1
|
Iwaki M, Yoneda M, Wada N, Otani T, Kobayashi T, Nogami A, Saito S, Nakajima A. Emerging drugs for the treatment of hepatic fibrosis on nonalcoholic steatohepatitis. Expert Opin Emerg Drugs 2024:1-11. [PMID: 38469871 DOI: 10.1080/14728214.2024.2328036] [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] [Received: 09/30/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Approved drug therapies for nonalcoholic steatohepatitis (NASH) are lacking, for which various agents are currently being tested in clinical trials. Effective drugs for liver fibrosis, the factor most associated with prognosis in NASH, are important. AREAS COVERED This study reviewed the treatment of NASH with a focus on the effects of existing drugs and new drugs on liver fibrosis. EXPERT OPINION Considering the complex pathophysiology of fibrosis in NASH, drug therapy may target multiple pathways. The method of assessing fibrosis is important when considering treatment for liver fibrosis in NASH. The Food and Drug Administration considers an important fibrosis endpoint to be histological improvement in at least one fibrosis stage while preventing worsening of fatty hepatitis. To obtain approval as a drug for NASH, efficacy needs to be demonstrated on endpoints such as liver-related events and myocardial infarction. Among the current therapeutic agents for NASH, thiazolidinedione, sodium-glucose co-transporter 2, and selective peroxisome proliferator-activated receptors α modulator have been reported to be effective against fibrosis, although further evidence is required. The effects of pan-peroxisome proliferator-activated receptors, obeticholic acid, and fibroblast growth factor-21 analogs on liver fibrosis in the development stage therapeutics for NASH are of particular interest.
Collapse
Affiliation(s)
- Michihiro Iwaki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naohiro Wada
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomohiro Otani
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Asako Nogami
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Satoru Saito
- Department of Gastroenterology, Sanno Hospital, Minato-Ku, Tokyo, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| |
Collapse
|
2
|
Yoneda M, Kobayashi T, Wada N, Otani T, Nogami A, Iwaki M, Nakajima A. Tropifexor, a selective non-acid farnesoid X receptor agonist, improved nonalcoholic steatohepatitis in a phase 2 trial, but several issues remain to be resolved. Hepatobiliary Surg Nutr 2023; 12:759-762. [PMID: 37886193 PMCID: PMC10598311 DOI: 10.21037/hbsn-23-342] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/30/2023] [Indexed: 10/28/2023]
Affiliation(s)
| | | | - Naohiro Wada
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | - Tomohiro Otani
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | | | | | | |
Collapse
|
3
|
Nogami A, Wada N, Muraoka E, Iwaki M, Kobayashi T, Matsumura M, Kato I, Fujii S, Nakajima A, Yoneda M. Mortality associated with the development of acute liver failure after a single dose of nivolumab. Clin J Gastroenterol 2023; 16:464-469. [PMID: 37076635 DOI: 10.1007/s12328-023-01789-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 03/22/2023] [Indexed: 04/21/2023]
Abstract
AIM Immune-related adverse events (irAEs) caused by immune checkpoint inhibitors are reported in all organs; however, the frequency of liver injury is low compared to irAEs in other organs. We describe a case of fulminant hepatitis after administration of the first dose of nivolumab for the management of esophageal cancer. METHODS A man in his 80s was treated with nivolumab as a second-line therapy after his overall health worsened during preoperative chemotherapy for esophageal cancer. He was admitted to the hospital as an emergency case 30 days later with complaints of vomiting, following which acute liver failure was diagnosed. RESULTS The patient developed hepatic encephalopathy on the third day after admission and died on the seventh day. The pathological results showed sub-extensive spread hepatocellular necrosis throughout the liver, and immunostaining confirmed the presence of CD8-positive cells, which is consistent with irAEs. CONCLUSIONS Immune checkpoint inhibitors have proven to be effective for the treatment of malignant tumors, and although fatalities due to acute liver failure are extremely rare, such cases have been reported previously. Among the immune checkpoint inhibitors, anti-programmed death-1 receptor is associated with less hepatotoxicity. However, even a single dose of this treatment can cause acute liver failure, which could be fatal.
