019/ST67 for the first time in Japan. Results The pathogenicity locus carried by B18-123 (19.6 kb) showed higher homology (97.29% nucleotide identity) with strain R20291 (RT027/ST1) than the reference strain 630 (RT012/ST54), and B18-123 harbored 8-nucleotide substitutions in tcdC. However, it did not contain an 18-base pair (bp) deletion or a single-bp deletion at position 117 in tcdC, which was identified in the previous strain R20291. A cytotoxicity assay revealed similar cytotoxicity levels between strains B18-123 and ATCC BAA-1870 (RT027/ST1). The B18-123 strain was found to be susceptible to metronidazole and vancomycin. Conclusion Our findings contribute to the further understanding of the characteristics of hypervirulent clade 2 including RT019/ST67 lineages.
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Affiliation(s)
- Ryoichi Saito
- 1Department of Molecular Microbiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,2Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Yukino Usui
- 1Department of Molecular Microbiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Alafate Ayibieke
- 1Department of Molecular Microbiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jun Nakajima
- 2Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan.,3Department of Clinical Laboratory, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Isaac Prah
- 1Department of Molecular Microbiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazunari Sonobe
- 2Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan.,3Department of Clinical Laboratory, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Yoshibumi Aiso
- 2Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Shiori Ito
- 4Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Yasuhiro Itsui
- 4Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Yoshiro Hadano
- 2Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Yoko Nukui
- 2Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Ryuji Koike
- 2Department of Infection Control and Prevention, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Shuji Tohda
- 3Department of Clinical Laboratory, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
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Nukui Y, Ayibieke A, Taniguchi M, Aiso Y, Shibuya Y, Sonobe K, Nakajima J, Kanehira S, Hadano Y, Tohda S, Koike R, Saito R. Whole-genome analysis of EC129, an NDM-5-, CTX-M-14-, OXA-10- and MCR-1-co-producing Escherichia coli ST167 strain isolated from Japan. J Glob Antimicrob Resist 2019; 18:148-150. [PMID: 31295582 DOI: 10.1016/j.jgar.2019.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 06/06/2019] [Revised: 06/19/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The emergence and spread of carbapenemase-producing Enterobacteriaceae is a worldwide concern. This study reports the whole genome sequence of an NDM-5-, CTX-M-14-, OXA-10- and MCR-1-co-producing Escherichia coli sequence type 167 (ST167) multidrug-resistant clinical strain (EC129) isolated from a sputum sample of a hospitalised patient diagnosed with pneumonia. METHODS The genome of E. coli EC129 was subjected to next-generation sequencing and reads were assembled. The draft genome was annotated using DDBJ Read Annotation Pipeline DFAST server, followed by subsequent in silico analysis. RESULTS The genome of E. coli ST167 strain EC129 is 5319159 bp in length and contains 5022 protein-coding sequences. The blaNDM-5, blaCTX-M-14, blaOXA-10 and mcr-1 genes were detected along with other antimicrobial resistance genes conferring resistance to aminoglycosides, fluoroquinolones, sulfonamides, trimethoprim and tetracyclines. Antimicrobial susceptibility testing revealed that the isolate was resistant to all antimicrobial agents except colistin. CONCLUSION To our knowledge, this study is the first to report anE. coli ST167 strain co-producing NDM-5, CTX-M-14, OXA-10 and MCR-1 isolated from a sputum sample of an individual with pneumonia in Japan, thus elucidating the molecular characteristics and resistance gene diversity of this strain.
