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Kakuwa T, Ariga A, Takasaki J, Kato M, Igari T, Shida Y, Okafuji T, Nakamura S, Miyazaki Y, Katano H, Iikura M, Izumi S, Sugiyama H. Mucor pulmonary embolism in a patient with myelodysplastic syndrome. Respir Med Case Rep 2020; 30:101035. [PMID: 32190545 PMCID: PMC7068122 DOI: 10.1016/j.rmcr.2020.101035] [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: 09/07/2019] [Revised: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 11/28/2022] Open
Abstract
Mucormycosis is a life-threatening infectious disease that occurs most commonly in immunocompromised patients such as those with hematological malignancies. Its clinical symptoms and associated radiological findings vary and specific biomarkers and culture characteristics have not been defined. An 85-year-old man who had been treated for myelodysplastic syndrome and tuberculosis for several months presented with subacute fever and worsening left-side chest pain. Contrast-enhanced computed tomography images depicted massive tumor-like consolidation without enhancement, expanding from the left lower lobe. Emboli that did not respond to anticoagulants were detected in the left descending pulmonary artery. Despite intensive treatment he developed multiple organ failure and died 47 days after hospitalization. Gross pathology of a lung autopsy specimen revealed left lower pulmonary arterial emboli and pulmonary infarction, which was concluded to be the direct cause of death. The emboli were histopathologically identified as invasive mycelia in vessels. Mucor sp. was detected via real-time polymerase chain reaction and immunohistopathological analyses revealed that the mold in the blood vessels of lung tissue was partially positive for the mucor antigen. In the present case of Mucor sp. pulmonary emboli in a patient with myelodysplastic syndrome, radiographic findings were hard to distinguish from those typical of a lung abscess.
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Affiliation(s)
- T Kakuwa
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - A Ariga
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Orthopedics, Tokyo Medical and Dental University, Tokyo, Japan
| | - J Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Kato
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Igari
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Shida
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Okafuji
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Nakamura
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan.,Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Y Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - H Katano
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - M Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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2
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Tanaka H, Nakatani E, Fukutomi Y, Sekiya K, Kaneda H, Iikura M, Yoshida M, Takahashi K, Tomii K, Nishikawa M, Kaneko N, Sugino Y, Shinkai M, Ueda T, Tanikawa Y, Shirai T, Hirabayashi M, Aoki T, Kato T, Iizuka K, Fujii M, Taniguchi M. Identification of patterns of factors preceding severe or life-threatening asthma exacerbations in a nationwide study. Allergy 2018; 73:1110-1118. [PMID: 29197099 PMCID: PMC6668009 DOI: 10.1111/all.13374] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reducing near-fatal asthma exacerbations is a critical problem in asthma management. OBJECTIVES To determine patterns of factors preceding asthma exacerbations in a real-world setting. METHODS In a nationwide prospective study of 190 patients who had experienced near-fatal asthma exacerbation, cluster analysis was performed using asthma symptoms over the 2-week period before admission. RESULTS Three distinct clusters of symptoms were defined employing the self-reporting of a visual analogue scale. Cluster A (42.1%): rapid worsening within 7.4 hours from moderate attack to admission, young to middle-aged patients with low Body mass index and tendency to depression who had stopped anti-asthma medications, smoked, and hypersensitive to environmental triggers and furred pets. Cluster B (40.0%): fairly rapid worsening within 48 hours, mostly middle-aged and older, relatively good inhaled corticosteroid (ICS) or ICS/long-acting beta-agonist (LABA) compliance, and low perception of dyspnea. Cluster C (17.9%): slow worsening over 10 days before admission, high perception of dyspnea, smokers, and chronic daily mild-moderate symptoms. There were no differences in overuse of short-acting beta-agonists, baseline asthma severity, or outcomes after admission for patients in these 3 clusters. CONCLUSION To reduce severe or life-threatening asthma exacerbation, personalized asthma management plans should be considered for each cluster. Improvement of ICS and ICS/LABA compliance and cessation of smoking are important in cluster A. To compensate for low perception of dyspnea, asthma monitoring of peak expiratory flow rate and/or exhaled nitric oxide would be useful for patients in cluster B. Avoidance of environmental triggers, increase usual therapy, or new anti-type 2 response-targeted therapies should be considered for cluster C.