Collapse
Affiliation(s)
- Asako Nogami
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Naohiro Wada
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Erika Muraoka
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Michihiro Iwaki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Mai Matsumura
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ikuma Kato
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Satoshi Fujii
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan.
| |
Collapse
|
4
|
Hamada R, Kikunaga K, Kaneko T, Okamoto S, Tomotsune M, Uemura O, Kamei K, Wada N, Matsuyama T, Ishikura K, Oka A, Honda M. Urine alpha 1-microglobulin-to-creatinine ratio and beta 2-microglobulin-to-creatinine ratio for detecting CAKUT with kidney dysfunction in children. Pediatr Nephrol 2023; 38:479-487. [PMID: 35589989 DOI: 10.1007/s00467-022-05577-3] [Citation(s) in RCA: 2] [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: 03/27/2021] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND The leading cause of advanced chronic kidney disease (CKD) in children is congenital anomalies of the kidney and urinary tract (CAKUT). However, the most appropriate parameters of biochemical urine analysis for detecting CAKUT with kidney dysfunction are not known. METHODS The present observational study analyzed data on children with CAKUT (stage 2-4 CKD) and the general pediatric population obtained from school urine screenings. The sensitivity and specificity of urine alpha 1-microglobulin-, beta 2-microglobulin-, protein-, and the albumin-to-creatinine ratios (AMCR, BMCR, PCR, ACR, respectively) in detecting CAKUT with kidney dysfunction were compared with those of the conventional urine dipstick, and the most appropriate of these four parameters were evaluated. RESULTS In total, 77 children with CAKUT and 1712 subjects in the general pediatric population fulfilled the eligibility criteria. Conventional dipstick urinalysis was insufficient due to its low sensitivity; even when the threshold of proteinuria was +/-, its sensitivity was only 29.7% for stage 2 and 44.1% for stage 3 CKD. Among the four parameters assessed, the AMCR and BMCR were adequate for detecting CAKUT in children with stage 3-4 CKD (the respective sensitivity and specificity of the AMCR for detecting CAKUT in stage 3 CKD was 79.4% and 97.5% while that of BMCR was 82.4% and 97.5%). These data were validated using national cohort data. CONCLUSION AMCR and BMCR are superior to dipstick urinalysis, PCR, and ACR in detecting CAKUT with kidney dysfunction, particularly stage 3 CKD. However, for AMCR, external validation is required. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Riku Hamada
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Kaori Kikunaga
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. .,Department of Pediatrics, Fussa Hospital, Tokyo, Japan. .,Department of Pediatrics, Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara-shi, Kanagawa, 252-0374, Japan.
| | - Tetsuji Kaneko
- Teikyo Academic Research Center, Teikyo University, Tokyo, Japan.,Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | | | - Masako Tomotsune
- Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Osamu Uemura
- Ichinomiya Medical Treatment and Habilitation Center, Aichi, Japan
| | - Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Naohiro Wada
- Department of Pediatrics, Shizuoka Children's Hospital, Shizuoka, Japan
| | | | - Kenji Ishikura
- Department of Pediatrics, Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara-shi, Kanagawa, 252-0374, Japan
| | - Akira Oka
- Saitama Children's Medical Center, Saitama, Japan
| | - Masataka Honda
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| |
Collapse
|
5
|
Morohashi T, Wada N, Odaira S, Shimizu S, Takahashi S, Morioka I. β2-microglobulin measurement with dried urine spots for congenital anomalies of the kidney and urinary tract screening in 3-year-old children. Pediatr Int 2022; 64:e15077. [PMID: 34850504 DOI: 10.1111/ped.15077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 11/21/2021] [Accepted: 11/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Screening using dipstick urinalysis has long been performed in 3-year-old children; however, it is ineffective in detecting congenital anomalies of the kidney and urinary tract (CAKUT). Measurement of the urinary β2-microglobulin (β2MG)/creatinine (Cr) ratio may be more effective for this purpose. Analysis of dried urine spots (DUS) on filter paper is suitable for mass screening since operational costs are low and samples are easy to collect and transport. We examined the accuracy of measuring the urinary β2MG/Cr ratio in DUS on filter paper. METHODS We collected 2,623 urine samples from 3-year-old children. β2MG and Cr levels were measured in DUS on filter paper. We examined the correlation between the β2MG/Cr ratios measured in DUS and using the conventional method in 640 samples using the coefficient of determination test. Children with high β2MG/Cr ratios (>0.6 µg/mg Cr) in DUS samples were further examined to establish a definitive diagnosis. RESULTS There was strong correlation between the two methods for determination of β2MG levels (r2 = 0.68; P < 0.001) and β2MG/Cr ratios (r2 = 0.69; P < 0.001). Of the 2,623 children, 38 (1.45%) had β2MG/Cr ratios >0.6. Thirty-five children were subsequently examined, resulting in findings of renal hypodysplasia (n = 2, 0.08%), horseshoe kidney (n = 1, 0.04%), renal tubular dysfunction with hepatoblastoma (n = 1, 0.04%), data abnormality (high urine β2MG level, n = 6, 0.23%; high serum Cr level, n = 1, 0.04%), and normal values (n = 24, 0.91%). CONCLUSIONS We evaluated a practical method for measuring β2MG/Cr ratios in DUS as a screening method to detect CAKUT in 3-year-old children.
