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Matsunaga M, Sato Y, Nagao M, Ikeda M, Motomura C, Kameda M, Yoshida Y, Terada A, Miyairi I, Fujisawa T. Development and validation of a new asthma questionnaire to help achieve a high level of control in school-age children and adolescents. Allergol Int 2024; 73:224-230. [PMID: 38065704 DOI: 10.1016/j.alit.2023.11.001] [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: 07/26/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Maintaining good asthma control minimizes the risk of exacerbations and lung function decline and is a primary goal of asthma management. The Japanese Pediatric Asthma Guidelines (JPGL) employs different classification criteria for control status from other guidelines, stressing a higher level of control. Based on JPGL, we previously developed a caregiver-completed questionnaire for assessing and achieving best asthma control in preschoolers. In this study, we aimed to develop a questionnaire for school-age children and adolescents. METHODS A working questionnaire comprising 14 items for patients and 34 items for caregivers was administered to 362 asthma patients aged 6-15 years and their caregivers. Separately, physicians filled out a questionnaire to determine JPGL-defined control. Logistic regression analysis was performed to construct a model to predict control levels using data from a randomly selected set of completed questionnaires from two-thirds of the subjects. Validation was performed using the remaining questionnaires. RESULTS A set of 7 questions, encompassing self-assessed control status at the time of the visit and in the past month, and nocturnal/early morning asthma symptoms for patients and frequency of asthma symptoms, dyspnea, rescue beta-agonist use, and asthma hospitalization for caregivers, were selected and the 7-item model showed a good statistical fit with AIC of 110.5. The model has been named the Best Asthma Control Test for School Children and Adolescents (Best ACT-S). Best ACT-S scores differed significantly in the hypothetical direction among the groups of different JPGL-defined control levels, step-up/down treatment decisions, and presence/non-presence of exacerbations in the previous year. CONCLUSIONS The Best ACT-S is a valid questionnaire for children/adolescents aiming for best asthma control.
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Affiliation(s)
- Mayumi Matsunaga
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan; Department of Pediatrics, Hamamatsu University Graduate School of Medicine, Hamamatsu, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Mizuho Nagao
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Masanori Ikeda
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chikako Motomura
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Yukinori Yoshida
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | | | - Isao Miyairi
- Department of Pediatrics, Hamamatsu University Graduate School of Medicine, Hamamatsu, Japan
| | - Takao Fujisawa
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan.
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Maeta A, Takaoka Y, Kameda M, Takahashi K. Relationship between the outcome of low-dose egg oral immunotherapy and the fold-difference levels of allergen-specific IgE and IgG4 in serum. Asian Pac J Allergy Immunol 2024; 42:36-42. [PMID: 33865297 DOI: 10.12932/ap-100620-0877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/05/2022]
Abstract
BACKGROUND There are no indices to monitor desensitization by low-dose egg oral immunotherapy (eOIT). OBJECTIVE We aimed to examine the relationship between desensitization by low-dose eOIT and the changes in allergen-specific immunoglobulin E (IgE) and IgG4 levels. METHODS We carried out low-dose eOIT in 31 patients with severe egg allergy in our previous two studies. After 4 months of treatment, the patients with no observed allergic symptoms in response to the open hard-boiled egg white challenge tests were classified as the negative group, and the remaining patients, the positive group. The fold-difference levels were calculated using 10 Log (Titer after eOIT/Titer before eOIT). RESULTS The 28 patients who completed eOIT with sufficient serum collected before and after eOIT were analyzed. The median fold-difference levels of ovomucoid-specific IgE in the negative and positive groups were 0.819 and 0.953, respectively (P = 0.082). The median fold-difference levels of ovalbumin-specific IgG4 in the negative and positive groups were 2.01 and 1.29, respectively (P = 0.057). In the receiver-operating characteristic curves, the area under the curves of fold-difference ovomucoid-specific IgE and ovalbumin-specific IgG4 were 0.701 and 0.719, respectively. The challenge positive predictive values of fold-difference ovomucoid-specific IgE and ovalbumin-specific IgG4 were 83.8% (cut-off point: 0.934) and 77.8% (cut-off point: 1.87), respectively. Moreover, the challenge positive predictive value in patients with both 0.934 < ovomucoid-specific IgE and ovalbumin-specific IgG4 <1.87 was 100%. CONCLUSIONS The fold-difference levels of allergen-specific IgE and IgG4 in serum are considered useful for monitoring desensitization by low-dose OIT.
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Affiliation(s)
- Akihiro Maeta
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women's University, Hyogo, Japan
| | - Yuri Takaoka
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Kyoko Takahashi
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women's University, Hyogo, Japan
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Korematsu S, Fujisawa T, Saito N, Tezuka J, Miura K, Kobayashi I, Miyata I, Kosugi Y, Gohda Y, Koike Y, Suda A, Matsuo A, Sasaki M, Handa Y, Fujiwara M, Ono A, Koizumi S, Oishi T, Tanaka T, Ando Y, Taba N, Tsurinaga Y, Sato T, Kanai R, Yashiro M, Takagi T, Hida S, Harazaki M, Hoshina T, Okada S, Yasutomi M, Nakata S, Muto A, Tanabe S, Ueda Y, Hasegawa S, Kameda M, Tanaka‐Taya K, Fujimoto T, Okada K. Suppressed pediatric asthma hospitalizations during the COVID-19 pandemic in Japan, from a national survey. Clin Transl Allergy 2024; 14:e12330. [PMID: 38282201 PMCID: PMC10795717 DOI: 10.1002/clt2.12330] [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: 08/09/2023] [Revised: 12/06/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Acute asthma exacerbation in children is often caused by respiratory infections. In this study, a coordinated national surveillance system for acute asthma hospitalizations and causative respiratory infections was established. We herein report recent trends in pediatric acute asthma hospitalizations since the COVID-19 pandemic in Japan. METHODS Thirty-three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID-19 pandemic and whether or not COVID-19 caused acute asthma exacerbation were investigated. RESULTS From fiscal years 2010-2019, the median number of acute asthma hospitalizations per year was 3524 (2462-4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3- to 6-year group. SARS-CoV-2 was evaluated in 2094 patients from fiscal years 2020-2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS-CoV-2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long-term control medications before admission despite the severity of bronchial asthma. CONCLUSION SARS-CoV-2 was hardly detected in children with acute asthma hospitalization during the COVID-19 pandemic. This result indicated that SARS-CoV-2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long-term control medications is a major problem that should be addressed.
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Takaoka Y, Sato N, Nakamura M, Matsunaga K, Shigekawa A, Kameda M. Corn-dependent exercise-induced anaphylaxis with cross-antigenicity to avocado. Pediatr Int 2024; 66:e15746. [PMID: 38409905 DOI: 10.1111/ped.15746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/24/2023] [Accepted: 12/26/2023] [Indexed: 02/28/2024]
Affiliation(s)
- Yuri Takaoka
- Department of Pediatrics, Osaka Habikino Medical Center, Habikino, Osaka, Japan
| | - Nayu Sato
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Aichi, Japan
- General Research and Development Institute, Hoyu Co., Ltd., Nagakute, Aichi, Japan
| | - Masashi Nakamura
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Aichi, Japan
- General Research and Development Institute, Hoyu Co., Ltd., Nagakute, Aichi, Japan
| | - Kayoko Matsunaga
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Aichi, Japan
| | - Amane Shigekawa
- Department of Pediatrics, Osaka Habikino Medical Center, Habikino, Osaka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Habikino, Osaka, Japan
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Takaoka Y, Maeta A, Nakano A, Hamada M, Hiraguchi Y, Kawakami T, Okafuji I, Takemura Y, Kameda M, Takahashi K, Akagawa S, Anzai K, Sumimoto S, Bando K, Doi M, Enomoto M, Fujikawa S, Ikeda A, Nagai M, Nishiyama A, Otsuka K, Shimizu S, Sugimoto Y, Tanaka Y, Tanaka Y, Tanaka Y, Wakahara R, Yamasaki K. Pediatric allergies in Japan: Coronavirus disease pandemic-related risk factors. Asia Pac Allergy 2023; 13:114-120. [PMID: 37744957 PMCID: PMC10516313 DOI: 10.5415/apallergy.0000000000000116] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/11/2023] [Indexed: 09/26/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic impacted various parts of society, including Japanese children with allergies. Objective This study investigated risk factors for pediatric allergic diseases associated with the state of emergency owing to the COVID-19 pandemic in Japan, including during school closures. Methods Parents of pediatric patients (0-15 years) with allergies were enrolled and queried regarding the impact of school closure on pediatric allergies compared to that before the COVID-19 pandemic. Results A valid response was obtained from 2302 parents; 1740 of them had children with food allergies. Approximately 4% (62/1740) of the parents reported accidental food allergen ingestion was increased compared to that before the COVID-19 pandemic. Accidental ingestion during school closures was associated with increased contact with meals containing allergens meant for siblings or other members of the family at home. The exacerbation rate during the pandemic was highest for atopic dermatitis at 13% (127/976), followed by allergic rhinitis at 8% (58/697), and bronchial asthma at 4% (27/757). The main risk factors for worsening atopic dermatitis, allergic rhinitis, and bronchial asthma were contact dermatitis of the mask area (34/120 total comments); home allergens, such as mites, dogs, and cats (15/51 total comments); and seasonal changes (6/25 total comments), respectively. Conclusion The main factors affecting allergic diseases were likely related to increased time at home, preventive measures against COVID-19, and refraining from doctor visits. Children with allergies were affected by changes in social conditions; however, some factors, such as preventing accidental ingestion and the management of allergens at home, were similar to those before the COVID-19 pandemic. Patients who had received instructions on allergen avoidance at home before the pandemic were able to manage their disease better even when their social conditions changed.
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Affiliation(s)
- Yuri Takaoka
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
| | - Akihiro Maeta
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
| | - Atsuko Nakano
- Department of Pediatrics, Kokuho Chuo Hospital, Shiki, Nara, Japan
| | - Masaaki Hamada
- Department of Pediatrics, Yao Municipal Hospital, Yao, Osaka, Japan
| | - Yukiko Hiraguchi
- Department of Pediatrics, Osaka Saiseikai Nakatsu Hospital, Osaka, Osaka, Japan
| | - Tomoko Kawakami
- Department of Pediatrics, Sumitomo Hospital, Osaka, Osaka, Japan
| | - Ikuo Okafuji
- Department of Pediatrics, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yutaka Takemura
- Department of Pediatrics, Kindai University Hospital, Osakasayama, Osaka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan
| | - Kyoko Takahashi
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women’s University, Nishinomiya, Hyogo, Japan
| | - Shohei Akagawa
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Kaori Anzai
- Department of Pediatrics, Japanese Osaka Red Cross Hospital, Osaka, Osaka, Japan
| | - Shinichi Sumimoto
- Department of Pediatrics, Japanese Osaka Red Cross Hospital, Osaka, Osaka, Japan
| | - Kenji Bando
- Department of Pediatrics, Izumi City General Hospital, Izumi, Osaka, Japan
| | - Masaaki Doi
- Department of Pediatrics, Higashiosaka City Medical Center, Higashiosaka, Osaka, Japan
| | - Masahiro Enomoto
- Department of Pediatrics, Takatsuki General Hospital, Takatsuki, Osaka, Japan
| | - Shiori Fujikawa
- Department of Pediatrics, Abeno Medical Clinic, Osaka, Osaka, Japan
| | - Akiko Ikeda
- Department of Pediatrics, Yamatotakada Municipal Hospital, Yamatotakada, Nara, Japan
| | - Megumi Nagai
- Department of Pediatrics, Kindai University Hospital, Osakasayama, Osaka, Japan
| | - Atsuko Nishiyama
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara, Nara, Japan
| | - Keita Otsuka
- Department of Pediatrics, Nara City Hospital, Nara, Nara, Japan
| | - Satoko Shimizu
- Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
- Department of Pediatrics, Shimizu Family Clinic, Moriguchi, Osaka, Japan
| | - Yukiko Sugimoto
- Department of Pediatrics, Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | - Yukiko Tanaka
- Department of Pediatrics, Kobe City Medical Center West Hospital, Kobe, Hyogo, Japan
| | - Yuko Tanaka
- Department of Pediatrics, Osaka Police Hospital, Osaka, Osaka, Japan
| | - Yuya Tanaka
- Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan
| | - Ryohei Wakahara
- Department of Pediatrics, PL Hospital, Tondabayashi, Osaka, Japan
| | - Koji Yamasaki
- Department of Pediatrics, Kaizuka City Hospital, Kaizuka, Osaka, Japan
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Maeta A, Takaoka Y, Hamada M, Nakano A, Sumimoto S, Anzai K, Tanaka Y, Morikawa S, Kameda M, Takahashi K. Development of an Oral Immunotherapy-Related Parental Burden Scale. Int Arch Allergy Immunol 2023; 184:1203-1215. [PMID: 37647864 DOI: 10.1159/000533332] [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: 05/19/2023] [Accepted: 07/27/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Oral immunotherapy (OIT) imposes a burden on parents and their children with food allergies (FAs). We already developed a questionnaire for OIT-related Parental Burden (OIT-PB) scale. However, the previous questionnaire had some problems. This study modified OIT-PB and verified its reliability and validity. METHODS A 20-item draft covering the physical and mental burdens caused by OIT was prepared jointly with multiple allergists. The Food Allergy Quality of Life Questionnaire-Parental Burden (FAQLQ-PB) and Stress Response Scale-18 (SRS-18) were used to verify concurrent validity. A questionnaire survey was administered during treatment to parents of FA children who had started OIT for the first time. An additional OIT-PB survey was performed at one specific institution 1 week after the posttreatment survey. RESULTS The responses of 64 of the 76 recruited parents were analyzed. Of the 20 questions, 1 item was excluded owing to the floor effect, 1 was excluded because its commonality was less than 0.2, and 2 were excluded because their factor loading values were less than 0.4. Factor analysis was used to classify the OIT-PB into the following 4 subscales: "burden caused by adherence to treatment plan," "anxiety about symptom-induced risk," "burden due to patient's eating behavior," and "anxiety about treatment effect." The Cronbach's α for all 16 items of the OIT-PB was 0.893; Cronbach's α for each subscale was 0.876, 0.898, 0.874, and 0.717. The re-test reliability coefficient was 0.864 (95% confidence interval [CI]: 0.720-0.937, p < 0.001). A significant positive correlation was found between the OIT-PB and FAQLQ-PB (R = 0.610 [95% CI: 0.422-0.747], p < 0.001) and the SRS-18 (R = 0.522 [95% CI: 0.306-0.687], p < 0.001). A significant negative correlation was found between the rate of increase in OIT food intake and the "anxiety about treatment effect" score (R = -0.355 [95% CI: -0.558-0.112], p < 0.001). Parents of children on the hen's egg OIT treatment scored higher on the "burden due to patient's eating behavior" subscale than did parents of children on the milk and wheat OIT treatment. CONCLUSION The burden of OIT experienced by parents can be broadly classified into four categories. The modified OIT-PB was able to evaluate them individually and was shown to have reliability and validity. This scale is expected to be useful in the development of OIT that considers not only therapeutic effect but also the burden experienced by FA children and their parents.