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Affiliation(s)
- H. Tanaka
- NPO Sapporo Cough Asthma, and Allergy CenterSapporoJapan
- Formerly at the Department of Respiratory Medicine and AllergologySapporo Medical University School of MedicineSapporoJapan
| | - E. Nakatani
- Translational Research Informatics CenterFoundation for Biomedical Research and InnovationKobeJapan
- Department of Biostatistics and Data ScienceOsaka University Graduate School of MedicineSuitaJapan
| | - Y. Fukutomi
- Clinical Research Center for Allergology and RheumatologySagamihara National HospitalSagamiharaJapan
| | - K. Sekiya
- Clinical Research Center for Allergology and RheumatologySagamihara National HospitalSagamiharaJapan
| | - H. Kaneda
- Department of Biostatistics and Data ScienceOsaka University Graduate School of MedicineSuitaJapan
| | - M. Iikura
- Department of Respiratory MedicineNational Center for Global Health and MedicineTokyoJapan
| | - M. Yoshida
- Division of Respiratory MedicineNational Hospital Organization Fukuoka HospitalFukuokaJapan
| | - K. Takahashi
- Department of Respiratory Diseases and Chest SurgeryOtsu Red Cross HospitalOtsuJapan
| | - K. Tomii
- Department of Respiratory MedicineKobe City Medical Center General HospitalKobeJapan
| | - M. Nishikawa
- Department of Respiratory MedicineFujisawa City HospitalFujisawaJapan
| | - N. Kaneko
- Department of Pulmonary MedicineKameda Medical CenterKamogawaJapan
| | - Y. Sugino
- Department of Respiratory MedicineToyota Memorial HospitalToyotaJapan
| | - M. Shinkai
- Respiratory Disease CenterYokohama City University Medical CenterYokohamaJapan
| | - T. Ueda
- The Department of Respiratory MedicineSaiseikai Nakatsu HospitalOsakaJapan
| | - Y. Tanikawa
- Department of Respiratory Medicine and Clinical ImmunologyToyota Kosei HospitalToyotaJapan
| | - T. Shirai
- Department of Respiratory MedicineShizuoka General HospitalShizuokaJapan
| | - M. Hirabayashi
- Department of Respiratory DiseasesAmagasaki General Medical CenterAmagasakiJapan
| | - T. Aoki
- Department of Internal Medicine, Respiratory DivisionTokai University School of MedicineIseharaJapan
| | - T. Kato
- Department of Respiratory Medicine and AllergologyKariya Toyota General HospitalKariyaJapan
| | - K. Iizuka
- Internal MedicinePublic Tomioka General HospitalTomiokaJapan
| | - M. Fujii
- Formerly at the Department of Respiratory Medicine and AllergologySapporo Medical University School of MedicineSapporoJapan
| | - M. Taniguchi
- Clinical Research Center for Allergology and RheumatologySagamihara National HospitalSagamiharaJapan
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3
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Hirano S, Naka G, Takeda Y, Iikura M, Hiroishi T, Shikano K, Yanagisawa A, Hayama N, Fujita T, Amano H, Nakamura M, Nakamura S, Tabeta H, Sugiyama H. P2.03-005 Overall Survival Results from a Prospective, Multicenter Phase II Trial of Low-Dose Erlotinib as Maintenance in NSCLC Harboring EGFR Mutation. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1256] [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]
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4
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Chino H, Iikura M, Saito N, Sato N, Suzuki M, Ishii S, Morino E, Naka G, Takasaki J, Izumi S, Hojo M, Takeda Y, Sugiyama H. Subinterlobular Pleural Location Is a Risk Factor for Pneumothorax After Bronchoscopy. Respir Care 2016; 61:1664-1670. [DOI: 10.4187/respcare.04874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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5
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Sekiya K, Nakatani E, Fukutomi Y, Kaneda H, Iikura M, Yoshida M, Takahashi K, Tomii K, Nishikawa M, Kaneko N, Sugino Y, Shinkai M, Ueda T, Tanikawa Y, Shirai T, Hirabayashi M, Aoki T, Kato T, Iizuka K, Homma S, Taniguchi M, Tanaka H. Severe or life-threatening asthma exacerbation: patient heterogeneity identified by cluster analysis. Clin Exp Allergy 2016; 46:1043-55. [PMID: 27041475 DOI: 10.1111/cea.12738] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 03/19/2016] [Accepted: 03/19/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Severe or life-threatening asthma exacerbation is one of the worst outcomes of asthma because of the risk of death. To date, few studies have explored the potential heterogeneity of this condition. OBJECTIVES To examine the clinical characteristics and heterogeneity of patients with severe or life-threatening asthma exacerbation. METHODS This was a multicentre, prospective study of patients with severe or life-threatening asthma exacerbation and pulse oxygen saturation < 90% who were admitted to 17 institutions across Japan. Cluster analysis was performed using variables from patient- and physician-orientated structured questionnaires. RESULTS Analysis of data from 175 patients with severe