Collapse
Affiliation(s)
- Tamaki Morohashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Naohiro Wada
- Department of Nephrology, Shizuoka Children's Hospital, Shizuoka, Japan
| | | | - Shoichi Shimizu
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | | | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
6
|
Sonnenschein V, Tsuji Y, Kokuryu S, Kubo W, Suzuki S, Tomita H, Kiyanagi Y, Iguchi T, Matsushita T, Wada N, Kitaguchi M, Shimizu HM, Hirota K, Shinohara T, Hiroi K, Hayashida H, Guo W, Ito D, Saito Y. An experimental setup for creating and imaging 4He 2 * excimer cluster tracers in superfluid helium-4 via neutron- 3He absorption reaction. Rev Sci Instrum 2020; 91:033318. [PMID: 32259963 DOI: 10.1063/1.5130919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/29/2020] [Indexed: 06/11/2023]
Abstract
For the purpose of future visualization of the flow field in superfluid helium-4, clusters of the triplet state excimer 4He2 * are generated along the micro-scale recoil tracks of the neutron-absorption reaction n + 3He → 3T + p. This reaction is induced by neutron irradiation of the 3He fraction contained in natural isotopic abundance liquid helium with neutron beams either from the Japan Proton Accelerator Research Complex, Materials and Life Science Experimental Facility (JPARC)/Materials and Life Science Experimental Facility or from the Kyoto University Institute for Integrated Radiation and Nuclear Science. These 4He2 * clusters are expected to be ideal tracers of the normal-fluid component in superfluid helium with several advantageous properties. Evidence of the excimer generation is inferred by detection of laser induced fluorescence emitted from the 4He2 * clusters excited by a purpose-built short pulse gain-switched titanium:sapphire (Ti:sa) laser operating at a wavelength of 905 nm. The setup and performance characteristics of the laser system including the Ti:sa and two continuous wave re-pumping lasers are described. Detection at the fluorescence wavelength of 640 nm is performed by using optical bandpass filtered photomultiplier tubes (PMT). Electrical noise in the PMT acquisition traces could successfully be suppressed by post-processing with a simple algorithm. Despite other laser-related backgrounds, the excimer was clearly identified by its fluorescence decay characteristics. Production of the excimer was found to be proportional to the neutron flux, adjusted via insertion of different collimators into the neutron beam. These observations suggest that the apparatus we constructed does function in the expected manner and, therefore, has the potential for groundbreaking turbulence research with superfluid helium.
Collapse
Affiliation(s)
- V Sonnenschein
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - Y Tsuji
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - S Kokuryu
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - W Kubo
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - S Suzuki
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - H Tomita
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - Y Kiyanagi
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - T Iguchi
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - T Matsushita
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - N Wada
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - M Kitaguchi
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - H M Shimizu
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - K Hirota
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - T Shinohara
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - K Hiroi
- J-PARC Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - H Hayashida
- Comprehensive Research Organization for Science and Society, Tokai, Ibaraki 319-1106, Japan
| | - W Guo
- National High Magnetic Field Laboratory, Tallahassee, Florida 32310, USA
| | - D Ito
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori, Osaka 590-0494, Japan
| | - Y Saito
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori, Osaka 590-0494, Japan
| |
Collapse
|
7
|
Matsuda S, Kawakubo H, Takeuchi H, Hayashi M, Mayanagi S, Takemura R, Irino T, Fukuda K, Nakamura R, Wada N, Kitagawa Y. Minimally invasive oesophagectomy with extended lymph node dissection and thoracic duct resection for early-stage oesophageal squamous cell carcinoma. Br J Surg 2020; 107:705-711. [PMID: 32077101 DOI: 10.1002/bjs.11487] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/05/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oesophageal squamous cell carcinoma is an aggressive disease owing to early and widespread lymph node metastases. Multimodal therapy and radical surgery may improve prognosis. Few studies have investigated the efficacy of radical lymph node and thoracic duct resection. METHODS Patients with oesophageal squamous cell carcinoma who underwent transthoracic minimally invasive oesophagectomy (TMIE) for cancer at Keio University Hospital between January 2004 and December 2016 were selected. Between 2004 and 2008, TMIE was performed in the lateral decubitus position without thoracic duct resection (standard TMIE). From 2009 onwards, TMIE with extended lymph node and thoracic duct resection was introduced (extended TMIE). Demographics, co-morbidity, number of retrieved lymph nodes, pathology, postoperative complications and recurrence-free survival (RFS) were compared between groups. RESULTS Forty-four patients underwent standard TMIE and 191 extended TMIE. There were no significant differences in clinical and pathological tumour stage or postoperative complications. The extended-TMIE group had more lymph nodes removed at nodal stations 106recL and 112. Among patients with cT1 N0 disease, RFS was better in the extended-TMIE group (P < 0·001), whereas there was no difference in RFS between groups in patients with advanced disease. CONCLUSION Extended TMIE including thoracic duct resection increased the number of lymph nodes retrieved and was associated with improved survival in patients with cT1 N0 oesophageal squamous cell carcinoma.