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Affiliation(s)
- Akihiro Maeta
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women's University, Nishinomiya, Japan
| | - Yuri Takaoka
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Masaaki Hamada
- Department of Pediatrics, Yao Municipal Hospital, Osaka, Japan
| | - Atsuko Nakano
- Department of Pediatrics, Kokuho Chuo Hospital, Nara, Japan
| | - Shinichi Sumimoto
- Department of Pediatrics, Japanese Osaka Red Cross Hospital, Osaka, Japan
| | - Kaori Anzai
- Department of Pediatrics, Japanese Osaka Red Cross Hospital, Osaka, Japan
| | - Yukiko Tanaka
- Department of Pediatrics, Kobe City Medical Center West Hospital, Kobe, Japan
| | - Satoru Morikawa
- Department of Pediatrics, Kobe City Medical Center West Hospital, Kobe, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Kyoko Takahashi
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women's University, Nishinomiya, Japan
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Takaoka Y, Ito YM, Kumon J, Yamaguchi T, Ueno R, Tsurinaga Y, Nakano T, Fukasawa Y, Shigekawa A, Yoshida Y, Kameda M, Doi S. Efficacy and safety of low- and high-dose slow oral egg immunotherapy for hen's egg allergy: Single-center non-inferiority randomized trial. Asian Pac J Allergy Immunol 2023. [PMID: 37061933 DOI: 10.12932/ap-130722-1411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
BACKGROUND Low-dose oral immunotherapy (OIT) is a safe treatment for hen's egg allergy; however, comparison of its therapeutic effects with those of high-dose OIT has not been reported. OBJECTIVE To compare the efficacy of low- and high-dose boiled egg-white (EW) OIT for hen's egg allergy. METHODS Patients with hen's egg allergy were randomly assigned to two groups: OIT using hard-boiled EW with a maximum maintenance dose of 2 and 20 g in the low-dose (L-D) and high-dose (H-D) groups, respectively. The intake dose was ingested twice a week, increased by approximately 20% per week until reaching the target maintenance dose (2 or 20 g hard-boiled EW), and maintained thereafter according to the schedule. The threshold was confirmed via oral food challenge (OFC) after 6 months, and the difference in the proportion of subjects passing the exit OFC between groups was evaluated. RESULTS Fifty-two patients (L-D, n = 23; H-D, n = 29) were enrolled. Thirty-three patients (L-D, n = 17; H-D, n = 16) completed the 6-month OIT and underwent an exit OFC. In total, three (L-D, 3/17; H-D, 3/16) patients in each group tested negative for an exit OFC with a 20-g reactive dose (p = 1.000). EW-specific IgE levels in both groups decreased significantly after OIT (L-D, p < 0.001; H-D, p = 0.002). CONCLUSIONS A threshold-elevating effect was observed in the L-D group, not inferior to that in the H-D group. Low-dose OIT may be appropriate to treat hen's egg allergy for the first 6 months.
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Affiliation(s)
- Yuri Takaoka
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Yoichi M Ito
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Hokkaido, Japan
| | - Junko Kumon
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | | | - Rumi Ueno
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Yuki Tsurinaga
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Tamana Nakano
- Children's Medical Center, Kitakyushu City Yahata Hospital, Fukuoka, Japan
| | - Yohei Fukasawa
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Amane Shigekawa
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Yukinori Yoshida
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
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Nakano A, Maeta A, Takaoka Y, Saeki K, Hamada M, Hiraguchi Y, Kawakami T, Okafuji I, Takemura Y, Takahashi K, Kameda M. Parents' Fears about Hospital Visits and Trait Anxiety in the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11081080. [PMID: 37107913 PMCID: PMC10137802 DOI: 10.3390/healthcare11081080] [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: 02/23/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Anxiety in parents of children with allergic diseases during the COVID-19 pandemic may impact hospital visits. This study explored the effect of the pandemic on parents' fears about hospital visits and their relationship with their personality traits. A cross-sectional, questionnaire-based study was conducted between September 2020 and March 2021, with parents of children aged 0-15 years, who regularly visited 24 outpatient facilities for allergic disease. The survey included patient information, fears about hospital visits, desired information, and the State-Trait Anxiety Inventory. Responses were compared between parents with high and low trait anxiety. The response rate was 97.6% (2439/2500). The most common fear was "Fear of getting medical care as usual (85.2%)" and "Fear of COVID-19 infection during hospital visits (87.1%)". High trait anxiety showed a significant association with "Fear of worsening of children's allergies" (adjusted OR: 1.31, 95%CI: 1.04 to 1.65, p = 0.022), and "Fear of worsening of COVID-19 due to allergy" (adjusted OR: 1.52, 95%CI: 1.27 to 1.80, p < 0.01). Healthcare professionals should share updates on COVID-19 and healthcare system to reduce parents' fear. Subsequently, they should communicate the importance of continuing treatment to prevent worsening of COVID-19 and avoid emergency visits, considering parental trait anxiety.
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Affiliation(s)
- Atsuko Nakano
- Department of Pediatrics, Kokuho Central Hospital, Nara 6360302, Japan
| | - Akihiro Maeta
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women's University, Hyogo 6638558, Japan
| | - Yuri Takaoka
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka 5830872, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara 6348522, Japan
| | - Masaaki Hamada
- Department of Pediatrics, Yao Municipal Hospital, Osaka 5810069, Japan
| | - Yukiko Hiraguchi
- Department of Pediatrics, Osaka Saiseikai Nakatsu Hospital, Osaka 5300012, Japan
| | - Tomoko Kawakami
- Department of Pediatrics, Sumitomo Hospital, Osaka 5300005, Japan
| | - Ikuo Okafuji
- Department of Pediatrics, Kobe City Hospital Organization Kobe City Medical Center General Hospital, Hyogo 6500047, Japan
| | - Yutaka Takemura
- Department of Pediatrics, Kindai University Hospital, Osaka 5898511, Japan
| | - Kyoko Takahashi
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women's University, Hyogo 6638558, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka 5830872, Japan
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Kawabe T, Kawashima K, Okuno M, Yamamoto M, Sasaki T, Hanada Y, Tanaka S, Kumon J, Yamaguchi T, Ueno R, Tsurinaga Y, Fukazawa Y, Shigekawa A, Takaoka Y, Yoshida Y, Kameda M. [OBJECTIVE EVALUATION OF SUBLINGUAL IMMUNOTHERAPY FOR PEDIATRIC ALLERGIC RHINITIS RESPOND TO SQ HOUSE DUST MITE]. Arerugi 2023; 72:375-387. [PMID: 37316242 DOI: 10.15036/arerugi.72.375] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) has become applicable to insurance for children in Japan in 2018. However, as for the efficacy of SLIT for children, objective evaluation methods have not been sufficiently investigated. SUBJECTS AND METHODS We investigated the efficacy of SLIT as both subjective and objective evaluation in 44 children with allergic rhinitis sensitized to house dust mite who started the treatment in the summer of 2018 in our hospital. The children and their patients wrote the allergy diary every day, and in winter/spring/summer vacations, they answered Japanese allergic rhinitis quality of life standard questionnaire and were evaluated with nasal provocation test, blood test, rhinomanometry for 3 years. RESULTS 29 (66%) of the 44 children continued SLIT for 3 years. Symptom scores, QOL scores, symptom medication scores halved in a year and the effect lasted in the second and third year. Nasal provocation test and rhinomanometry showed significant improvement. Specific IgE increased transiently and then decreased. Specific IgG4 increased annually. CONCLUSION The present study showed a decrease in scores not only for subjective assessments but also for objective evaluation methods, the house dust nasal provocation test and the nasal airway resistance.
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Affiliation(s)
- Takanari Kawabe
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | - Kayoko Kawashima
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | - Mika Okuno
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | | | | | - Yukiko Hanada
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | - Shohei Tanaka
- Department of Otorhinolaryngology, Osaka National Hospital
| | - Junko Kumon
- Department of Pediatrics, Osaka Habikino Medical center
| | | | - Rumi Ueno
- Department of Pediatrics, Osaka Habikino Medical center
| | | | | | | | - Yuri Takaoka
- Department of Pediatrics, Osaka Habikino Medical center
| | | | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical center
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Yoshida Y, Fukasawa Y, Kumon J, Yamaguchi T, Ueno R, Tsurinaga Y, Nakano T, Shigekawa A, Takaoka Y, Kameda M. [LUNG FUNCTION IN EARLY-PERIOD SCHOOL-AGED ASTHMATIC CHILDREN MAY BE A PREDICTOR OF TREATMENT LEVEL AT ADOLESCENCE]. Arerugi 2022; 71:221-230. [PMID: 35569944 DOI: 10.15036/arerugi.71.221] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Lung function in early-period school-aged children with asthma influences remission in adolescence. However, there are no reports of this in Japan. OBJECTIVE This study investigated the influence of lung function in early-period school-aged asthmatic children on medication during adolescence. SUBJECTS AND METHODS Forty-nine subjects who had visited our hospital at age 6 years or younger were evaluated on March 31, 2018, at the ages of 16 to 18, to determine their asthma treatment step (step 1 to 4). The patients were divided into four groups, and lung function at six years old. RESULTS The groups for steps 1, 2, 3 and 4 had 11, 13, 6, and 8 participants, respectively. FEV1.0% at six years old for step 1, 2, 3 and 4 had 88.4%, 89.1%, 86.9%, 80.9%, and %V50 had 111.5%, 107.9%, 108.2% and 69.9%, respectively. There were significant differences between the groups of step 4 and 1, 2 regarding FEV1.0% and %V50. CONCLUSION As for the patient of treatment step 4 of adolescence, lung function decreased at 6 years old in comparison with step 1, 2 patients. Lung function in early-period school-aged asthmatic children may predict the treatment level at adolescence.