or life-threatening asthma exacerbation revealed five distinct clusters. Cluster 1 (n = 27) was younger-onset asthma with severe symptoms at baseline, including limitation of activities, a higher frequency of treatment with oral corticosteroids and short-acting beta-agonists, and a higher frequency of asthma hospitalizations in the past year. Cluster 2 (n = 35) was predominantly composed of elderly females, with the highest frequency of comorbid, chronic hyperplastic rhinosinusitis/nasal polyposis, and a long disease duration. Cluster 3 (n = 40) was allergic asthma without inhaled corticosteroid use at baseline. Patients in this cluster had a higher frequency of atopy, including allergic rhinitis and furred pet hypersensitivity, and a better prognosis during hospitalization compared with the other clusters. Cluster 4 (n = 34) was characterized by elderly males with concomitant chronic obstructive pulmonary disease (COPD). Although cluster 5 (n = 39) had very mild symptoms at baseline according to the patient questionnaires, 41% had previously been hospitalized for asthma. CONCLUSIONS & CLINICAL RELEVANCE This study demonstrated that significant heterogeneity exists among patients with severe or life-threatening asthma exacerbation. Differences were observed in the severity of asthma symptoms and use of inhaled corticosteroids at baseline, and the presence of comorbid COPD. These findings may contribute to a deeper understanding and better management of this patient population.
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Affiliation(s)
- K Sekiya
- Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.,Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - E Nakatani
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Y Fukutomi
- Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - H Kaneda
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - M Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Yoshida
- Department of Internal Medicine, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan
| | - K Takahashi
- Department of Respiratory Diseases and Chest Surgery, Otsu Red Cross Hospital, Otsu, Japan
| | - K Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Nishikawa
- Department of Respiratory Medicine, Fujisawa City Hospital, Fujisawa, Japan
| | - N Kaneko
- Department of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Y Sugino
- Department of Respiratory Medicine, Toyota Memorial Hospital, Toyota, Japan
| | - M Shinkai
- Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Japan
| | - T Ueda
- The Department of Respiratory Medicine, Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Y Tanikawa
- Department of Respiratory Medicine and Clinical Immunology, Toyota Kosei Hospital, Toyota, Japan
| | - T Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - M Hirabayashi
- Department of Respiratory Diseases, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Japan
| | - T Aoki
- Department of Internal Medicine, Respiratory Division, Tokai University School of Medicine, Isehara, Japan
| | - T Kato
- Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital, Kariya, Japan
| | - K Iizuka
- Internal Medicine, Public Tomioka General Hospital, Tomioka, Japan
| | - S Homma
- Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - M Taniguchi
- Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - H Tanaka
- NPO Sapporo Cough Asthma and Allergy Center, Sapporo, Japan
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6
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Mishima S, Nozaki Y, Mikami S, Kihira E, Iikura M, Koketsu R, Sugiyama H, Masuda T, Kaname H, Egami Y, Nakayama T, Hasuo K, Nakamura H, Igari T, Watanabe K, Nagata N, Sakurai T, Yokoi C, Kobayakawa M, Kojima Y, Akiyama J, Imamura M, Masaki N, Yanase M. Diffuse Liver Metastasis of Small-Cell Lung Cancer Presenting as Acute Liver Failure and Diagnosed by Transjugular Liver Biopsy: A Rare Case in Whom Nodular Lesions Were Detected by Enhanced CT Examination. Case Rep Gastroenterol 2015; 9:81-7. [PMID: 25969674 PMCID: PMC4427142 DOI: 10.1159/000381140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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] [Indexed: 12/11/2022] Open
Abstract
Small-cell lung cancer (SCLC) is a subgroup of lung cancer with a high frequency of liver metastasis, which is a predictor of poor prognosis. Diffuse liver metastases of SCLC with no visible nodular lesions in the liver when examined using computed tomography (CT) are relatively rare; however, a few cases with rapid progression to acute liver failure that were diagnosed after death have been reported. In this paper, we report a 63-year-old man with diffuse liver metastases of SCLC that were histologically diagnosed using a transjugular liver biopsy while the patient was alive, even though no lesions were visible during a contrast-enhanced CT examination.