Collapse
Affiliation(s)
- S Matsuda
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - H Kawakubo
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - H Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - M Hayashi
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - S Mayanagi
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - R Takemura
- Biostatistics Unit, Clinical and Translational Research Centre, Keio University Hospital, Tokyo, Japan
| | - T Irino
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - K Fukuda
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - R Nakamura
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - N Wada
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - Y Kitagawa
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| |
Collapse
|
8
|
Saburi M, Yamada H, Wada N, Motoyama S, Sugimoto T, Kubota H, Miyawaki D, Wakana N, Matoba S. P732Maternal high-fat diet promotes the expansion of abdominal aortic aneurysm in adult offspring by enhancing osteoclast-like macrophage differentiation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and objective
Maternal high-fat diet (HFD) has been shown to modulate vascular function and remodeling in adult offspring. Here, we investigated the impact of maternal HFD on abdominal aortic aneurysm (AAA) formation.
Methods and results
Eight-week-old female wild-type mice (C57BL/6) were fed a HFD or normal diet (ND) one week prior to mating and received during pregnancy and lactation. In eight-week-old offspring of both genders, AAA was induced with the application of 0.5M calcium chloride (CaCl2) on the infrarenal aorta. Male offspring of HFD-fed dams (O-HFD) showed a significant increase in maximum outer diameter of AAA at 1, 4 and 8 weeks after surgery compared with offspring of ND-fed dams (O-ND) (P<0.05). The lengths of outer circumference assessed by histological analysis were increased in O-HFD (P<0.05). Likewise, female O-HFD showed a greater length of outer circumference than female O-ND (P<0.05). While the number of F4/80-positive cells at 1 wk after surgery was comparable between the male O-HFD and O-ND, the percentage of MMP-9/F4/80 double-positive cells was significantly increased in male O-HFD. Consistently, fluorescent image of abdominal aorta taken by IVIS at 1 wk after surgery revealed a 2-fold increase in MMP activity (P<0.01). Intriguingly, F4/80-positive cells in male O-HFD showed a 2.5-fold increase in co-staining with tartrate-resistant acid phosphate (TRAP), typical marker of osteoclast-like macrophages which abundantly secrete proteases than classically activated macrophages (M1), while the percentage of TNF-α/F4/80 double-positive cells was comparable between the 2 groups. Pharmacological inhibition of osteoclastogenesis by zoledronic acid (ZA) (100μg/kg) completely abolished the exaggerated AAA development in male O-HFD to a similar extent of that in male O-ND, while AAA development in male O-ND mice did not change even after ZA treatment. Furthermore, in vitro TNF-α-induced osteoclast differentiation of bone marrow-derived macrophages (BMDMs) showed a significantly higher number of TRAP-positive cells, accompanied by increased calcitonin receptor mRNA expression. Western blotting analysis showed that protein expression level of NFATc1, master regulator of osteoclastogenesis, was significantly higher in BMDM of O-HFD than O-ND.
Conclusion
Our findings demonstrate that maternal HFD accelerates CaCl2-induced AAA expansion, accompanied by the exaggerated accumulation of osteoclast-like macrophages and augmented activity of MMPs. Inhibition of macrophages skewing toward osteoclast-like cells could be a potential therapeutic target for preventing AAA development.
Collapse
Affiliation(s)
- M Saburi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - H Yamada
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Wada
- Kyoto Chubu medical Center, Department of Cardiology, Kyoto, Japan
| | - S Motoyama
- Kyoto Yamashiro General Medical Center, Kyoto, Japan
| | - T Sugimoto
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - H Kubota
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - D Miyawaki
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Wakana
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| |
Collapse
|
9
|
Sugimoto T, Yamada H, Kubota H, Miyawaki D, Motoyama S, Wada N, Saburi M, Wakana N, Matoba S. P740Repeated social defeat exaggerates fibrin-rich clot formation in FeCl3-induced arterial thrombosis mice model by enhancing NETs formation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and objective
Depression is an independent risk factor of cardiovascular disease (CVD). We have recently shown that repeated social defeat (RSD) precipitates depressive-like behaviorsin apoE−/− mice and exaggerates atherosclerosis development by enhancing neutrophil extracellular traps (NETs) formation (BBRC 2018; 500:490). Here, we investigated the impact of RSD on arterial thrombosis.