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Affiliation(s)
| | | | - Junko Kumon
- Department of Pediatrics, Osaka Habikino Medical Center
| | | | - Rumi Ueno
- Department of Pediatrics, Osaka Habikino Medical Center
| | | | - Tamana Nakano
- Department of Pediatrics, Kitakyushu City Yahata Hospital
| | | | - Yuri Takaoka
- Department of Pediatrics, Osaka Habikino Medical Center
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center
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11
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Maeta A, Takaoka Y, Nakano A, Hiraguchi Y, Hamada M, Takemura Y, Kawakami T, Okafuji I, Kameda M, Takahashi K. Progress of Home-Based Food Allergy Treatment during the Coronavirus Disease Pandemic in Japan: A Cross-Sectional Multicenter Survey. Children 2021; 8:children8100919. [PMID: 34682185 PMCID: PMC8535074 DOI: 10.3390/children8100919] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/05/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic’s impact on food allergy treatment such as home-based oral immunotherapy (OIT) is not known. This cross-sectional, questionnaire-based anonymized survey screened 2500 parents of children with allergic diseases and was conducted in the pediatric outpatient clinics of 24 hospitals. Basic clinical data of the children were collected along with the degree of allergy control, parental anxiety about emergency visits, and the risk of COVID-19 in the first state of emergency. A total of 2439 (97.6%) questionnaires were collected, and 1315 parents who were instructed to initiate home-based OIT for their children were enrolled (OIT group). Subjective OIT progress compared to before the COVID-19 pandemic was ascertained as “Full”, “Middle”, “Low”, “Little”, and “Stop” in 264 (20.1%), 408 (31.0%), 384 (29.2%), 203 (15.4%), and 56 (4.3%) participants, respectively. Anxiety about emergency visits and the risk of COVID-19 were negatively associated with the subjective OIT progress. In Japan, approximately half of the children continued smoothly the home-based OIT during the COVID-19 pandemic. Parents with high levels of anxiety about the disruption of the medical care system due to COVID-19 and the risk of COVID-19 did not experience a smooth continuation of home-based OIT.
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Affiliation(s)
- Akihiro Maeta
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women’s University, 6-46, Ikebiraki-cho, Nishinomiya 663-8558, Japan;
| | - Yuri Takaoka
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, 3-7-1, Habikino 583-8588, Japan; (Y.T.); (M.K.)
| | - Atsuko Nakano
- Department of Pediatrics, Kokuho Chuo Hospital, 404-1, Miyako, Shiki 636-0302, Japan;
| | - Yukiko Hiraguchi
- Department of Pediatrics, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Osaka 530-0012, Japan;
| | - Masaaki Hamada
- Department of Pediatrics, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao 581-0069, Japan;
| | - Yutaka Takemura
- Department of Pediatrics, Kindai University Hospital, 377-2, Onohigashi, Osakasayama 577-8502, Japan;
| | - Tomoko Kawakami
- Department of Pediatrics, Sumitomo Hospital, 5-3-20, Nakanoshima, Osaka 530-0005, Japan;
| | - Ikuo Okafuji
- Department of Pediatrics, Kobe City Hospital Organization Kobe City Medical Center General Hospital, 2-1-1, Minatoshima-cho, Kobe 650-0047, Japan;
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, 3-7-1, Habikino 583-8588, Japan; (Y.T.); (M.K.)
| | - Kyoko Takahashi
- Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women’s University, 6-46, Ikebiraki-cho, Nishinomiya 663-8558, Japan;
- Correspondence: ; Tel.: +81-798-45-9878
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12
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Hashimoto S, Yoshizaki K, Uno K, Kitajima H, Arai T, Tamura Y, Morishita H, Matsuoka H, Han Y, Minamoto S, Hirashima T, Yamada T, Kashiwa Y, Kameda M, Yamaguchi S, Tsuchihashi Y, Iwahashi M, Nakayama E, Shioda T, Nagai T, Tanaka T. Prompt Reduction in CRP, IL-6, IFN-γ, IP-10, and MCP-1 and a Relatively Low Basal Ratio of Ferritin/CRP Is Possibly Associated With the Efficacy of Tocilizumab Monotherapy in Severely to Critically Ill Patients With COVID-19. Front Med (Lausanne) 2021; 8:734838. [PMID: 34631752 PMCID: PMC8494777 DOI: 10.3389/fmed.2021.734838] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022] Open
Abstract
Background and Aim: Tocilizumab, a humanized anti-IL-6 receptor antibody, has been used to treat severely to critically ill patients with COVID-19. A living systematic review with meta-analysis of recent RCTs indicates that the combination therapy of corticosteroids and tocilizumab produce better outcomes, while previous observational studies suggest that tocilizumab monotherapy is beneficial for substantial numbers of patients. However, what patients could respond to tocilizumab monotherapy remained unknown. Methods: In this retrospective study we evaluated the effects of tocilizumab monotherapy on the clinical characteristics, serum biomediator levels, viral elimination, and specific IgG antibody induction in 13 severely to critically ill patients and compared with those of dexamethasone monotherapy and dexamethasone plus tocilizumab. Results: A single tocilizumab administration led to a rapid improvement in clinical characteristics, inflammatory findings, and oxygen supply in 7 of 11 patients with severe COVID-19, and could recover from mechanical ventilation management (MVM) in 2 patients with critically ill COVID-19. Four patients exhibited rapidly worsening even after tocilizumab administration and required MVM and additional methylprednisolone treatment. Tocilizumab did not delay viral elimination or inhibit IgG production specific for the virus, whereas dexamethasone inhibited IgG induction. A multiplex cytokine array system revealed a significant increase in the serum expression of 54 out of 80 biomediators in patients with COVID-19 compared with that in healthy controls. Compared with those who promptly recovered in response to tocilizumab, patients requiring MVM showed a significantly higher ratio of basal level of ferritin/CRP and a persistent increase in the levels of CRP and specific cytokines and chemokines including IL-6, IFN-γ, IP-10, and MCP-1. The basal high ratio of ferritin/CRP was also associated with clinical deterioration even in patients treated with dexamethasone and tocilizumab. Conclusion: Tocilizumab as monotherapy has substantial beneficial effects in some patients with severe COVID-19, who showed a relatively low level of the ratio of ferritin/CRP and prompt reduction in CRP, IL-6, IFN-γ, IP-10, and MCP-1. The high ratio of ferritin/CRP is associated with rapid worsening of pneumonia. Further evaluation is warranted to clarify whether tocilizumab monotherapy or its combination with corticosteroid is preferred for severely to critically ill patients with COVID-19.
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Affiliation(s)
- Shoji Hashimoto
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Kazuyuki Yoshizaki
- Department of Organic Fine Chemicals, Institute of Scientific and Industry Research, Osaka University, Osaka, Japan
| | - Kazuko Uno
- Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
| | - Heita Kitajima
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Tsuyoshi Arai
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Yoshitaka Tamura
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Hiroshi Morishita
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Hiroto Matsuoka
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Yuki Han
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Seijiro Minamoto
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Tomonori Hirashima
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Tomoki Yamada
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Yozo Kashiwa
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Makoto Kameda
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Seiji Yamaguchi
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Yasunari Tsuchihashi
- Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
| | | | - Emi Nakayama
- Department of Viral Infection, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Tatsuo Shioda
- Department of Viral Infection, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Takayuki Nagai
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Toshio Tanaka
- Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
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13
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Fukuda Y, Yamamoto S, Nishida K, Takaoka Y, Kameda M. A study on the effect of nutrient intake on the body mass index of mothers of children with food allergies. Asian Pac J Allergy Immunol 2021; 38:264-270. [PMID: 31012594 DOI: 10.12932/ap-260718-0377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND No previous studies have reported the effect of the presence of children with food allergies (FAs) on the diet and body mass index (BMI) of mothers. Therefore, we conducted a dietary survey and considered nutrients that influenced BMI of mothers. OBJECTIVE Subjects included 554 mothers-305 mothers of children with FAs (FA mothers; aged 38.4 ± 5.1 years, FA group) and 249 mothers of children without FAs (non-FA mothers; aged 37.7 ± 5.5 years, NFA group). METHODS We extracted dietary patterns from dietary survey results and investigated the correlation between nutrient intake and BMI. We divided the FA group into two groups (one containing 181 mothers whose children were allergic to ≤ 1 of the three major allergenic foods-eggs, milk and wheat-and another containing 124 mothers whose children were allergic to ≥ 2 of these foods) and conducted a comparative analysis. RESULTS BMI was significantly lower in the FA group than in the NFA group (20.7 vs. 21.4 kg/m2). There was a significant negative correlation between BMI and vegetable protein intake (β = -0.196, SE = 0.05). Vegetable protein intake was higher in the group that was allergic to ≥ 2 of the allergenic foods. CONCLUSIONS BMI of FA mothers is affected by a diet that strictly follows their FA child's allergen-free state-a diet dominated by vegetable protein. These observations suggested that the degree to which an FA mother is affected depends on the number of the three major allergenic foods to which her FA child is allergic.
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Affiliation(s)
- Yasuko Fukuda
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo Prefecture 663-8558, Japan
| | - Shumi Yamamoto
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo Prefecture 663-8558, Japan
| | - Kyoko Nishida
- Department of Nutrition Management, Osaka Prefecture Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino, Osaka Prefecture, 583-8588, Japan
| | - Yuri Takaoka
- Department of Pediatrics, Osaka Prefecture Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino, Osaka Prefecture, 583-8588, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefecture Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino, Osaka Prefecture, 583-8588, Japan
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14
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Ueno R, Takaoka Y, Shimojo N, Ohno F, Yamaguchi T, Matsunaga K, Kameda M. A case of pediatric anaphylaxis caused by gummy tablets containing fish collagen. Asia Pac Allergy 2020; 10:e35. [PMID: 33178560 PMCID: PMC7610083 DOI: 10.5415/apallergy.2020.10.e35] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 09/14/2020] [Indexed: 11/04/2022] Open
Abstract
Fish collagen is one of the major allergens involved in fish allergies; however, it has not been well-established whether fish collagen can cause anaphylaxis among individuals with fish allergies, especially children. A 9-year-old girl experienced anaphylaxis after consuming 2 fruit-flavored gummy tablets. Contacting the manufacturing company revealed that fish-derived collagen was used in the gummy tablets, and an oral fish collagen challenge test confirmed that the anaphylaxis was induced by fish collagen. Immunoblot analysis showed a 120-kDa band in a sample of the fish collagen in the gummy tablets, and no reactive band of the pork gelatin was observed. Additionally, salmon collagen and other fish samples that provoked symptoms were detected as a 120-kDa band in the immunoblot analysis. The 120-kDa band was identified as fish collagen by mass spectrometry confirming that it was the causative antigen of our patient's allergy. This case study confirms that fish collagen can cause anaphylaxis in children with fish allergies. Physicians and allergic individuals need to be aware that processed foods may contain fish collagen to avoid allergic reactions.
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Affiliation(s)
- Rumi Ueno
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Yuri Takaoka
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoshi Shimojo
- General Research and Development Institute, Hoyu Co., Ltd., Aichi, Japan.,Department of Integrative Medical Science for Allergic Disease, Fujita Health University Bantane Hospital, Aichi, Japan
| | - Fumiaki Ohno
- General Research and Development Institute, Hoyu Co., Ltd., Aichi, Japan.,Department of Integrative Medical Science for Allergic Disease, Fujita Health University Bantane Hospital, Aichi, Japan
| | | | - Kayoko Matsunaga
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University Bantane Hospital, Aichi, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
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15
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Hiramatsu M, Sugiu K, Hishikawa T, Haruma J, Takahashi Y, Murai S, Nishi K, Yamaoka Y, Shimazu Y, Fujii K, Kameda M, Kurozumi K, Date I. Detailed Arterial Anatomy and Its Anastomoses of the Sphenoid Ridge and Olfactory Groove Meningiomas with Special Reference to the Recurrent Branches from the Ophthalmic Artery. AJNR Am J Neuroradiol 2020; 41:2082-2087. [PMID: 33004344 DOI: 10.3174/ajnr.a6790] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/15/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Detailed arterial anatomy of the sphenoid ridge and olfactory groove meningiomas is complicated due to the fine angioarchitecture and anastomoses between each feeder. Herein, we present details of the arterial anatomy and the relationships of feeders in these lesions. MATERIALS AND METHODS This study included 20 patients admitted to our department between April 2015 and March 2020. Conditions of subjects consisted of 16 sphenoid ridge meningiomas and 4 olfactory groove meningiomas. We mainly analyzed arterial anatomy using 3D rotational angiography and slab MIP images of these lesions. We also analyzed the anastomoses of each feeder. RESULTS We found that 19 (95%), 15 (75%), and 15 (75%) lesions had feeders from the ophthalmic, internal carotid, and external carotid arteries, respectively. As feeders from the ophthalmic artery, recurrent meningeal arteries were involved in 18 lesions (90%). Fifteen lesions (75%) had anastomoses between each feeder. CONCLUSIONS Most of the meningiomas in the sphenoid ridge and olfactory groove had feeders from the ophthalmic and internal carotid arteries. There were various anastomoses between each feeder. This is the first report to demonstrate the detailed arterial anatomy and frequency of recurrent branches from the ophthalmic artery and their anastomoses using detailed imaging techniques.