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Affiliation(s)
- S Mishima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Nozaki
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Mikami
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - E Kihira
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - R Koketsu
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Masuda
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Kaname
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Egami
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Nakayama
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - K Hasuo
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Nakamura
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Igari
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - K Watanabe
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Nagata
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Sakurai
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - C Yokoi
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Kobayakawa
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Kojima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - J Akiyama
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Imamura
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Masaki
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Yanase
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
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7
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Hirano S, Takeda Y, Naka G, Iikura M, Udagawa H, Izumi S, Sugiyama H, Kobayashi N. Docetaxel Monotherapy Compared with Carboplatin and Paclitaxel Doublet Chemotherapy in Elderly Patients with Non-Small-Cell Lung Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32450-9] [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: 11/15/2022] Open
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8
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Suzukawa M, Komiya A, Iikura M, Nagase H, Yoshimura-Uchiyama C, Yamada H, Kawasaki H, Ohta K, Matsushima K, Hirai K, Yamamoto K, Yamaguchi M. Trans-basement Membrane Migration of Human Basophils: Role of Matrix Metalloproteinase-9. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Yoshimura-Uchiyama C, Iikura M, Yamaguchi M, Nagase H, Ishii A, Matsushima K, Yamamoto K, Shichijo M, Bacon KB, Hirai K. Differential modulation of human basophil functions through prostaglandin D2 receptors DP and chemoattractant receptor-homologous molecule expressed on Th2 cells/DP2. Clin Exp Allergy 2004; 34:1283-90. [PMID: 15298571 DOI: 10.1111/j.1365-2222.2004.02027.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Both prostaglandin (PG) D receptor (DP) and CRTH2 (chemoattractant receptor-homologous molecule expressed on Th2 cells)/DP2 are high-affinity receptors for PGD2. Previous studies have demonstrated that PGD2 enhances releasability and induces CRTH2/DP2-mediated migration in human basophils, but the precise effects of PGD2 on basophils as well as receptor usage have not been fully clarified. OBJECTIVE We comprehensively explored the roles of DP and CRTH2/DP2 in basophil functions by using selective agonists and antagonists for each receptor. METHODS DP and CRTH2/DP2 transcripts were quantified by real-time PCR. We studied the effects of selective agonists (DP: BW245C; CRTH2/DP2: 13,14-dihydro-15-keto (DK)-PGD2) and/or antagonists (DP: BWA868C; CRTH2/DP2: ramatroban) on Ca2+ mobilization, migration, degranulation, CD11b expression and survival of human basophils. RESULTS Basophils expressed transcripts of both DP and CRTH2/DP2, but the levels of CRTH2/DP2 transcripts were ca. 100-fold higher compared with DP transcripts. Ca2+ influx was induced in basophils by either PGD2 or DK-PGD2/CRTH2 agonist but not by BW245C/DP agonist. Basophils treated with PGD2 were completely desensitized to subsequent stimulation with DK-PGD2, but not vice versa. DK-PGD2 as well as PGD2 up-regulated CD11b expression, induced migration and enhanced degranulation, and those effects were completely antagonized by ramatroban/CRTH2 antagonist. In contrast, BW245C/DP agonist exhibited an inhibitory effect on basophil migration and IgE-mediated degranulation, and the migration inhibitory effect was effectively antagonized by BWA868C/DP antagonist. On the other hand, while PGD2 significantly shortened the basophil life-span, neither DK-PGD2/CRTH2 agonist nor BW245C/DP agonist did. CONCLUSION CRTH2/DP2 is primarily responsible for the pro-inflammatory effects of PGD2 on human basophils, while DP introduces negative signals capable of antagonizing the effects of CRTH2/DP2 in these cells. The effects of PGD2 on longevity imply a mechanism(s) other than via DP or CRTH2/DP2. CRTH2/DP2 on basophils may afford opportunities for therapeutic targeting in allergic inflammation.