Methods and results
Eight-week-old male WT mice were exposed to RSDby housing with a larger CD-1 mouse in a shared home cage. They were subjected to vigorous physical contact daily for 10 consecutive days. Control mice were housed in the same gage without physical contact. After social interaction testto confirm depressive-like behaviors, defeated mice (19 of 31) and control mice (12 of 14) were underwent arterial injury at 10 wks of age. A filter paper saturated with 10% FeCl3was applied on the adventitial surface of left carotid artery for 3 min and analyzed 3 hrs later. The volume of thrombi calculated by summing8–15 frozen cross-sectional images, each separated by 200 μm, was comparable between the 2 groups. However, fibrinogen/fibrin-positive areas in immunofluorescent images were significantly increased in defeated mice (27.8% vs. 48.8%, Control vs. Defeat, P<0.01).The numberof Ly-6G-positive cells in thrombi was markedly higher in defeated mice (144/mm2 vs. 878/mm2, Control vs. Defeat, P<0.05). Further, Ly-6G-positive cells were almost accumulated at the inner surface of injured artery, which were co-localized with neutrophil elastase, Cit-H3, and CD41-positive staining. Treatment with DNase Icompletely diminished the exaggerated fibrin-rich clot formation in defeated miceto a similar extent of control mice (25.7% vs. 22.3%, Control vs. Defeat, P= NS), while the volume of thrombi and number of Ly-6G-positive cells in thrombi were comparable between the 2 groups even afterDNase I treatment. Platelet aggregations induced by ADP or collagen were comparable between the 2 groups, suggesting that NETs formation primarily contributes to the exaggerated fibrin-rich clot formation in defeated mice.
Conclusions
Our findings demonstrate for the first time that repeated social defeat enhances fibrin-rich clot formation after arterial injury by enhancing NETs formation, suggesting that NETosis could be a new therapeutic target in depression-related CVD development.
Collapse
Affiliation(s)
- T Sugimoto
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Yamada
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Kubota
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - D Miyawaki
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - S Motoyama
- Kyoto Yamashiro General Medical Center, Kyoto, Japan
| | - N Wada
- Kyoto Chubu Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Saburi
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - N Wakana
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
10
|
Wada N, Yamada H, Motoyama S, Saburi M, Sugimoto T, Miyawaki D, Kubota H, Wakana N, Matoba S. 5220Maternal high-fat diet exaggerates the development of diet-induced insulin resistance in adult offspring by enhancing pyroptosis through augmented gasdermin D-mediated pore formation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Maternal high-fat diet (HFD) has been shown to promote the development of insulin resistance (IR) in adult offspring; however, the underlying mechanisms remain unclear.
Approach and results
Eight-week-old female wild-type mice (C57BL/6) were fed a HFD or normal diet (ND) one week prior to mating, and received during pregnancy and lactation. Eight-week-old male offspring of both groups were fed a HFD for 8 weeks. Offspring of HFD-fed dams (O-HFD) showed significantly enhanced IR compared with offspring of ND-fed dams (O-ND). There was no difference in body weight, epidydimal white adipose tissue (eWAT) weight, and cumulative caloric intake between the 2 groups. However, eWAT adipocyte size was significantly increased in O-HFD, accompanied by the abundant crown-like structures. Flow cytometric analysis revealed an increased percentage of M1, but not M2, macrophages. Serum and eWAT concentrations of IL-1β, but not TNF-α, were significantly higher in O-HFD than O-ND (3.7-fold and 2.0-fold, respectively, P<0.05). Treatment with NLRP3 inflammasome inhibitor MCC950 completely abrogated the enhanced IR in O-HFD to a similar extent of that in O-ND, although IR was modestly, but not significantly, ameliorated in O-ND even after MCC950 treatment. Consistent with in vivo findings, in vitro polarization of bone marrow-derived macrophages (BMDMs) did not show any difference in TNF-α mRNA expression after conventional stimulation. In contrast, palmitate acid (PA)-mediated metabolic activation of BMDMs following LPS priming showed a significantly higher concentration of IL-1β in culture supernatants from O-HFD (45%, P<0.05). However, protein expression levels of NLRP-3, ASC, and procaspase-1 after LPS priming were equivalent between the 2 groups. Consistently, intracellular flow cytometric analysis of caspase-1 activity after PA activation did not show any difference, which was compatible with the finding that ex vivo caspase-1 activity of eWAT assessed by fluorescent image of IVIS revealed no difference between the 2 groups. To further examine the mechanism of augmented IL-1β release in BMDM of O-HFD, we examined the cleavage of caspase substrate gasdermin D (GSDMD) and subsequent pore formation. Protein and gene expression levels of GSDM-D after LPS priming were significantly higher in O-HFD (50% and 381%, respectively, P<0.05). At 2 hrs after PA stimulation following LPS priming, cleaved GSDM-D was significantly increased in O-HFD (80%, P<0.01). Consistently, percentage of pore formation assessed by ethidium bromide staining was significantly higher in O-HFD (60%, P<0.05), while LDH release could not be observed.