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Affiliation(s)
- M Hiramatsu
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - K Sugiu
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - T Hishikawa
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - J Haruma
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Y Takahashi
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - S Murai
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - K Nishi
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Y Yamaoka
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Y Shimazu
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - K Fujii
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - M Kameda
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - K Kurozumi
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Neurosurgery (K.K.), Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - I Date
- From the Department of Neurological Surgery (M.H., K.S., T.H., J.H., Y.T., S.M., K.N., Y.Y., Y.S., K.F., M.K., K.K., I.D.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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16
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Arakawa H, Adachi Y, Ebisawa M, Fujisawa T, Arakawa H, Adachi Y, Ebisaw M, Fujisawa T, Akasawa A, Inoue T, Ohya Y, Kameda M, Kurihara K, Shimojo N, Suehiro Y, Mochizuki H, Yoshihara S, Iwanaga T, Kuroki H, Takase M, Masuko I, Hirai K, Yoshida K, Inoue Y, Nagao M, Miyaji Y, Iio M, Ito Y, Takizawa T, Futamura M, Tezuka J, Fukuda H, Yoshida Y, Nishimoto H, Fukuie T, Sato S, Yamada Y, Okafuji I, Yamamoto-Hanada K, Sasaki M, Tanaka Y, Nakajima Y, Isozaki A, Inage E, Yagi H, Shimizu M, Akashi K, Kawamoto N, Manabe T, Murai H, Takaoka Y, Miura T, Hiraguchi Y, Sugiyama T, Sugimoto M, Suzuki S, Natsume O, Kitazawa H, Yamaide A, Wada T, Nishima S. Japanese guidelines for childhood asthma 2020. Allergol Int 2020; 69:314-330. [PMID: 33213779 DOI: 10.1016/j.alit.2020.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/18/2020] [Indexed: 10/24/2022] Open
Abstract
The Japanese Guideline for Childhood Asthma (JGCA) 2020 is a translation of the Japanese Pediatric Guideline for the Treatment and Management of Asthma (JPGL) 2017 into English, which was published by the Japanese Society of Pediatric Allergy and Clinical Immunology. It makes recommendations for best practices in the management of childhood asthma, including management of acute exacerbations and non-pharmacological and pharmacological management. These guidelines will be of interest to non-specialist physicians involved in the care of children with asthma. In JPGL, JPGL2017 is the first evidence-based guidelines updated according to the GRADE system and Minds approach, and it addresses eight clinical questions about the treatment of childhood asthma. In children aged ≤5 years, infant and preschool asthma is diagnosed according to the response to short acting beta2 agonists or the effect of a therapeutic trial during 1 month with controller treatment and worsening after treatment cessation. Long-term management both promotes pharmacological therapy and measures against risk factors that induce exacerbation, better patient education and a partnership with trinity. In addition, long-term management should not be carried out without review but rather be based on a cycle of evaluation, adjustment and treatment. In JPGL2017, the transdermal patch and oral beta2 agonists are positioned as drugs within the concept of "short-term additional treatment" to be used until the symptoms are stabilized when the control state transiently deteriorates.
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Takaoka Y, Yajima Y, Ito YM, Kumon J, Muroya T, Tsurinaga Y, Shigekawa A, Takahashi S, Iba N, Tsuji T, Nishikido T, Yoshida Y, Doi S, Kameda M. Single-Center Noninferiority Randomized Trial on the Efficacy and Safety of Low- and High-Dose Rush Oral Milk Immunotherapy for Severe Milk Allergy. Int Arch Allergy Immunol 2020; 181:699-705. [DOI: 10.1159/000508627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022] Open
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Fukuda Y, Yamamoto S, Hatakeyama A, Nishida K, Kameda M. A Study of Dietary and BMI Changes Over Time in Mothers of Children with Food Allergies. J Nutr Sci Vitaminol (Tokyo) 2020; 66:119-127. [PMID: 32350173 DOI: 10.3177/jnsv.66.119] [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: 11/27/2022]
Abstract
Few follow-up surveys have been conducted with regard to the changes in diet of mothers of children with food allergy. We examined changes in food and BMI over time in the mothers of children with food allergies. A total of 146 mothers completed a diet survey twice, with the first conducted in 2013-2016 and the second in 2018, and the dietary changes were examined. Furthermore, among the 120 mothers who eliminated eggs from their diet in the first survey, 98 continued to eliminate eggs and 22 reintroduced eggs during the second survey, and the change over time was examined. Additionally, factors related to BMI were analyzed. We observed a change in the amount of egg intake over time within each group. As the number of children who consumed eggs as the causative food declined, the amount of eggs consumed by the concerned mothers significantly increased (median: 7.8 g/1,000 kcal→12.7 g/1,000 kcal) (p<0.01), even in children who continued to not consume eggs. We found a negative correlation between BMI in mothers of children with FA and vegetable protein. The mothers indicated that their awareness on food allergy improved, which we believe led to increased consumption of foods that had been restricted thus far. BMI was believed to be related to synchronization with the elimination-substitution diet.
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Affiliation(s)
- Yasuko Fukuda
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University
| | - Shumi Yamamoto
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University
| | - Asami Hatakeyama
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University
| | - Kyoko Nishida
- Department of Nutrition Management, Osaka Habikino Medical Center
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center
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Itazawa T, Adachi Y, Takahashi Y, Miura K, Uehara Y, Kameda M, Kitamura T, Kuzume K, Tezuka J, Ito K, Ebisawa M. The severity of reaction after food challenges depends on the indication: A prospective multicenter study. Pediatr Allergy Immunol 2020; 31:167-174. [PMID: 31628866 DOI: 10.1111/pai.13140] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 04/09/2019] [Revised: 09/17/2019] [Accepted: 10/14/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND There are expanding indications for oral food challenges (OFCs). Although several studies have examined the risk of OFCs, little has been reported on allergic reactions during OFCs depending on the indication. This study assessed the prevalence, severity, and treatment of allergic reactions depending on the indication for OFCs. METHODS We performed a prospective multicenter study between March 2012 and May 2013. Severity of symptoms elicited by OFCs was classified according to grading of anaphylaxis that ranges from grade 1 (most mild) to grade 5 (most severe). RESULTS A total of 5062 cases (median age, 3.8 years; males, 65.2%) were analyzed. Allergic reactions were elicited in 2258 (44.6%) OFCs, of which 991 (43.9%) were classified as grade 1, 736 (32.6%) were classified as grade 2, 340 (15.1%) were classified as grade 3, and 191 (8.5%) were classified as grade 4-5. Epinephrine was administered in 7.1% (n = 160) of positive OFCs. Among the top three most common food allergens (hen's egg, cow's milk, and wheat), severity differed significantly depending on the indication for OFC, and adjusted standardized residuals indicated that severity of allergic reactions was higher for the indication to assess threshold level for oral immunotherapy. In addition, the prevalence of epinephrine use was highest for the indication to determine safe intake quantity. CONCLUSIONS Our study suggested that prevalence, severity, and treatment of allergic reactions differ depending on the indication for OFC. Further studies are needed to determine differences in risks depending on the indication for OFC.
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Affiliation(s)
- Toshiko Itazawa
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yutaka Takahashi
- Department of Pediatrics, KKR Sapporo Medical Center, Sapporo, Japan
| | - Katsushi Miura
- Department of Allergy, Miyagi Children's Hospital, Sendai, Japan
| | - Yumiko Uehara
- Department of Pediatrics, Niigata City General Hospital, Niigata, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Habikino, Japan
| | - Tetsuro Kitamura
- Department of Pediatrics, Nippon Kokan Fukuyama Hospital, Fukuyama, Japan
| | - Kazuyo Kuzume
- Department of Pediatrics, Ehime Prefectural Niihama Hospital, Niihama, Japan
| | - Junichiro Tezuka
- Department of Pediatrics, National Hospital Organization Fukuoka-higashi Medical Center, Koga, Japan
| | - Komei Ito
- Department of Allergy, Aichi Children's Health and Medical Center, Obu, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
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Takemura Y, Takaoka Y, Arima T, Masumi H, Yamasaki K, Nagai M, Sugimoto K, Hamada M, Takano T, Doi M, Kawakami T, Kameda M. Association between fruit and vegetable allergies and pollen-food allergy syndrome in Japanese children: a multicenter cross-sectional case series. Asia Pac Allergy 2020; 10:e9. [PMID: 32099831 PMCID: PMC7016322 DOI: 10.5415/apallergy.2020.10.e9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/23/2020] [Indexed: 11/19/2022] Open
Abstract
Background Recently, the prevalence of food allergies during childhood is increasing, with fruits being common allergens. However, data on allergens that cause fruit and vegetable allergies and pollen-food allergy syndrome (PFAS) in childhood are relatively few. This study aimed to examine the allergens in fruit and vegetable allergies in pediatric patients and to determine the association between fruit and vegetable allergies and PFAS. Objective This study aimed to examine the current status of fruit and vegetable allergies in Japanese children. Methods This was a multicenter case series observational study. The participants included children aged <15 years who developed allergic symptoms after eating fruits and vegetables and subsequently received treatment in the Pediatric Department of 6 hospitals in the Osaka Prefecture in Japan during the study period from August 2016 to July 2017. Participants' information was obtained using a questionnaire, and data were obtained by performing several types of allergy tests using blood samples. Results A total of 97 children (median age, 9 years; 56 males) were included in the study. Apple was the most common allergen, followed by peach, kiwi, cantaloupe, and watermelon. A total of 74 participants (76%) exhibited allergic symptoms due to PFAS; moreover, pathogenesis-related protein-10 (PR-10) was the most common allergen superfamily. On the contrary, in the group where neither PR-10 nor profilin was sensitized, kiwi and banana were the most common allergens, and the age of onset was lower than that in the PFAS group. Specific antibody titer was significantly associated with Birch for Bet v1 and latex for Bet v2 (r = 0.99 and r = 0.89). Conclusion When we examine patients with fruit and vegetable allergies, we should first consider PFAS even in childhood specifically for children greater than 4 years old.
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Affiliation(s)
- Yutaka Takemura
- Departmant of Pediatrics, Kindai University Faculty of Medicine, Higashiosaka, Japan
| | - Yuri Takaoka
- Departmant of Pediatrics, Osaka Habikino Medical Center, Habikino, Japan
| | - Tomoyuki Arima
- Departmant of Pediatrics, Kindai University Faculty of Medicine, Higashiosaka, Japan
| | - Hiroki Masumi
- Departmant of Pediatrics, Kindai University Faculty of Medicine, Higashiosaka, Japan
| | - Koji Yamasaki
- Departmant of Pediatrics, Kindai University Faculty of Medicine, Higashiosaka, Japan
| | - Megumi Nagai
- Departmant of Pediatrics, Kindai University Faculty of Medicine, Higashiosaka, Japan
| | - Keisuke Sugimoto
- Departmant of Pediatrics, Kindai University Faculty of Medicine, Higashiosaka, Japan
| | - Masaaki Hamada
- Department of Pediatrics, Yao Municipal Hospital, Yao, Japan
| | - Tomoko Takano
- Departmant of Pediatrics, Osaka General Medical Center, Bandaihigashi, Japan
| | - Masaaki Doi
- Departmant of Pediatrics, Higashiosaka City Medical Center, Higashiosaka, Japan
| | | | - Makoto Kameda
- Departmant of Pediatrics, Osaka Habikino Medical Center, Habikino, Japan
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Fukuda Y, Yamamoto S, Kameda M. Association Between Lifestyle Characteristics and Body Mass Index of Mothers of Children With Allergic Diseases. J Clin Med Res 2019; 11:780-788. [PMID: 31803322 PMCID: PMC6879037 DOI: 10.14740/jocmr3976] [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] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/16/2019] [Indexed: 11/11/2022] Open
Abstract
Background For mothers of children with allergic diseases, the amount of physical activity involved in childcare increases owing to factors, such as the need for diet therapy and environmental improvements. Reportedly, the body mass index (BMI) of mothers of children with food allergies (FAs) is significantly lower than that of those of children without allergies (non-FA mothers). The aim of this study was to evaluate the characteristics of diet and physical activity in FA mothers and to clarify their effects on BMI. Methods To investigate the association between lifestyle characteristics and BMI in 69 mothers of children with FA, bronchial asthma and atopic dermatitis, their diets and physical activity pattern (using a three-axis accelerometer) were investigated; dietary and physical activity patterns (every hour) were extracted using principal component analysis, and multiple regression analyses were performed. Results Multiple regression analyses revealed a significant positive correlation (P = 0.037) between BMI and the third principal component of dietary patterns (positive correlation with cereals and negative correlation with sweets), a significant negative correlation (P = 0.004) between BMI and FA and the total daily duration of performing low- and moderate-intensity physical activity (P = 0.031) and a significant positive correlation (P = 0.008) between FA and the first principal component of physical activity expenditure patterns (patterns of ongoing physical activity throughout the day). In FA mothers (n = 51), a significant positive correlation (P = 0.042) was observed between the third principal component of dietary patterns and BMI. Conclusion Low BMI in FA mothers may be related to reduced cereal intake, increased sweets intake and prolonged and continuous low- and moderate-intensity physical activity.