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Affiliation(s)
- C Yoshimura-Uchiyama
- Department of Allergy and Rheumatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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10
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Yoshimura C, Miyamasu M, Nagase H, Iikura M, Yamaguchi M, Kawanami O, Morita Y, Iwata T, Yamamoto K, Hirai K. Glucocorticoids induce basophil apoptosis. J Allergy Clin Immunol 2001; 108:215-20. [PMID: 11496237 DOI: 10.1067/mai.2001.116575] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Induction of apoptosis represents an important mechanism by which glucocorticoids (GCCs) exert their anti-inflammatory properties. The effects of GCCs on apoptosis have been determined in various immune cells and found to vary among different cell types. On the other hand, the effects of GCCs on apoptosis of basophils, active participants in allergic inflammation, have remained obscure. OBJECTIVE The objective of this study was to investigate the effects of GCCs on basophil apoptosis. METHODS Basophils were highly purified (purity, >97%) by Percoll density gradient centrifugation followed by negative selection. Cell status was determined by their ability to bind annexin V and exclude propidium iodide. DNA fragmentation was determined by flow cytometry. RESULTS Dexamethasone (DEX) significantly accelerated the decrease in live cells and increased the number of apoptotic cells in a time-dependent fashion. Light microscopy as well as DNA fragmentation assay confirmed the induction of apoptosis by DEX. A half-maximal effect was observed in a DEX concentration range from 10(-9) to 10(-8) mol/L. Sex steroids did not induce basophil apoptosis at all. DEX also induced basophil apoptosis in the presence of low doses of IL-3. CONCLUSION GCCs exert potent apoptogenic effects on basophils. GCC-mediated apoptogenic effects on basophils might have implications with respect to the mechanism of action of this class of drugs in allergic disorders.
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Affiliation(s)
- C Yoshimura
- Department of Allergy and Rheumatology, University of Tokyo Graduate School of Medicine, Japan
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11
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Iikura M, Miyamasu M, Yamaguchi M, Kawasaki H, Matsushima K, Kitaura M, Morita Y, Yoshie O, Yamamoto K, Hirai K. Chemokine receptors in human basophils: inducible expression of functional CXCR4. J Leukoc Biol 2001; 70:113-20. [PMID: 11435493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
We examined the expression profile of chemokine receptors in human basophils and their regulation by cytokines. Basophils expressed transcripts of CC chemokine receptors (CCR)1, CCR2, CCR3, and CCR5 and CXC chemokine receptors (CXCR)1, CXCR2, and CXCR4. In contrast to the other receptors, surface-CXCR4 expression was not detected in fresh- and whole-blood basophils, but it became apparent gradually during incubation. Among 16 chemokines tested, eotaxin induced the most potent basophil migration. SDF-1 also induced a strong, migratory response comparable with that induced by eotaxin in 24-h, cultured basophils, but it failed to induce degranulation. IL-3 abrogated CXCR4 expression completely, and it only down-regulated CCR2 and CCR3 expression slightly. IL-5, GM-CSF, and IL-4 also down-regulated CXCR4 expression. Thus, expression of CXCR4 was the most strongly affected by cytokines, and this may represent an alternative mechanism for control of cell-specific, biological responses to SDF-1.
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MESH Headings
- Basophils/immunology
- Basophils/metabolism
- Chemokines/immunology
- Chemokines/pharmacology
- Flow Cytometry
- Humans
- Immunization
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- Receptors, CCR2
- Receptors, CCR3
- Receptors, CXCR4/biosynthesis
- Receptors, CXCR4/genetics
- Receptors, CXCR4/physiology
- Receptors, Chemokine/biosynthesis
- Receptors, Chemokine/genetics
- Receptors, Chemokine/physiology
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Affiliation(s)
- M Iikura
- Department of Allergy and Rheumatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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12
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Iikura M, Yamaguchi M, Hirai K, Miyamasu M, Yamada H, Nakajima T, Fujisawa T, Ra C, Morita Y, Yamamoto K. Regulation of surface FcepsilonRI expression on human eosinophils by IL-4 and IgE. Int Arch Allergy Immunol 2001; 124:470-7. [PMID: 11340330 DOI: 10.1159/000053782] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recent studies have demonstrated that eosinophils from allergic patients express low levels of FcepsilonRI on their surface, but the regulatory mechanisms of eosinophil surface FcepsilonRI expression are not fully understood. We investigated whether IL-4 and IgE, which are reported to regulate surface FcepsilonRI expression on human mast cells, are able to affect surface FcepsilonRI expression in normal human eosinophils. METHODS Eosinophils purified from peripheral blood were cultured with IL-5 and with or without IL-4 and/or IgE, and surface FcepsilonRI expression was analyzed by flow cytometry using an anti-FcepsilonRI mAb, CRA-1. RESULTS Apparent FcepsilonRI expression (approximately 1% of mast cell FcepsilonRI levels) was observed in eosinophils cultured with both IL-4 and IgE. A combination of IL-4 (>or=1 ng/ml) and IgE (>or= 0.5 microg/ml) was necessary for the maximal induction of surface FcepsilonRI expression. In the presence of IL-4 and IgE, eosinophils cultured for 2 days demonstrated low but statistically significant levels of surface FcepsilonRI, which reached a plateau after 7 days of culture. However, cross-linkage of surface FcepsilonRI molecules by CRA-1 or anti-IgE did not induce any eosinophil activation. CONCLUSIONS IL-4 and IgE can affect the levels of surface FcepsilonRI on normal human eosinophils. FcepsilonRI expression on eosinophils may be regulated by a mechanism similar to that in mast cells.