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Affiliation(s)
- Yoko Nukui
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Alafate Ayibieke
- Department of Molecular Microbiology, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Yoshibumi Aiso
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka Shibuya
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazunari Sonobe
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan; Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jun Nakajima
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan; Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Saki Kanehira
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan; Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiro Hadano
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shuji Tohda
- Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryuji Koike
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Saito
- Department of Infection Control and Prevention, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan; Department of Molecular Microbiology, Tokyo Medical and Dental University, Tokyo, Japan
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Toba M, Moriwaki M, Oshima N, Aiso Y, Shima M, Nukui Y, Obayashi S, Fushimi K. Prevention of surgical site infection via antibiotic administration according to guidelines after gynecological surgery. J Obstet Gynaecol Res 2018; 44:1800-1807. [PMID: 30051538 DOI: 10.1111/jog.13714] [Citation(s) in RCA: 3] [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: 12/13/2017] [Accepted: 05/25/2018] [Indexed: 12/13/2022]
Abstract
AIM We modified the antimicrobial prophylaxis of surgical site infection (SSI) according to the guidelines of the Japanese Society of Chemotherapy and Japan Society of Infectious Diseases (hereinafter referred to as optimization) and measured outcomes. METHODS From April 2016 to March 2017, we performed cesarean section and open hysterectomy with optimization, and compared the outcome to that of surgery performed without optimization between April 2014 and March 2016. We measured the rates of antibiotic discontinuation, appropriate antibiotic selection, SSI incidence, resumption of antibiotic therapy and fever incidence, as well as the length of postoperative hospital stay and medical expenses for antibiotics to evaluate the appropriateness and outcomes of antibiotic prophylaxis. RESULTS Optimization resulted in a change in the method of selecting antibiotics for cesarean section, but there was no change in SSI incidence rate (0.74% vs 0.0%, P = 0.36). Optimization reduced the use of antibiotics and medical expenses of hysterectomy (median reduction of 50% and 78% for hysterectomy without or with lymphadenectomy, respectively). However, there was no change in outcome regarding SSI incidence (5.7% vs 0.0%, P = 0.11 and 7.8% vs 9.5%, P = 0.77, respectively). CONCLUSION Appropriate use of antibiotics according to guidelines reduced antibiotic dose and medical expenses, but there was no change in outcome regarding SSI incidence rate. These findings suggested that implementation of dosing regimens according to the guidelines would be useful to reduce antibiotic medicine costs and prevent resistant bacteria and complications associated with antibiotics.
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Affiliation(s)
- Mikayo Toba
- Quality Management Center, Tokyo Medical and Dental University, Tokyo, Japan.,Perinatal and Women's Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mutsuko Moriwaki
- Quality Management Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Oshima
- Perinatal and Women's Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshibumi Aiso
- Division of Infection Control and Prevention, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mari Shima
- Division of Infection Control and Prevention, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoko Nukui
- Division of Infection Control and Prevention, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoshi Obayashi
- Perinatal and Women's Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyohide Fushimi
- Quality Management Center, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
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Ogihara S, Saito R, Sawabe E, Kozakai T, Shima M, Aiso Y, Fujie T, Nukui Y, Koike R, Hagihara M, Tohda S. Molecular typing of methicillin-resistant Staphylococcus aureus: Comparison of PCR-based open reading frame typing, multilocus sequence typing, and Staphylococcus protein A gene typing. J Infect Chemother 2017; 24:312-314. [PMID: 29233460 DOI: 10.1016/j.jiac.2017.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/24/2017] [Accepted: 10/28/2017] [Indexed: 11/17/2022]
Abstract
The recently developed PCR-based open reading frame typing (POT) method is a useful molecular typing tool. Here, we evaluated the performance of POT for molecular typing of methicillin-resistant Staphylococcus aureus (MRSA) isolates and compared its performance to those of multilocus sequence typing (MLST) and Staphylococcus protein A gene typing (spa typing). Thirty-seven MRSA isolates were collected between July 2012 and May 2015. MLST, spa typing, and POT were performed, and their discriminatory powers were evaluated using Simpson's index analysis. The MRSA isolates were classified into 11, 18, and 33 types by MLST, spa typing, and POT, respectively. The predominant strains identified by MLST, spa typing, and POT were ST8 and ST764, t002, and 93-191-127, respectively. The discriminatory power of MLST, spa typing, and POT was 0.853, 0.875, and 0.992, respectively, indicating that POT had the highest discriminatory power. Moreover, the results of MLST and spa were available after 2 days, whereas that of POT was available in 5 h. Furthermore, POT is rapid and easy to perform and interpret. Therefore, POT is a superior molecular typing tool for monitoring nosocomial transmission of MRSA.