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Affiliation(s)
- Yasuko Fukuda
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo Prefecture, 663-8558, Japan
| | - Shumi Yamamoto
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo Prefecture, 663-8558, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, 3-7-1, Habikino, Habikino, Osaka Prefecture, 583-8588, Japan
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22
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Fukuda Y, Kameda M. Assessment of the Correlation Between Mother and Child Body Mass Index and Mother and Child Diet in Children With Food Allergies. J Clin Med Res 2019; 11:703-710. [PMID: 31636785 PMCID: PMC6785275 DOI: 10.14740/jocmr3959] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/13/2019] [Indexed: 11/30/2022] Open
Abstract
Background Children with food allergies (FA children) tend to be smaller in size, mothers of FA children (FA mothers) tend to have a significantly lower body mass index (BMI) than those of non-FA children (N mothers), and FA mothers’ diets tend to be synchronous with the substitute diets for their children. The study aims to examine the correlation between the diets of FA children and FA mothers as well as the BMI of FA mothers. Methods In total, 41 pairs of FA children (age: 6.5 ± 2.5 years) and FA mothers (FA group) and 37 pairs of children without food allergies (N children, age: 7.0 ± 2.7 years) and N mothers (N group) were included. BMIs of mothers and children, nutrient intake adequacy, correlation of meal content between mothers and children, and sampling of the combined dietary patterns of mothers and children were compared and contrasted to identify factors that affected the BMIs of FA mothers. Results There were no differences in BMI between the two groups of children, confirming the typical growth of FA children. BMIs of FA mothers were significantly smaller than those of N mothers (P = 0.038). The intake adequacy of sweets was significantly higher in FA mothers than in N mothers (P = 0.041). The correlation of meal contents between mothers and children was significantly higher in the FA group than in the N group (P = 0.019). However, there was a discrepancy in the combined dietary patterns (first principal component) between mothers and children in the FA group. There was a significant negative correlation between the BMIs of FA mothers and responses to the use of substitute food (P = 0.016). Conclusions Low BMI in FA mothers may be related to substitute diets that differ from those of the FA children, consumption of sweets in dietary habits, and the use of substitute food.
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Affiliation(s)
- Yasuko Fukuda
- Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefecture Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino, Osaka 583-8588, Japan.,Osaka Habikino Medical Center, 3-7-1, Habikino, Habikino, Osaka 583-8588, Japan
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Takaoka Y, Maeta A, Takahashi K, M Ito Y, Takahashi S, Muroya T, Shigekawa A, Tsurinaga Y, Iba N, Yoshida Y, Kameda M, Doi S. Effectiveness and Safety of Double-Blind, Placebo-Controlled, Low-Dose Oral Immunotherapy with Low Allergen Egg-Containing Cookies for Severe Hen's Egg Allergy: A Single-Center Analysis. Int Arch Allergy Immunol 2019; 180:244-249. [PMID: 31578023 DOI: 10.1159/000502956] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 05/07/2019] [Accepted: 08/27/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The usefulness of low-dose oral immunotherapy (OIT) for the treatment of egg allergy has been unclear. OBJECTIVE To evaluate the efficacy and safety of OIT with low allergen cookies (LACs) containing a low dose of hen's egg. METHOD Thirty-three patients with severe hen's egg allergy were randomly administered either OIT with LACs (n = 21) or placebo (n = 12). Two patients in the LACs group withdrew before completing OIT. The primary endpoint was the number of good responders (G-R), patients with negative results in the oral food challenge (OFC) with a final dose of 2 g hard-boiled egg whites after 4 months of OIT, in each group. Total OFC Aichi score for anaphylaxis/cumulative protein dose (TS/Pro) as the marker of severity of food allergy was also compared. Adverse events during OIT were evaluated using patients' diaries. RESULTS The proportion of G-R in the LACs group was higher than in the placebo group (7/19 [37%] vs. 1/12 [8%], χ2 test; p = 0.077). The TS/Pro after OIT in the LACs group was lower than in the placebo group (median score, 44.2 vs. 104.1, p = 0.059; Mann-Whitney U test). The threshold and TS/Pro before and after OIT significantly improved in the LACs group (p = 0.015, p = 0.027, respectively; Wilcoxon signed-rank test). There were 99 recorded incidences of symptoms of 1,938 intake events in the LACs group during OIT. Of these, 90 were mild; no severe symptoms occurred. CONCLUSIONS OIT with LACs potentially increases the OFC threshold and decreases allergy severity and is a relatively safe treatment modality.
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Affiliation(s)
- Yuri Takaoka
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan,
| | - Akihiro Maeta
- Department of Food Science and Nutrition, School of Human Environmental Science, Mukogawa Women's University, Nishinomiya, Japan
| | - Kyoko Takahashi
- Department of Food Science and Nutrition, School of Human Environmental Science, Mukogawa Women's University, Nishinomiya, Japan
| | - Yoichi M Ito
- Department of Statistical Data Science, The Institute of Statistical Mathematics, Tachikawa, Japan
| | | | - Takahiro Muroya
- Department of Pediatrics, Suita Municipal Hospital, Suita, Japan
| | - Amane Shigekawa
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Yuki Tsurinaga
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Norihito Iba
- Department of Pediatrics, Arida Municipal Hospital, Arida, Japan
| | - Yukinori Yoshida
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
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Murayama N, Doi S, Kameda M. 10-Year Follow-Up of Frequently Relapsed Chronic Eosinophilic Pneumonia Starting at 15 Years Old; Attempts to Treat with Inhaled Corticosteroid (A Case Report). Am J Case Rep 2019; 20:822-827. [PMID: 31182706 PMCID: PMC6581014 DOI: 10.12659/ajcr.915402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patient: Female, 15 Final Diagnosis: Eosinophilic pneumonia Symptoms: Fever up • chest pain • general fatigue • dry cough Medication: Budesonide • Fulticasone Clinical Procedure: Inhaled steroids • systemic steroid Specialty: Immunology
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Affiliation(s)
- Norihide Murayama
- Department of Pediatrics, Murayama Pediatrics, Osaka City, Osaka, Japan
| | - Satoru Doi
- Department of Education, Shitennouji University, Osaka City, Osaka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka City, Osaka, Japan
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Murayama N, Doi S, Inoue T, Takamatsu I, Kameda M, Takeda K, Toyoshima K. Inhaled steroid inhibits development of total and mite IgE. Immunol Med 2018; 41:17-22. [PMID: 30938257 DOI: 10.1080/09114300.2018.1451599] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Serum levels of total immunoglobulin E (IgE) and allergen-specific IgE are related to asthma severity and risk factors for persistent asthma in childhood wheezing. Inhaled corticosteroids (ICS) have been the most effective therapy in children with asthma, as well as in adults. The serum levels of total and mite specific IgE in children with asthma and the effects on IgE levels of beclomethasone dipropionate (BDP) treatment on IgE levels in asthmatic children were investigated. First, a cross-sectional study of 255 children with asthma was carried out to measure IgE levels. Children under three years of age with asthma who were negative for Df-specific IgE were then treated with BDP or disodium cromoglycate (DSCG) as controls for one year. Serum IgE levels, numbers of eosinophils in peripheral blood and clinical variables were determined before and after treatment. After one-year DSCG treatment, the total IgE levels increased significantly, whereas the levels remained the same during BDP treatment. Five of 22 (23%) patients in the DSCG-treated group became positive for Df-specific IgE; however, only one of 13 (8%) in the BDP-treated group became positive. Taken together, ICS therapy may modulate the levels of total IgE and allergen-specific IgE.
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Affiliation(s)
- Norihide Murayama
- a Department of Pediatrics , Osaka Prefectural Medical Center for Respiratory and Allergy Diseases , Habikino , Japan.,b Department of Pediatrics , Murayama Pediatrics , Osaka , Japan
| | - Satoru Doi
- a Department of Pediatrics , Osaka Prefectural Medical Center for Respiratory and Allergy Diseases , Habikino , Japan
| | | | - Isamu Takamatsu
- a Department of Pediatrics , Osaka Prefectural Medical Center for Respiratory and Allergy Diseases , Habikino , Japan
| | - Makoto Kameda
- a Department of Pediatrics , Osaka Prefectural Medical Center for Respiratory and Allergy Diseases , Habikino , Japan
| | - Katsuyuki Takeda
- d Department of Pediatrics , National Jewish Medical and Research Center , Denver , CO , USA
| | - Kyoichiro Toyoshima
- a Department of Pediatrics , Osaka Prefectural Medical Center for Respiratory and Allergy Diseases , Habikino , Japan
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Itoh-Nagato N, Inoue Y, Nagao M, Fujisawa T, Shimojo N, Iwata T, Adachi Y, Arakawa K, Arima T, Fukushima K, Hoshioka A, Igarashi T, Itazawa T, Itoh K, Kameda M, Kando N, Kato I, Kitabayashi T, Kobayashi T, Koyama H, Morita Y, Nakano T, Suzuki S, Takaoka Y, Tomiita M, Yagi H, Yajima Y, Yamaide A, Yasui M, Yoshihara S. Desensitization to a whole egg by rush oral immunotherapy improves the quality of life of guardians: A multicenter, randomized, parallel-group, delayed-start design study. Allergol Int 2018; 67:209-216. [PMID: 28778455 DOI: 10.1016/j.alit.2017.07.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/29/2017] [Accepted: 07/04/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Patients with food allergies and their families have a significantly reduced health-related quality of life (QOL). METHODS We performed a multicenter, randomized, parallel-group, delayed-start design study to clarify the efficacy and safety of rush oral immunotherapy (rOIT) and its impact on the participants' daily life and their guardians (UMIN000003943). Forty-five participants were randomly divided into an early-start group and a late-start group. The early-start group received rOIT for 3 months, while the late-start group continued the egg elimination diet (control). In the next stage, both groups received OIT until all participants had finished 12 months of maintenance OIT. RESULTS The ratio of the participants in whom an increase of the TD was achieved in the first stage was significantly higher in the early-start group (87.0%), than in the late-start group (22.7%). The QOL of the guardians in the early-start group significantly improved after the first stage (65.2%), in comparison to the late-start group (31.8%). During 12 months of rOIT, the serum ovomucoid-specific IgE levels, the percentage of CD203c+ basophils upon stimulation with egg white, and the wheal size to egg white were decreased, while the serum ovomucoid-specific IgG4 levels were increased. However, approximately 80% of the participants in the early-start group showed an allergic reaction during the first stage of the study, whereas none of the patients in the late-start group experienced an allergic reaction. CONCLUSIONS rOIT induced desensitization to egg and thus improved the QOL of guardians; however, the participants experienced frequent allergic reactions due to the treatment.
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Maeta A, Matsushima M, Muraki N, Asano M, Takaoka Y, Kameda M, Takahashi K. Low-Dose Oral Immunotherapy Using Low-Egg-Allergen Cookies for Severe Egg-Allergic Children Reduces Allergy Severity and Affects Allergen-Specific Antibodies in Serum. Int Arch Allergy Immunol 2018; 175:70-76. [DOI: 10.1159/000485891] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 11/29/2017] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> We evaluated the safety and efficacy of low-egg-allergen cookies (LAC) as low-dose oral immunotherapy (OIT) in children with severe egg allergy. We also examined the relationship between mild desensitization by low-dose OIT and serum biomarkers of allergy. <b><i>Methods:</i></b> We enrolled 13 children with egg allergy who could not receive OIT with hard-boiled egg white (EW). For 11 participants, OIT was carried out using LAC for 3-4 months. Open food challenges with hard-boiled EW and blood samplings were performed before and after OIT. Participants were divided into 2 groups: high effect (H-E) and no/low effect (N/L-E). Serum levels of total IgE and egg yolk-, EW-, and ovomucoid (OM)-specific IgE, ovalbumin (OVA)- and OM-specific IgG<sub>4</sub>, IgA<sub>1</sub>, and IgA<sub>2</sub>, and the percentage of CD 203c<sup>+</sup> were measured. <b><i>Results:</i></b> Allergic severity was reduced in 7 patients, who were assigned to the H-E group. Moreover, no study participants were taken off the intake of LAC during OIT. In the H-E group, OVA-specific IgA<sub>2</sub> levels after OIT were significantly higher than before OIT. The ratios of OM-specific IgG<sub>4</sub>/OM-specific IgE and OM-specific IgA<sub>2</sub>/OM-specific IgE in the H-E group after OIT were significantly higher than before OIT. <b><i>Conclusion:</i></b> Our findings suggest that low-dose OIT using LAC is an effective and safe treatment for patients with severe egg allergy.