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Affiliation(s)
- M Iikura
- Department of Allergy and Rheumatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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13
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Iikura M, Yamaguchi M, Miyamasu M, Morita Y, Iwase T, Moro I, Yamamoto K, Hirai K. Secretory IgA-mediated basophil activation. II. Roles of GTP-binding regulatory proteins and phosphatidylinositol 3-kinase. Biochem Biophys Res Commun 1999; 264:575-9. [PMID: 10529404 DOI: 10.1006/bbrc.1999.1543] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Secretory IgA (sIgA) is the most abundant Ig isotype in mucous secretions in the upper and lower airways, where basophils exert effector functions during allergic inflammation. We recently demonstrated that immobilized sIgA on Sepharose beads is capable of inducing basophil degranulation ( approximately 15% of total histamine). To investigate the detailed mechanisms of this degranulation, we established in this study a new assay system for sIgA-mediated basophil activation. Immobilized sIgA on a plastic surface induced strong histamine release ( approximately 50% of total histamine) comparable to anti-IgE, and we analyzed the nature of basophil signal transduction by sIgA using various inhibitors. sIgA-induced basophil histamine release was inhibited completely by pertussis toxin, but anti-IgE-induced release was not affected. sIgA-mediated release was also inhibited by phosphatidylinositol 3-kinase (PI 3-kinase) inhibitor, wortmannin. These results strongly suggest that sIgA activates basophils via an IgE-independent novel mechanism involving both Gi protein and PI 3-kinase.
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Affiliation(s)
- M Iikura
- Department of Allergy and Rheumatology, Department of Respiratory Medicine, Department of Bioregulatory Function, University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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14
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Nakajima T, Yamada H, Iikura M, Miyamasu M, Izumi S, Shida H, Ohta K, Imai T, Yoshie O, Mochizuki M, Schröder JM, Morita Y, Yamamoto K, Hirai K. Intracellular localization and release of eotaxin from normal eosinophils. FEBS Lett 1998; 434:226-30. [PMID: 9742928 DOI: 10.1016/s0014-5793(98)00863-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Eotaxin is a potent and selective CC chemokine for eosinophils and basophils. We established several monoclonal antibodies (Mabs) allowing the neutralization and measurement of human eotaxin. Using the Mabs as probes, we demonstrated that normal eosinophils contained intracellular granule-associated eotaxin. Quantification of cell-associated eotaxin in different leukocyte subsets revealed that it was principally expressed in eosinophils. Finally, we showed that normal eosinophils released eotaxin upon stimulation with either of two secretagogues, C5a or ionomycin. These findings raise the possibility that eosinophil-derived eotaxin contributes to the local accumulation of eosinophils at the site of inflammation.
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Affiliation(s)
- T Nakajima
- Department of Bioregulatory Function, University of Tokyo, School of Medicine, Japan
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15
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Iikura M, Yamaguchi M, Fujisawa T, Miyamasu M, Takaishi T, Morita Y, Iwase T, Moro I, Yamamoto K, Hirai K. Secretory IgA induces degranulation of IL-3-primed basophils. J Immunol 1998; 161:1510-5. [PMID: 9686618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We examined whether secretory IgA (sIgA), known to mediate eosinophil stimulation, has an effect on basophil functions. An immobilized preparation of sIgA, but not of monomeric IgA, induced histamine release (approximately 15% of total histamine contents) from human basophils in vitro. sIgA-induced basophil histamine release was totally dependent on pretreatment with IL-3. IL-5 and granulocyte-macrophage CSF also primed basophils for sIgA-mediated release. Exogenous divalent ions, i.e., Ca2+ and Mg2+, were essential for sIgA-mediated basophil degranulation, and the degranulation was completed within 45 min. A newly synthesized lipid mediator, leukotriene C4, was also liberated from IL-3-primed, sIgA-stimulated basophils. Enzyme digestion experiments revealed that the (Fc)2 x secretory component portion of sIgA is important for sIgA-mediated basophil activation, but the functional binding sites of sIgA on basophils were surmised to be different from FcalphaR. These observations reveal the novel finding that sIgA is able to stimulate basophils as well as eosinophils. Since sIgA is the most abundant Ig isotype in the secretions from mucosal tissues, and basophils are active participants in allergic late-phase reactions, sIgA-mediated basophil mediator release is potentially involved in exacerbation of the inflammation associated with allergic disorders.