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Affiliation(s)
- Shinji Ogihara
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Ryoichi Saito
- Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
| | - Etsuko Sawabe
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Takahiro Kozakai
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Mari Shima
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Yoshibumi Aiso
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Toshihide Fujie
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Yoko Nukui
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Ryuji Koike
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Michio Hagihara
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Shuji Tohda
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
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Abstract
AIMS To compare clinical efficacy of two different insulin sensitizers, pioglitazone and metformin, and to reveal factors that influence the clinical efficacy. METHODS Seventy-eight Japanese subjects with Type 2 diabetes mellitus poorly controlled with sulphonylureas [38 men and 40 women, aged 57 +/- 9 years, body mass index 25.2 +/- 1.4 kg/m2, and HbA1c 8.3 +/- 0.6% (means +/- SD)] were randomly assigned to groups for the addition of either pioglitazone or metformin and followed up for 4 months. A decrease in HbA1c levels was compared with baseline factors including homeostasis model assessment of insulin sensitivity (HOMA-R) and beta-cell function (HOMA-beta) with 71 subjects who completed the study. RESULTS The overall decrease in HbA1c levels was similar for the pioglitazone (-1.2 +/- 0.2%) and metformin (-1.3 +/- 0.1%) groups. In the pioglitazone group, the decrease in HbA1c levels was negatively correlated with baseline HOMA-R (r=-0.698, P<0.0001) and HOMA-beta (r=-0.680, P<0.0001). In contrast, the decrease was positively correlated with baseline HOMA-beta (r=0.556, P=0.0004) in the metformin group. Multivariate analysis revealed that either HOMA-R or HOMA-beta was a main determinant of the decrease in HbA1c levels in the pioglitazone group. In the metformin group, baseline levels of fasting glucose were also included as an independent determinant in addition to HOMA-beta. The subjects with greater HOMA-R (> or =4.0) or HOMA-beta (> or =40%) displayed better response to pioglitazone than to metformin, and vice versa. CONCLUSIONS In Type 2 diabetic subjects poorly controlled with sulphonylureas, addition of pioglitazone or metformin resulted in a comparable reduction in HbA1c levels. Subjects with greater insulin resistance or preserved beta-cell function displayed better response to pioglitazone, whereas subjects with reduced beta-cell function displayed better response to metformin.
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Affiliation(s)
- S Nagasaka
- Division of Endocrinology and Metabolism, Jichi Medical School, Tochigi, Japan.
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Kawasaki T, Yamanouchi T, Kashiwabara A, Inoue T, Yoshimura T, Fujimori S, Tanabe T, Aiso Y. The influence of traditional Chinese herbal drugs on serum 1, 5-anhydroglucitol levels. Diabetes Res Clin Pract 2000; 50:97-101. [PMID: 10960719 DOI: 10.1016/s0168-8227(00)00167-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The serum concentration of 1,5-anhydroglucitol (1,5-AG), a polyol which originates mainly in the diet, is used in Japan as a new marker for glycemia. To evaluate the potential interference of 1, 5-AG measurements by traditional Chinese medicines (Kampo), we examined the 1,5-AG content in 32 types of concentrated dosage forms of Kampo using high performance liquid chromatography (HPLC). The 32 types of Kampo were the most frequently used in Japan, two of which, Ninjin-yoei-to (7030 microg/g dry weight) and Kami-kihi-to (6700 microg/g dry weight), contained large amounts of 1,5-AG. Six others contained small amounts of 1,5-AG. Both Ninjin-yoei-to and Kami-kihi-to contain the same ingredient, Polygalae radix, which is a crude form of polygalitol (1,5-AG). To confirm the effects of these Kampo medicines on the serum levels of 1,5-AG, we administered Ninjin-yoei-to (7.5 g/day) for 8 weeks to 18 patients with Type 2 diabetes mellitus (Type 2 DM). The serum level of 1,5-AG increased from 9.8+/-8.9 to 28.1+/-17.5 microg/ml by week 8. Hemoglobin A1c (HbA1c) had not changed by week 8. Thus, an abnormal serum 1,5-AG level may be present in patients taking Kampo which contains Polygalae radix.
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Affiliation(s)
- T Kawasaki
- Department of Internal Medicine, Teikyo University School of Medicine 11-1, 2-chome Kaga, Itabashi-ku, 173-0003, Tokyo, Japan.
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Hiraishi K, Sagara H, Niwano K, Seo T, Matsubara Y, Aiso Y, Iimura T, Ukai S, Inoue I, Karaki K, Kawagoe T, Mori M, Toyoda T. [Treatment of chronic biliary typhoid and paratyphoid carriers--results on 78 treated cases obtained in 16 years (1963 to 1978) (author's transl)]. Kansenshogaku Zasshi 1982; 56:207-17. [PMID: 6809859 DOI: 10.11150/kansenshogakuzasshi1970.56.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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