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Kameda M, Ichihara M, Maruyama S, Kurokawa N, Aoki Y, Okumura S, Uesugi K. Advancement of magma fragmentation by inhomogeneous bubble distribution. Sci Rep 2017; 7:16755. [PMID: 29196692 PMCID: PMC5711883 DOI: 10.1038/s41598-017-16941-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/17/2017] [Indexed: 11/09/2022] Open
Abstract
Decompression times reported in previous studies suggest that thoroughly brittle fragmentation is unlikely in actual explosive volcanic eruptions. What occurs in practice is brittle-like fragmentation, which is defined as the solid-like fracture of a material whose bulk rheological properties are close to those of a fluid. Through laboratory experiments and numerical simulation, the link between the inhomogeneous structure of bubbles and the development of cracks that may lead to brittle-like fragmentation was clearly demonstrated here. A rapid decompression test was conducted to simulate the fragmentation of a specimen whose pore morphology was revealed by X-ray microtomography. The dynamic response during decompression was observed by high-speed photography. Large variation was observed in the responses of the specimens even among specimens with equal bulk rheological properties. The stress fields of the specimens under decompression computed by finite element analysis shows that the presence of satellite bubbles beneath a large bubble induced the stress concentration. On the basis of the obtained results, a new mechanism for brittle-like fragmentation is proposed. In the proposed scenario, the second nucleation of bubbles near the fragmentation surface is an essential process for the advancement of fragmentation in an upward magma flow in a volcanic conduit.
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Affiliation(s)
- M Kameda
- Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology, Koganei, Tokyo, 184-8588, Japan.
| | - M Ichihara
- Earthquake Research Institute, University of Tokyo, Bunkyo-ku, Tokyo, 113-0032, Japan
| | - S Maruyama
- Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology, Koganei, Tokyo, 184-8588, Japan
| | - N Kurokawa
- Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology, Koganei, Tokyo, 184-8588, Japan
| | - Y Aoki
- Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology, Koganei, Tokyo, 184-8588, Japan
| | - S Okumura
- Department of Earth Science, Tohoku University, Sendai, Miyagi, 980-8578, Japan
| | - K Uesugi
- Japan Synchrotron Radiation Research Institute, Sayo-cho, Hyogo, 679-5198, Japan
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Sagara H, Tanaka A, Ohta S, Jinno E, Uchida N, Sambe T, Hida N, Suehiro Y, Doi S, Kameda M, Yoshida Y, Fukuoka J, Kinoshita Y. [The Safety and efficacy of airway-hyperresponsiveness test for asthma using by SK-1211 (Methacholine Chloride)]. Arerugi 2016; 65:32-40. [PMID: 26923652 DOI: 10.15036/arerugi.65.32] [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: 11/17/2022]
Abstract
BACKGROUND In abroad, Methacholine Chloride (Provocholine®) is used to meet the indications of the diagnosis of bronchial airway hyperreactivity in subjects who do not have clinically apparent asthma. We examined efficacy, safety and pharmacokinetics of Methacholine Chloride (name of study drug: SK-1211) in order to get approved for the airway hyperresponsiveness test in Japan. METHODS Fifteen adult healthy volunteers, fifteen adult patients with asthma and ten pediatric patients with asthma were enrolled in this study. The airway hyperresponsiveness test with SK-1211 was conducted in accordance with Japanese Society of Allergology Standard Method. RESULTS When the threshold value of PC20 was 8 mg/mL, the sensitivity of adult patients with asthma was 66.7% (10/15 subjects) and the specificity of adult healthy volunteers was 86.7% (13/15 subjects). The sensitivity of pediatric patients with asthma was 70.0% (7/10 subjects). Not all subjects experienced some adverse reactions during inhalation of SK-1211, all of which were mild in severity and resolved soon with inhalation of a bronchodilator. There were no serious adverse reactions reported. CONCLUSION The airway hyperresponsiveness test with SK-1211 was no specific concern with safety and useful in the diagnosis of bronchial airway hyperresponsiveness.
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Affiliation(s)
- Hironori Sagara
- Department of Medicine, Division of Allergology and Respiratory Medicine, Showa University School of Medicine
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30
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Takaoka Y, Kameda M, Yajima Y, Tsuji T, Nishikido T, Yoshida Y, Doi S. [THE COMPARISON OF EFFECTIVENESS OF SLOW SPECIFIC ORAL IMMUNOTHERAPY FOR WHEAT ALLERGY USING TWO DIFFERENT INTAKE FREQUENCY]. Arerugi 2016; 65:1009-1017. [PMID: 27616175 DOI: 10.15036/arerugi.65.1009] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE We performed a constructive study on the effectiveness of oral immunotherapy for wheat allergy using two different intake frequency, and evaluated the impact of intake frequency. SUBJECTS Of all the subjects who had a positive result in an oral food challenge test for udon (wheat noodles), informed consent was obtained from 49 subjects. Forty-one of the subjects successfully completed testing; data was tabulated for only the 16 in each group who complied with their assigned intake frequency. METHOD Oral immunotherapy was administered after randomly dividing the subjects into the following two groups according to intake frequency: the frequent group, whose intake was six times/week or more; and the intermittent group, whose intake was two times/week. The ability of these patients to ingest the noodles at the target dose was evaluated after 6 months. RESULTS After six months, the proportion of subjects who had a negative result on testing with the target dose (20g dried noodle weight for subjects ≤3 years of age, and 50g dried noodle weight for those ≥4 years of age) or who were capable of the target intake within six months was 75%, and there was no difference among the both groups. CONCLUSION The findings suggest that even when intake frequency is reduced to twice/week, no clear difference is seen with the target dose after six months of immunotherapy.
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Affiliation(s)
- Yuri Takaoka
- Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
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31
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Sato K, Sato Y, Nagao M, Shimojo N, Yoshihara S, Adachi Y, Kameda M, Terada A, Fujisawa T. Development and validation of asthma questionnaire for assessing and achieving best control in preschool-age children. Pediatr Allergy Immunol 2016; 27:307-12. [PMID: 26659837 DOI: 10.1111/pai.12523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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] [Accepted: 12/06/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Several patient-/caregiver-completed questionnaires have been utilized for the assessment of asthma control. However, due to the diversity in medical/social circumstances, they may not be optimal for use in all countries. The Japanese pediatric asthma guideline (JPGL) aims at higher levels of control compared with other international guidelines, based on a strong social demand for best care. We developed a new control test to help meet that demand. METHODS A 34-item working questionnaire was developed based on input from pediatric asthma specialists and the caregivers of preschool children with asthma. The questionnaire was administered to caregivers of 565 patients aged <6 years who had physician-diagnosed asthma or β2-agonist-responsive recurrent wheeze. Then, 6 questions for assessing JPGL-defined control levels were selected from the 34 questions by stepwise logistic regression methods using randomly selected questionnaires completed by two-thirds of the caregivers. We named that set of questions the Best Asthma Control Test for Preschoolers (Best ACT-P). Validation of Best ACT-P was performed using the remaining completed questionnaires. RESULTS The 6 questions asked about the frequency/severity of cold-induced wheeze, nighttime awakening, exercise-induced symptoms, and disruption of family life due to asthma in the past 4 weeks and hospitalization in the past 12 months. The 6-item logistic model showed good statistical fit, and the scores for the physicians' ratings of the asthma control differed significantly in the hypothetical direction. CONCLUSIONS Best ACT-P is a valid caregiver-completed questionnaire of asthma control in preschoolers in whom total control needs to be achieved.
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Affiliation(s)
- Kazuki Sato
- Department of Pediatrics, Shimoshizu National Hospital, Yotsukaido, Japan
| | - Yasunori Sato
- Clinical Research Center, Chiba University, Chiba, Japan
| | - Mizuho Nagao
- Allergy Center, Mie National Hospital, Tsu, Japan
| | - Naoki Shimojo
- Department of Pediatrics, University of Chiba Graduate School of Medicine, Chiba, Japan
| | - Shigemi Yoshihara
- Department of Pediatrics, Dokkyo Medical University, Utsunomiya, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Toyama University Graduate School of Medicine, Toyama, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan
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32
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Hamasaki Y, Kohno Y, Ebisawa M, Kondo N, Nishima S, Nishimuta T, Morikawa A, Aihara Y, Akasawa A, Adachi Y, Arakawa H, Ikebe T, Ichikawa K, Inoue T, Iwata T, Urisu A, Ohya Y, Okada K, Odajima H, Katsunuma T, Kameda M, Kurihara K, Sakamoto T, Shimojo N, Suehiro Y, Tokuyama K, Nambu M, Fujisawa T, Matsui T, Matsubara T, Mayumi M, Mochizuki H, Yamaguchi K, Yoshihara S. Japanese pediatric guideline for the treatment and management of bronchial asthma 2012. Pediatr Int 2014; 56:441-50. [PMID: 25252046 DOI: 10.1111/ped.12389] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 03/19/2014] [Accepted: 05/01/2014] [Indexed: 11/30/2022]
Abstract
A new version of the Japanese pediatric guideline for the treatment and management of bronchial asthma was published in Japanese at the end of 2011. The guideline sets the pragmatic goal for clinicians treating childhood asthma as maintaining a "well-controlled level" for an extended period in which the child patient can lead a trouble-free daily life, not forgetting the ultimate goal of obtaining remission and/or cure. Important factors in the attainment of the pragmatic goal are: (i) appropriate use of anti-inflammatory drugs; (ii) elimination of environmental risk factors; and (iii) educational and enlightening activities for the patient and caregivers regarding adequate asthma management in daily life. The well-controlled level refers to a symptom-free state in which no transient coughs, wheezing, dyspnea or other symptoms associated with bronchial asthma are present, even for a short period of time. As was the case in the previous versions of the guideline, asthmatic children younger than 2 years of age are defined as infantile asthma patients. Special attention is paid to these patients in the new guideline: they often have rapid exacerbation and easily present chronic asthmatic conditions after the disease is established.
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Affiliation(s)
- Yuhei Hamasaki
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan; Japanese Society of Pediatric Allergy and Clinical Immunology, Gifu, Japan
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33
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Kiyota K, Fujiwara Y, Adachi K, Kameda M, Akutsu K, Kajimura K. [Allergy due to probable contamination of bread used for school meals with milk]. Arerugi 2014; 63:787-793. [PMID: 24953738] [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] [Received: 10/25/2013] [Accepted: 04/14/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND In May 2012, two schoolchildren developed allergic symptoms after eating a school meal of fried bread in Osaka, Japan. One specific raw material, milk, should not be present in fried bread. However, we suspected the unintentional mixing of milk in the bread manufacturing process. Our aim was to verify the reason if this was so. METHODS We first manufactured bread that contained milk as one of its components. We then thoroughly cleaned the manufacturing line except for the dough divider and, as per the revised instruction manual, continuously manufactured bread that did not contain milk. In this manner, we tried to simulate the conditions at the time of the incident. Casein is a major milk protein. We, therefore, determined casein concentration in the milk-free bread, using casein enzyme-linked immunosorbent assay. RESULTS We observed casein levels higher than 1000 ppm in the initial lots of breads, but lower levels in the later lots. Casein levels also decreased upon frying of bread. CONCLUSION High casein levels, which were observed in the earlier lots of breads, were lower in the later lots. In the manufacturing line, the remnants of the bread dough that contained milk presumably got mixed with the dough used in the subsequent manufacture of milk-free bread.