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Affiliation(s)
- M Iikura
- Department of Medicine and Physical Therapy, University of Tokyo School of Medicine, Japan
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16
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Iikura M, Takaishi T, Hirai K, Yamada H, Iida M, Koshino T, Morita Y. Exogenous nitric oxide regulates the degranulation of human basophils and rat peritoneal mast cells. Int Arch Allergy Immunol 1998; 115:129-36. [PMID: 9482701 DOI: 10.1159/000023892] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This study was designed to investigate whether anti-IgE-induced or ionophore A23187-induced histamine release from human basophils is regulated by exogenous nitric oxide (NO), and to assess some similarities between the effect of NO on basophils and that on rat peritoneal mast cells (RPMC). The NO donor, sodium nitroprusside (SNP), inhibited A23187-induced histamine release from crude human basophils and crude RPMC in a dose-dependent fashion. This downregulation was still observed when SNP was washed out just before the cell stimulation, indicating that the effect of SNP was irreversible. The downregulation disappeared in both purified cell populations after the removal of contaminating cells. However, when purified cells were preincubated with SNP in the presence of 5 mM N-acetylcysteine (NAC), increasing the bioavailability of NO, the downregulation was recovered. The presence of NAC significantly augmented the downregulation of SNP on A23187-induced histamine release from both crude cell populations. In contrast, SNP had no effect on anti-IgE-induced histamine release from either crude or purified basophil preparation in the absence of NAC, and SNP plus NAC inhibited anti-IgE-induced histamine release from both cell preparations. The same results were obtained with crude and purified RPMC preparations under the same conditions. These results show that SNP similarly downregulated exocytosis of basophils and RPMC, and acquired the potent effect in the presence of NAC, indicating that exogenous NO plays a part in the regulation of basophil and mast cell activation.
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Affiliation(s)
- M Iikura
- Department of Medicine and Physical Therapy, Faculty of Medicine, University of Tokyo, Japan
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17
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Sakuyama T, Nakamura Y, Takamura S, Takahashi N, Iikura M, Kase H. [Our experience of PEG and home care for twelve years]. Gan To Kagaku Ryoho 1997; 24 Suppl 4:491-8. [PMID: 9429554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Percutaneous endoscopic gastrostomy (PEG) was introduced in 1980 by Ponsky et al. This technique does not require general anesthesia and is performed safely and rapidly under local anesthesia without laparotomy. For the past twelve years, in order to maintain enteral alimentation for patients who suffered from dysphagia due to cerebral angiopathy, and to reduce patients' suffering from the long-term placement of a nasogastric tube, PEGs were performed in 150 patients (130 patients for enteral nutrition and 20 for drainage of gastrointestinal contents). We also provided home care service for 30 (27 for enteral nutrition and 3 for decompression) of these patients. We pointed out two problems connected with our retrospective studies for PEG. One is related to the indication of PEG, especially to the evaluation of preoperative status. We suggested a new method for measuring the preoperative status of patients for PEG (PEG-POS score). Retrospective studies showed the PEG-POS score was effective. Using this PEG-POS score, we have not had any early-stage deaths after PEG. Another is related to the home care service for patients with PEG. Consulting the questionnaire survey of families who experienced PEG home care, we examined various problems of home care.
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Affiliation(s)
- T Sakuyama
- Dept. of Surgery, Aoto Hospital, Jikei University School of Medicine
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Yamada H, Hirai K, Miyamasu M, Iikura M, Misaki Y, Shoji S, Takaishi T, Kasahara T, Morita Y, Ito K. Eotaxin is a potent chemotaxin for human basophils. Biochem Biophys Res Commun 1997; 231:365-8. [PMID: 9070280 DOI: 10.1006/bbrc.1997.6100] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We studied the effect of eotaxin, a novel eosinophil-active CC chemokine with high target cell specificity, on human basophils. Eotaxin induced higher levels of chemotactic response with a lower ED50 compared with RANTES in basophils; half-maximal migration occurred at a concentration of approximately 3 nM. On the other hand, it exerted only a marginal effect on either histamine release or leukotriene C4 generation. In addition, nested PCR amplification experiments revealed the expression of CC CKR3, a putative receptor for eotaxin, on basophils. Since accumulation of both basophils and eosinophils is an important aspect of allergic inflammation, eotaxin potentially plays a pathogenic role in allergic disorders by inducing migration of both of these cell types.