Conclusions
Our findings demonstrate that maternal HFD exaggerates diet-induced insulin resistance in adult offspring by enhancing pyroptosis through augmented GSDM-D-mediated pore formation.
Collapse
Affiliation(s)
- N Wada
- Kyoto Chubu Medical Center, Kyoto, Japan
| | - H Yamada
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - S Motoyama
- Yamashiro General Medical Center, Kyoto, Japan
| | - M Saburi
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Sugimoto
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - D Miyawaki
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Kubota
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - N Wakana
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
11
|
Iriki H, Takahashi H, Wada N, Hori S, Amagai M. 052 Regulatory T cell-mediated, OX40-dependent peripheral tolerance to autoantigen, desmoglein 3. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
12
|
Sakaguchi C, Ashida K, Yano S, Ohe K, Wada N, Hasuzawa N, Matsuda Y, Sakamoto S, Sakamoto R, Uchi H, Furue M, Nomura M, Ogawa Y. A case of nivolumab-induced acute-onset type 1 diabetes mellitus in melanoma. ACTA ACUST UNITED AC 2019; 26:e115-e118. [PMID: 30853818 DOI: 10.3747/co.26.4130] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Nivolumab, an anti-PD-1 antibody, is now considered an important therapeutic agent in several advanced malignancies. However, immune-related adverse events such as endocrinopathies have been reported with its use. Thyroid disorder and isolated adrenocorticotropic hormone deficiency have frequently been reported as nivolumab-induced immune-related adverse events. Another endocrinopathy is nivolumab-induced type 1 diabetes mellitus (t1dm), described as diabetes mellitus with rapid onset and complete insulin insufficiency, at times leading to fulminant t1dm. We report the case of a 68-year-old woman who developed pancreatic islet-related autoantibody-negative t1dm, possibly induced by nivolumab, under continuous glucocorticoid administration. She was treated with nivolumab for advanced malignant melanoma, concomitant with 10 mg prednisolone daily for thrombophlebitis tapered to 5 mg after 13 courses of nivolumab therapy. At approximately the 27th course of nivolumab therapy, she showed elevated plasma glucose levels despite preserved insulin secretion. A month later, she developed diabetic ketoacidosis. Her insulin secretion decreased and finally was exhausted. She was diagnosed with acute-onset rather than fulminant t1dm because of a rapidly progressive course to diabetic ketoacidosis during just more than 1 week. She is currently receiving insulin replacement. There has been no recurrence of the melanoma. Thus, nivolumab might induce autoimmune diabetes mellitus, with patients having t1dm-sensitive human leucocyte antigen being more susceptible even when receiving glucocorticoids. Physicians should be aware that nivolumab could potentially induce t1dm as a critical immune-related adverse event.