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Affiliation(s)
- Kyohei Kiyota
- Division of Food Chemistry, Osaka Prefectural Institute of Public Health
| | - Yuka Fujiwara
- Central Region Block, Osaka Prefectural Council of Food Sanitation Inspectors
| | - Kazuto Adachi
- Central Region Block, Osaka Prefectural Council of Food Sanitation Inspectors
| | - Makoto Kameda
- Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
| | - Kazuhiko Akutsu
- Division of Food Chemistry, Osaka Prefectural Institute of Public Health
| | - Keiji Kajimura
- Division of Food Chemistry, Osaka Prefectural Institute of Public Health
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34
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Nakano T, Shimojo N, Okamoto Y, Ebisawa M, Kurihara K, Hoshioka A, Yamaguchi K, Ito K, Fujisawa T, Kameda M, Suehiro Y, Ogura H, Shibata R, Suzuki S, Takahashi Y, Ikeda M, Kohno Y. The use of complementary and alternative medicine by pediatric food-allergic patients in Japan. Int Arch Allergy Immunol 2012; 159:410-5. [PMID: 22846790 DOI: 10.1159/000338936] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 04/18/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In developed countries, increasing food allergy prevalence and concern regarding food allergies have been reported. Although the use of complementary and alternative medicine (CAM) for the treatment of allergic diseases has increased in some Western countries, the actual proportion and patterns of CAM use for pediatric food allergies in Japan are still unknown. METHODS Fourteen allergy centers in Japan participated in the study using a questionnaire survey regarding the use of CAM by pediatric patients. A diagnosis of food allergy was made at each hospital by pediatric allergists. RESULTS Surveys were completed by parents/guardians, and data were collected for a total of 962 pediatric food-allergic patients. Overall, 8.4% of the participants used CAM to treat a food allergy. The major CAM therapies used were herbal teas (22.2%), including several Japanese herbal teas, Chinese herbal medicine (18.5%) and lactic acid bacteria (16%). Among the participants using CAM to treat food allergy, 13.6% thought that the CAM being used was very effective, while 11.1% of participants thought that CAM caused some type of side effect. CONCLUSIONS Our study is the first large-scale national survey regarding the use of CAM in pediatric patients with food allergies in Japan. Unlike in the USA, which has a higher rate of CAM use (17%), approximately 8.4% of food-allergic patients used CAM in Japan. Interestingly, the major types of CAM used in Japan differed from those used in the USA. Cultural differences and food customs may affect the use of CAM.
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Affiliation(s)
- Taiji Nakano
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba City, Japan.
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35
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Lemaire C, Gillet S, Ooi T, Kameda M, Takeuchi M, Maruoka K, Plenevaux A, Luxen A. Enantioselective synthesis of 2-[18F]fluoro-L-tyrosine by catalytic phase-transfer alkylation. J Labelled Comp Radiopharm 2012. [DOI: 10.1002/jlcr.25804401301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
The recent discovery of a large latent population of precursor cells in the dentate gyrus of adult mice led us to investigate whether activation of this population is regulated by synaptic activity, thereby explaining the observation that environmental signals can affect neurogenesis. Using a variety of stimulation protocols, we found that only a long-term potentiation (LTP)-inducing protocol activated the latent precursor pool, leading to increased neurogenesis in the dentate gyrus. LTP induced by high-frequency stimulation (HFS) of the perforant pathway in vivo produced a two-fold increase in the number of neurospheres cultured from the stimulated hippocampus, compared with the unstimulated hippocampus. No increase in neurosphere number or neurogenesis was observed when the HFS failed to induce LTP. These results show that LTP can activate latent neural precursor cells in the adult mouse dentate gyrus, thereby providing a direct mechanism for regulating activity-driven neurogenesis. In the future, it may be possible to utilize such learning- or stimulation-induced neurogenesis to overcome disorders characterized by neuronal loss.
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Affiliation(s)
- M Kameda
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - C J Taylor
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - T L Walker
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - D M Black
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - W C Abraham
- Department of Psychology and the Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - P F Bartlett
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia,Queensland Brain Institute, The University of Queensland, Brisbane, Queensland 4072, Australia. E-mail:
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37
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Wang F, Kameda M, Yasuhara T, Tajiri N, Kikuchi Y, Liang HB, Tayra JT, Shinko A, Wakamori T, Agari T, Date I. GDNF-pretreatment enhances the survival of neural stem cells following transplantation in a rat model of Parkinson's disease. Neurosci Res 2011; 71:92-8. [PMID: 21699926 DOI: 10.1016/j.neures.2011.05.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 05/25/2011] [Accepted: 05/26/2011] [Indexed: 12/21/2022]
Abstract
Cell transplantation has been shown to be an effective therapy for central nervous system disorders in animal models. Improving the efficacy of cell transplantation depends critically on improving grafted cell survival. We investigated whether glial cell line-derived neurotrophic factor (GDNF)-pretreatment of neural stem cells (NSCs) enhanced grafted cell survival in a rat model of Parkinson's disease (PD). We first examined the neuroprotective effects of GDNF on oxygen-glucose deprivation (OGD) in NSCs. Cells were pretreated with GDNF for 3 days before subjecting them to OGD. After 12h of OGD, GDNF-pretreated NSCs showed significant increases in survival rates compared with PBS-pretreated NSCs. An apoptosis assay showed that the number of apoptotic cells was significantly decreased in GDNF-pretreated NSCs at 1h and 6h after OGD. A PD rat model was then established by unilateral injection of 6-hydroxydopamine (6-OHDA, 9μg) into the medial forebrain bundle. Two weeks after 6-OHDA injection, GDNF-pretreated NSCs, PBS-pretreated NSCs, or PBS were injected into PD rat striatum. The survival of grafted cells in the striatum was significantly increased in the GDNF-pretreated NSC group compared with the control groups. GDNF pretreatment increased survival of NSCs following transplantation, at least partly through suppression of cell apoptosis.
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Affiliation(s)
- F Wang
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
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38
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Nakano S, Wakisaka K, Kameda M, Isomura M, Matsuyama T, Nakamura N, Tsuda S, Ohnishi M, Kuwano Y. High-Quality A-Si Films Prepared by the Direct Photo-Cvd Method. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-149-417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTA high-efficiency integrated-type a-Si solar cell submodule with a size of 10cm × 10cm has been fabricated and a total area efficiency of 9.6% is obtained by using a high-quality p-layer doped with B(CH3)3 We have developed an advanced direct photo-CVD method. High-quallt” a-SI films with low tail characteristic energy and low light-induced degradation is prepared by this method. We have also studied the role of Si-H2 bonds on the light-induced effect. The result implies that Si-H bonds stabilize the defect states, resulting in a large light-induced degradation.
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Harada M, Hirota T, Jodo AI, Hitomi Y, Sakashita M, Tsunoda T, Miyagawa T, Doi S, Kameda M, Fujita K, Miyatake A, Enomoto T, Noguchi E, Masuko H, Sakamoto T, Hizawa N, Suzuki Y, Yoshihara S, Adachi M, Ebisawa M, Saito H, Matsumoto K, Nakajima T, Mathias RA, Rafaels N, Barnes KC, Himes BE, Duan QL, Tantisira KG, Weiss ST, Nakamura Y, Ziegler SF, Tamari M. Thymic stromal lymphopoietin gene promoter polymorphisms are associated with susceptibility to bronchial asthma. Am J Respir Cell Mol Biol 2010; 44:787-93. [PMID: 20656951 DOI: 10.1165/rcmb.2009-0418oc] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Thymic stromal lymphopoietin (TSLP) triggers dendritic cell--mediated T helper (Th) 2 inflammatory responses. A single-nucleotide polymorphism (SNP), rs3806933, in the promoter region of the TSLP gene creates a binding site for the transcription factor activating protein (AP)-1. The variant enhances AP-1 binding to the regulatory element, and increases the promoter--reporter activity of TSLP in response to polyinosinic-polycytidylic acid (poly[I:C]) stimulation in normal human bronchial epithelium (NHBE). We investigated whether polymorphisms including the SNP rs3806933 could affect the susceptibility to and clinical phenotypes of bronchial asthma. We selected three representative (i.e., Tag) SNPs and conducted association studies of the TSLP gene, using two independent populations (639 patients with childhood atopic asthma and 838 control subjects, and 641 patients with adult asthma and 376 control subjects, respectively). We further examined the effects of corticosteroids and a long-acting β(2)-agonist (salmeterol) on the expression levels of the TSLP gene in response to poly(I:C) in NHBE. We found that the promoter polymorphisms rs3806933 and rs2289276 were significantly associated with disease susceptibility in both childhood atopic and adult asthma. The functional SNP rs3806933 was associated with asthma (meta-analysis, P = 0.000056; odds ratio, 1.29; 95% confidence interval, 1.14-1.47). A genotype of rs2289278 was correlated with pulmonary function. Moreover, the induction of TSLP mRNA and protein expression induced by poly(I:C) in NHBE was synergistically impaired by a corticosteroid and salmeterol. TSLP variants are significantly associated with bronchial asthma and pulmonary function. Thus, TSLP may serve as a therapeutic target molecule for combination therapy.
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Affiliation(s)
- Michishige Harada
- Laboratory for Respiratory Diseases, Center for Genomic Medicine, Institute of Physical and Chemical Research, Kanagawa, Japan
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Kondo N, Nishimuta T, Nishima S, Morikawa A, Aihara Y, Akasaka T, Akasawa A, Adachi Y, Arakawa H, Ikarashi T, Ikebe T, Inoue T, Iwata T, Urisu A, Ebisawa M, Ohya Y, Okada K, Odajima H, Katsunuma T, Kameda M, Kurihara K, Kohno Y, Sakamoto T, Shimojo N, Suehiro Y, Tokuyama K, Nambu M, Hamasaki Y, Fujisawa T, Matsui T, Matsubara T, Mayumi M, Mukoyama T, Mochizuki H, Yamaguchi K, Yoshihara S. Japanese pediatric guidelines for the treatment and management of bronchial asthma 2008. Pediatr Int 2010; 52:319-26. [PMID: 19968817 DOI: 10.1111/j.1442-200x.2009.03010.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [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: 11/29/2022]
Abstract
Abstract The fourth version of the Japanese Pediatric Guidelines for the Treatment and Management of Bronchial Asthma 2008 (JPGL 2008) was published by the Japanese Society of Pediatric Allergy and Clinical Immunology in December 2008. In JPGL 2008, the recommendations were revised on the basis of the JPGL 2005. The JPGL 2008 is different to the Global Initiative for Asthma guideline in that it contains the following items: a classification system of asthma severity; recommendations for long-term management organized by age; a special mention of infantile asthma; and an emphasis on prevention and early intervention. Here we show a summary of the JPGL 2008 revising our previous report concerning JPGL 2005.
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Affiliation(s)
- Naomi Kondo
- Department of Pediatrics, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
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Kameda M. [Bronchial asthma in children]. Arerugi 2010; 59:6-12. [PMID: 20139687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases.
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Yoshida Y, Kameda M, Nishikido T, Takamatsu I, Matsumoto T, Doi S. Very short gastroesophageal acid reflux during the upright position could be associated with asthma in children. Allergol Int 2009; 58:395-401. [PMID: 19542763 DOI: 10.2332/allergolint.08-oa-0083] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 03/02/2009] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is diagnosed by the reflux index of 24-hour pH monitoring (pH monitoring). In our previous study, GER episodes during the upright position were more frequent than those during the supine position in asthmatic children. In this study, we investigated the clinical usefulness of the mean hourly number of acid refluxes, designated as the mean number of acid refluxes/hour (h) during the upright position in addition to the pH index for the diagnosis of GERD. METHODS The subjects were 22 preschool asthmatic children. When the reflux index was over 4% or the mean number of acid refluxes/h during the upright position were three times more frequent than those during the supine position even if the reflux index was below 4%, we prescribed famotidine. Children whose asthmatic symptoms improved with famotidine were included in a GERD group. Children who did not meet the criteria by pH monitoring were included in a non-GERD group in asthmatic children. RESULTS The GERD group was comprised of 9 children. In 2 out of 9 GERD group children, the reflux index was below 4%. The median of the mean number of acid refluxes/h during the upright position was 12.9 in the GERD group, and 3.15 in the non-GERD group. The mean number of acid refluxes/h during the upright position were associated with asthmatic symptoms (p < 0.05). CONCLUSIONS Reflux during the upright position was associated with asthmatic symptoms. The mean number of acid refluxes/h during the upright position in addition to the reflux index could be useful in the diagnosis of GERD when associated with asthma.
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Affiliation(s)
- Yukinori Yoshida
- Department of Pediatrics, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Osaka, Japan.