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Affiliation(s)
- H Yamada
- Department of Medicine and Physical Therapy, University of Tokyo School of Medicine, Japan
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Abstract
The functional disorder of defecation after low anterior resection (LAR) was studied from the aspect of colonic motility in an experiment with dogs using a strain gage transducer, and the following results were obtained: 1) In early phase after LAR, the frequency of the colonic contractile waves increased at the proximal and distal sites of the anastomosis in both subgroups of dogs denervated and innervated of hypogastric and pelvic nerves. The increase was more remarkable at the distal site of the anastomosis. Also, the contractile waves were not propagated across the anastomosis. 2) After LAR, strong colonic contractions occurred during defecation only at the distal anastomosis. Various patterns of contraction time required for defecation were demonstrated as compared to a single pattern in control dogs. 3) The frequency of the occurrence of colonic contractile waves and the propagation of the contraction tended to be normalized with time after LAR both in denervated and innervated groups, though the recovery was faster in the latter subgroup. 4) The frequency of defecation increased after LAR both in denervated and innervated groups compared to be in the control dogs, though more remarkable in the denervated groups. Although tended to be gradually normalized with time after LAR, the colectomized dogs required a long time for normalization of the frequency of defecation. These results suggested the significant effect of reduction in reservoir space and disturbed continuity of intramural plexus caused by colectomy. Less severity, however, of functional disorder of defecation and earlier recovery from colonic motility disorder in the subgroup of the dogs innervated of autonomic nerves indicated usefulness of retaining autonomic nerves in colectomy.
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Affiliation(s)
- M Iikura
- Department of Surgery 2, Jikei University School of Medicine, Tokyo, Japan
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Ohira Y, Hanyu N, Aoki T, Hashimoto Y, Iikura M, Fukuda S. [Effects of various histamine H2-receptor antagonists on gastrointestinal motility and gastric emptying]. J Smooth Muscle Res 1993; 29:131-42. [PMID: 7907895 DOI: 10.1540/jsmr.29.131] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Effects of various histamine H2-receptor antagonists (H2-RA) on gastrointestinal motility and gastric emptying were investigated. Ranitidine, nizatidine and cimetidine dose dependently induced contractions over the entire gastrointestinal tract, and the order of their effects was ranitidine > nizatidine > cimetidine. Roxatidine or famotidine had no effects on motility of the gastrointestinal tract. Ranitidine and nizatidine also induced contractions during the postprandial period and facilitated gastric emptying, while cimetidine, roxatidine or famotidine did not influence gastric emptying. Since acid reduction is thought to be the most important element of the treatment of peptic ulcer and reflux esophagitis, it was inferred that administration of a H2-RA selected with consideration of its property of facilitating gastrointestinal motility is effective in the treatment of patients with abnormal gastrointestinal motility.
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Affiliation(s)
- Y Ohira
- Second Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
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Hanyu N, Aoki T, Ohira Y, Nakada K, Iikura M, Fukuda S, Hashimoto Y. [Gallbladder function and CCK after gastrectomy]. Nihon Geka Gakkai Zasshi 1991; 92:1189-92. [PMID: 1944183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Postgastrectomy cholelithiasis has become a problem and biliary tract dyskinesia has been cited as an etiologic factor. CCK is the most important gut hormone with respect to biliary tract function, so we conducted an experimental study of postgastrectomy gallbladder function and CCK levels which gave the following results: 1. Although postprandial gallbladder contraction for the most part occurred in response to endogenous CCK, another mechanism (the gastro-cholecystic reflex) seemed to be responsible for some of them. 2. The postgastrectomy decrease in postprandial gallbladder contraction appeared to be due to disappearance of this gastro-cholecystic reflex. 3. Gallbladder contraction occurred in association with postprandial CCK secretion following total gastrectomy and Roux-en-Y reconstruction, but the altered food passage route caused changes in the dynamics of CCK secretion, and this is believed to have had an influence on the gallbladder contractile response.
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Affiliation(s)
- N Hanyu
- Second Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
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Nakada K, Furukawa Y, Abe T, Ohira Y, Morita S, Hashimoto Y, Iikura M, Haneu Y, Aoki T. [Gallbladder motility after gastrectomy]. Nihon Heikatsukin Gakkai Zasshi 1989; 25:362-4. [PMID: 2702292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Fujimoto K, Shinomiya M, Yoshizawa K, Fujimura H, Iikura M. [Etiological study on chronic subdural hematoma]. No To Shinkei 1966; 18:689-692. [PMID: 5953677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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