Collapse
Affiliation(s)
- C Sakaguchi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan
| | - K Ashida
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - S Yano
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan
| | - K Ohe
- Faculty of Pharmaceutical Sciences, Fukuoka University, Japan
| | - N Wada
- Department of Dermatology, Kyushu University Hospital, Fukuoka City, Japan
| | - N Hasuzawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Y Matsuda
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan
| | - S Sakamoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan
| | - R Sakamoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan
| | - H Uchi
- Department of Dermatology, Kyushu University Hospital, Fukuoka City, Japan
| | - M Furue
- Department of Dermatology, Kyushu University Hospital, Fukuoka City, Japan
| | - M Nomura
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Y Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Japan
| |
Collapse
|
13
|
Tomono J, Adachi H, Wada N, Kurabayashi M. P636Impaired heart rate response to exercise in the mild degree of dysglycemia. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Tomono
- Gunma University Graduate School of Medicne, Department of Cardiovascular Medicine, Maebashi, Japan
| | - H Adachi
- Gunma Prefectural Cardiovascular Center, Division of Cardiology, Maebashi, Japan
| | - N Wada
- Gunma University Hospital, Department of Rehabilitation Medicine, Maebashi, Japan
| | - M Kurabayashi
- Gunma University Graduate School of Medicne, Department of Cardiovascular Medicine, Maebashi, Japan
| |
Collapse
|
14
|
Wada N, Tazawa M, Kurosaki M, Inoue T, Ibe Y. The effect of intensive physical therapy with repetitive transcranial magnetic stimulation in patients with degenerative cerebellar disease. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Saito Y, Takeuchi H, Fukuda K, Suda K, Nakamura R, Wada N, Kawakubo H, Kitagawa Y. Size of recurrent laryngeal nerve as a new risk factor for postoperative vocal cord paralysis. Dis Esophagus 2018; 31:4986869. [PMID: 29701761 DOI: 10.1093/dote/dox162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/11/2022]
Abstract
Recurrent laryngeal nerve paralysis (RLNP) is a frequent and serious complication following esophageal cancer surgery. Therefore, this study aims to evaluate the correlation between recurrent laryngeal nerve (RLN) size and RLNP. This was a retrospective study of esophageal cancer patients who underwent thoracoscopic esophagectomy from January 2012 to December 2014. Eighty-four patients were included in the primary analysis. Diameter of the RLN was measured using the digital video recording of surgical procedures by the ratio between scissor and RLN. For evaluation of vocal cord paralysis or paresis, indirect laryngoscopy was performed. Because RLNP more frequently occurs on the left side than the right, we evaluated the correlation between size of the left RLN and left RLNP. The median size of the left RLN was 1.51 mm. We found that the incidence of postoperative left RLNP (Clavien-Dindo classification ≥1) was significantly higher (71% vs. 24%; P < 0.001) in thin RLNs (≤1.5 mm) than in thick RLNs (>1.5 mm). Thin RLN (P < 0.001), female sex (P = 0.025), and being overweight (P = 0.034) were identified as significant independent risk factors for postoperative RLNP. RLNP more easily occurred when the RLN was thin. It is difficult to confirm occurrence of postoperative RLNP before and at extubation. Therefore, it is helpful to know its risk factors including size of RLN.
Collapse
Affiliation(s)
- Y Saito
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - H Takeuchi
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo.,Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - K Fukuda
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - K Suda
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - R Nakamura
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - N Wada
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - H Kawakubo
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - Y Kitagawa
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| |
Collapse
|
16
|
Nomura H, Takahashi H, Kase Y, Yamagami J, Wada N, Koyasu S, Amagai M. 017 FcγRIIb deficiency accelerates immunoglobulin class switch and pemphigus phenotype development in pathogenic anti-desmoglein 3 antibody knock-in mice. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
17
|
Booka E, Takeuchi H, Suda K, Fukuda K, Nakamura R, Wada N, Kawakubo H, Kitagawa Y. Meta-analysis of the impact of postoperative complications on survival after oesophagectomy for cancer. BJS Open 2018; 2:276-284. [PMID: 30263978 PMCID: PMC6156161 DOI: 10.1002/bjs5.64] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [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: 07/13/2017] [Accepted: 02/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background Oesophagectomy has a high risk of postoperative morbidity. The impact of postoperative complications on overall survival of oesophageal cancer remains unclear. This meta‐analysis addressed the impact of complications on long‐term survival following oesophagectomy. Methods A search of PubMed and Cochrane Library databases was undertaken for systematic review of papers published between January 1995 and August 2016 that analysed the relation between postoperative complications and long‐term survival. In the meta‐analysis, data were pooled. The main outcome was overall survival (OS). Secondary endpoints included disease‐free (DFS) and cancer‐specific (CSS) survival. Results A total of 357 citations was reviewed; 21 studies comprising 11 368 patients were included in the analyses. Overall, postoperative complications were associated with significantly decreased 5‐year OS (hazard ratio (HR) 1·16, 95 per cent c.i. 1·06 to 1·26; P = 0·001) and 5‐year CSS (HR 1·27, 1·09 to 1·47; P = 0·002). Pulmonary complications were associated with decreased 5‐year OS (HR 1·37, 1·16 to 1·62; P < 0·001), CSS (HR 1·60, 1·35 to 1·89; P < 0·001) and 5‐year DFS (HR 1·16, 1·00 to 1·33; P = 0·05). Patients with anastomotic leakage had significantly decreased 5‐year OS (HR 1·20, 1·10 to 1·30; P < 0·001), 5‐year CSS (HR 1·81, 1·11 to 2·95; P = 0·02) and 5‐year DFS (HR 1·13, 1·02 to 1·25; P = 0·01). Conclusion Postoperative complications after oesophagectomy, including pulmonary complications and anastomotic leakage, decreased long‐term survival.