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Harada M, Hirota T, Jodo AI, Doi S, Kameda M, Fujita K, Miyatake A, Enomoto T, Noguchi E, Yoshihara S, Ebisawa M, Saito H, Matsumoto K, Nakamura Y, Ziegler SF, Tamari M. Functional Analysis of the Thymic Stromal Lymphopoietin Variants in Human Bronchial Epithelial Cells. Am J Respir Cell Mol Biol 2009; 40:368-74. [DOI: 10.1165/rcmb.2008-0041oc] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Inoue H, Mashimo Y, Funamizu M, Shimojo N, Hasegawa K, Hirota T, Doi S, Kameda M, Miyatake A, Kohno Y, Okamoto Y, Tamari M, Hata A, Suzuki Y. Association study of the C3 gene with adult and childhood asthma. J Hum Genet 2008; 53:728-738. [PMID: 18566738 DOI: 10.1007/s10038-008-0304-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 05/16/2008] [Indexed: 01/25/2023]
Abstract
Bronchial asthma (BA) is a multifactorial disorder, the development of which is affected by both environmental and genetic factors. The complement system plays an important role in immunological response against invading microorganisms. It has been shown that complement-C3-deficient mice have reduced inflammation of asthmatic airways. Previously, we reported the association of four single nuclear proteins (SNPs) in the exons of the C3 gene with childhood and adult BA. The C3 gene, however, is a large gene, and functional SNPs associated with susceptibility to BA have not yet been identified. We analyzed 26 SNPs in the C3 gene and its promoter region to narrow down the regions showing association with childhood and adult BA. Childhood and adult atopic BA patients and healthy child and adult controls were recruited from urban cities in Japan and genotyped. In SNP analysis, an SNP (SNP24, rs11569562) located in intron 31 of the C3 gene was associated with adult BA [corrected P (Pcor) = 0.030]. In linkage disequilibrium (LD) block 4 spanning exons 24-41, the frequency of the CCC haplotype in adult BA was significantly higher than that in adult controls (Pcor = 0.038). Neither the SNP nor the haplotype showing association with adult BA demonstrated a significant association with serum total immunoglobulin E (IgE) level in BA patients and controls. Our results suggest that LD block 4 confers susceptibility to adult BA with mechanisms relevant to the effector phase of allergic inflammation.
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Affiliation(s)
- Hiroki Inoue
- Department of Public Health, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Yoichi Mashimo
- Department of Public Health, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Makiko Funamizu
- Department of Public Health, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Naoki Shimojo
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koichi Hasegawa
- Laboratory for Genetics of Allergic Diseases, SNP Research Center, The Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - Tomomitsu Hirota
- Laboratory for Genetics of Allergic Diseases, SNP Research Center, The Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - Satoru Doi
- Department of Pediatrics, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan
| | | | - Yoichi Kohno
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshitaka Okamoto
- Department of Otolaryngology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Mayumi Tamari
- Laboratory for Genetics of Allergic Diseases, SNP Research Center, The Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - Akira Hata
- Department of Public Health, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Yoichi Suzuki
- Department of Public Health, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
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Yoshida Y, Kameda M, Nishikido T, Takamatu I, Doi S. [Gastroesophageal reflux disease in preschool children with asthma]. Arerugi 2008; 57:529-535. [PMID: 18520174] [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] [Received: 05/30/2007] [Accepted: 01/15/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND In pediatric intractable asthma, there is occasionally an association with GERD (gastroesophageal reflux disease). It is not clear in which cases GERD should be suspected or how effective the GERD therapy is in treating the asthma. METHODS Twenty-seven preschool children (<6 years of age) suffering from recurrent asthma attack in spite of asthma therapy underwent 24-hour esophageal pH monitoring. We examined retrospectively the incidence of GERD and the effectiveness of famotidine in GERD positive patients. RESULTS 18 of the 27 patients (66.7%) had positive results (GERD positive group). In 12 of the 15 patients (80%) who underwent GERD therapy (famotidine), respiratory symptoms were decreased. In the GERD positive group, the incidence of acid reflux during waking hours was more frequent than during sleeping hours. In 8 of 12 patients (66.7%) in whom famotidine was effective, cough and wheeze often occurred during the daytime and corresponded with the time when acid reflux must commonly occurred. CONCLUSION We conclude that children suffering from recurrent asthma attack in spite of asthma therapy must be examined for the presence of GERD.
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Affiliation(s)
- Yukinori Yoshida
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Disease. ,osaka.jp
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Yoshida Y, Inoue T, Nishikido T, Kameda M, Takamatu I, Doi S. [Influence of changing from chlorofluorocarbon (CFC)-beclomethasone dipropionate (BDP) to hydrofluoroalkane (HFA)-BDP on pulmonary function in asthmatic children]. Arerugi 2007; 56:1502-1509. [PMID: 18195554] [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] [Received: 04/03/2007] [Accepted: 10/24/2007] [Indexed: 05/25/2023]
Abstract
UNLABELLED The discontinuation of chlorofluorocarbon- beclomethasone dipropionate (CFC-BDP) products has made it necessary to switch to hydrofluoroalkane (HFA)-BDP. We studied the influence of the changing from CFC-BDP to HFA-BDP on pulmonary function in asthmatic children. METHODS In twenty asthmatic children (mean: 10.5 years of age) who were clinically well-controlled with CFC-BDP for longer than 6 months, CFC-BDP was switched to HFA-BDP, at half the dose of CFC-BDP. We examined the changes in spirometric parameters at 3-6 months after the switch. RESULTS FEV1.0% ([FEV1.0/FVC]x100) and %V50 ([V50 measured/V50 predicted]x100) were significantly improved (FEV1.0%: pre 81.7+/-4.7-->post 84.1+/-4.1 [p<0.05], % V50: pre 66.9+/-6.9-->post74.4+/-11.3 [p<0.05]). Comparison between patients with greater than 10% improvement in %V50 and those with less than 10% improvement revealed differences in the duration of using CFC-BDP (former 2.8+/-0.9 years, latter 5.2+/-2.4 years [p<0.05]) despite lack of difference in age at initiation of treatment with CFC-BDP. CONCLUSION The changing from CFC-BDP to HFA-BDP showed the improvement of lung function in a part of asthmatic children. We should keep in mind that there are some differences of efficacy among the inhaled corticosteroid products. The long-term anti-inflammatory medication should be adjusted to normalize the pulmonary function on the basis of the degree of airway inflammation.
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Affiliation(s)
- Yukinori Yoshida
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Disease
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47
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Kameda M, Shingo T, Takahashi K, Muraoka K, Kurozumi K, Yasuhara T, Maruo T, Tsuboi T, Uozumi T, Matsui T, Miyoshi Y, Hamada H, Date I. Adult neural stem and progenitor cells modified to secrete GDNF can protect, migrate and integrate after intracerebral transplantation in rats with transient forebrain ischemia. Eur J Neurosci 2007; 26:1462-78. [PMID: 17880388 DOI: 10.1111/j.1460-9568.2007.05776.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [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: 12/16/2022]
Abstract
Adult neural stem and progenitor cells (NSPCs) are important autologous transplantation tools in regenerative medicine, as they can secrete factors that protect the ischemic brain. We investigated whether adult NSPCs genetically modified to secrete more glial cell line-derived neurotrophic factor (GDNF) could protect against transient ischemia in rats. NSPCs were harvested from the subventricular zone of adult Wistar rats and cultured for 3 weeks in the presence of epidermal growth factor. The NSPCs were treated with fibre-mutant Arg-Gly-Asp adenovirus containing the GDNF gene (NSPC-GDNF) or enhanced green fluorescent protein (EGFP) gene (NSPC-EGFP; control group). In one experiment, cultured cells were transplanted into the right ischemic boundary zone of Wistar rat brains. One week later, animals underwent 90 min of intraluminal right middle cerebral artery occlusion followed by magnetic resonance imaging and behavioural tests. The NSPC-GDNF group had higher behavioural scores and lesser infarct volume than did controls at 1, 7 and 28 days postocclusion. In the second experiment, we transplanted NSPCs 3 h after ischemic insult. Compared to controls, rats receiving NSPC-GDNF had decreased infarct volume and better behavioural assessments at 7 days post-transplant. Animals were killed on day 7 and brains were collected for GDNF ELISA and morphological assessment. Compared to controls, more GDNF was secreted, more NSPC-GDNF cells migrated toward the ischemic core and more NSPC-GDNF cells expressed immature neuronal marker. Moreover, the NSPC-GDNF group showed more effective inhibition of microglial invasion and apoptosis. These findings suggest that NSPC-GDNF may be useful in treatment of cerebral ischemia.
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Affiliation(s)
- M Kameda
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho Okayama, Okayama, 700-8558, Japan
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48
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Kamada F, Mashimo Y, Inoue H, Shao C, Hirota T, Doi S, Kameda M, Fujiwara H, Fujita K, Enomoto T, Sasaki S, Endo H, Takayanagi R, Nakazawa C, Morikawa T, Morikawa M, Miyabayashi S, Chiba Y, Tamura G, Shirakawa T, Matsubara Y, Hata A, Tamari M, Suzuki Y. The GSTP1 Gene Is a Susceptibility Gene for Childhood Asthma and the GSTM1 Gene Is a Modifier of the GSTP1 Gene. Int Arch Allergy Immunol 2007; 144:275-86. [PMID: 17643058 DOI: 10.1159/000106316] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Accepted: 04/11/2007] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Bronchial asthma is a chronic airway disorder characterized by bronchial inflammation. Oxidative stress is a key component of inflammation. Glutathione S-transferase P1 (GSTP1), the abundant isoform of glutathione S-transferases (GSTs) in lung epithelium, plays a key role in cellular protection against oxidative stress. Several studies have shown that the GSTP1 geneis involved in the pathogenesis of asthma and a gene-gene interaction may occur within the GST gene superfamily. METHODS We screened single-nucleotide polymorphisms (SNPs) at the GSTP1 locus and performed an association study in the Japanese population using two independent case-control groups (group 1: 391 pediatric patients with asthma, 462 adult patients with asthma, and 639 controls, and group 2: 115 pediatric patients with asthma and 184 controls). The effect of GSTM1 null/present genotype on the association between GSTP1 Ile105Val and asthma was also investigated. RESULTS We identified 20 SNPs at this locus and found this region consisted of one linkage disequilibrium block represented by four SNPs (tag SNPs). The association between the Ile105Val polymorphism in the GSTP1 gene and childhood asthma was significant in both groups (p = 0.047 in group 1, and p = 0.021 in group 2). This association was only significant in patients with GSTM1-positive genotype in both groups (group 1: GSTM1 present p = 0.013 and GSTM1 null p = 0.925, and group 2: GSTM1 present p = 0.015 and GSTM1 null p = 0.362). CONCLUSIONS These findings suggest that the GSTP1 gene is a childhood asthma susceptible gene, and the GSTM1 gene is a modifier gene of GSTP1 for the risk of childhood asthma in the Japanese population.
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Affiliation(s)
- Fumiaki Kamada
- Department of Medical Genetics, Tohoku University School of Medicine, Sendai, Japan
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49
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Tomioka K, Kumagai S, Kameda M, Kataoka Y. A case of occupational asthma induced by falcata wood (Albizia falcataria). J Occup Health 2007; 48:392-5. [PMID: 17053306 DOI: 10.1539/joh.48.392] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kimiko Tomioka
- Life and Hygiene Division, Osaka Prefectural Institute of Public Health, Osaka, Japan.
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50
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Muraoka K, Shingo T, Yasuhara T, Kameda M, Yuan W, Hayase H, Matsui T, Miyoshi Y, Date I. The high integration and differentiation potential of autologous neural stem cell transplantation compared with allogeneic transplantation in adult rat hippocampus. Exp Neurol 2006; 199:311-27. [PMID: 16529744 DOI: 10.1016/j.expneurol.2005.12.004] [Citation(s) in RCA: 42] [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] [Received: 05/03/2005] [Revised: 11/30/2005] [Accepted: 12/01/2005] [Indexed: 12/25/2022]
Abstract
Cell therapy is thought to have a central role in restorative therapy, which aims to restore function to the damaged nervous system. The purpose of this study was to establish an autologous neural stem cell (NSC) transplantation model using adult rats and to compare survival, migration, and differentiation between this system and allogeneic NSC transplantation. Furthermore, we compared the immunologic response of the host tissue between autologous and allogeneic transplantation. NSCs were removed from the subventricular zone of adult Fischer 344 rats using stereotactic methods. NSCs were expanded and microinjected into normal hippocampus in the autologous brain. Allogeneic NSC (derived from adult Wistar rats) transplantation was performed using the same procedure, and hippocampal sections were analyzed immunohistologically 3 weeks post-transplantation. The cell survival and migration rate were higher for autologous transplantation than for allogeneic transplantation, and the neuronal differentiation rate in the autologous transplanted cells far exceeded that of allogeneic transplantation. Furthermore, there was less astrocyte and microglia reactivity in the host tissue of the autologous transplantation compared with allogeneic transplantation. These findings demonstrate that immunoreactivity of the host tissue strongly influences cell transplantation in the CNS as the autologous transplantation did not induce host tissue immunoreactivity; the microenvironment was essentially maintained in an optimal condition for the transplanted cells.
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Affiliation(s)
- K Muraoka
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, 700-8558, Japan.
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