Collapse
Affiliation(s)
- E Booka
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - H Takeuchi
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan.,Department of Surgery Hamamatsu University School of Medicine Hamamatsu Shizuoka Japan
| | - K Suda
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - K Fukuda
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - R Nakamura
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - N Wada
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - H Kawakubo
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - Y Kitagawa
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| |
Collapse
|
18
|
Makino T, Yamasaki M, Miyazaki Y, Wada N, Takahashi T, Kurokawa Y, Nakajima K, Takiguchi S, Mori M, Doki Y. Utility of initial induction chemotherapy with 5-fluorouracil, cisplatin, and docetaxel (DCF) for T4 esophageal cancer: a propensity score-matched analysis. Dis Esophagus 2018; 31:4670862. [PMID: 29190316 DOI: 10.1093/dote/dox130] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
Although no consensus is available on the treatment of esophageal squamous cell carcinoma (ESCC) invading adjacent organs (T4), establishing effective induction treatments is crucial to altering an unresectable status and achieving curative resection. Here, we evaluated the efficacy of chemotherapy using 5-fluorouracil, cisplatin, and docetaxel (DCF) as the initial induction treatment for T4 ESCC. Fifty patients without distant metastasis who underwent initial induction chemotherapy using DCF for T4 ESCC were propensity score-matched with 50 patients who underwent radiotherapy concurrent with cisplatin and 5-fluorouracil (CRT). In the DCF group, 24 (48.0%) patients underwent surgery, achieving a 64% clinical response rate compared to 72.0% for induction CRT. CRT was also performed in another 24 (48.0%) patients in the DCF group in whom surgical resection was not indicated. The DCF group had significantly higher overall resectability than the CRT group (78.0% vs. 48.0%, P = 0.0017). The esophageal perforation rate during induction treatments was significantly lower in the DCF group than the CRT group (4.0% vs. 18.0%, P = 0.0205). Prognosis was significantly better in the DCF group than the CRT group (5-year cancer-specific survival 42.1% vs. 22.2%, P = 0.0146). Thus, induction DCF chemotherapy in patients with T4 ESCC reduced esophageal perforation and increased overall resectability, leading to better survival than CRT alone. Therefore, DCF chemotherapy may be an effective and safe option for initial induction treatment of T4 ESCC.
Collapse
Affiliation(s)
- T Makino
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - M Yamasaki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Y Miyazaki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - N Wada
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - T Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Y Kurokawa
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - K Nakajima
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - S Takiguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - M Mori
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Y Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| |
Collapse
|
19
|
Imoto S, Saito Oba M, Masuda N, Nagashima T, Wada N, Takashima T, Kitada M, Kawada M, Hayashida T, Taguchi T, Aihara T, Miura D, Toh U, Yoshida M, Sugae S, Yoneyama K, Matsumoto H, Jinno H, Sakamoto J. Abstract OT2-01-01: Observational study of axilla treatment for breast cancer patients with 1 to 3 positive micrometastases or macrometastases in sentinel lymph nodes. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-01-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
[Background] Axilla surgery in node-positive breast cancer is dramatically changing from axillary lymph node dissection (ALND) to sentinel node biopsy (SNB). From the results of ACOSOG Z0011, IBCSG23-01 and AMAROS trials, adjuvant therapy and regional node irradiation could reduce regional lymph node recurrence for sentinel node-positive breast cancer patients. However, optimal indication of SNB alone remains uncertain. Trial design: To evaluate the outcome of sentinel node-positive breast cancer patients, the Japanese Society for Sentinel Node Navigation Surgery (SNNS) conducted a prospective cohort study in 2013 (UMIN000011782, Jpn J Clin Oncol, p.876-9, 2014). [Eligibility criteria] For eligible patients, SNB was performed or scheduled after 1 January 2012. Then 1 to 3 positive micrometastases or macrometastases in sentinel lymph nodes are confirmed by histological or molecular diagnosis. Primary chemotherapy before or after SNB is also acceptable for registration. [Specific aims] The primary endpoint is the 5-year recurrence rate of regional lymph node in patients treated with SNB alone. The secondary endpoint is the 5-year overall survival rate of this cohort. Patients treated with SNB followed by ALND are also registered simultaneously to compare the prognosis. The propensity score matching (PSM) is used to make the distributions of baseline risk factors comparable. [Statistical method] Based on an estimated recurrence rate of 5% at 5 years among patients treated with SNB alone, 240 patients are needed to give a 80% power to reject the null hypothesis that the recurrence rate is 10% with a one-sided type I error rate of 2.5%. If we consider that some patients will be lost to follow-up or become ineligible, a total of 250 patients will be needed to comprise the sample. [Present accrual] Eight hundred and eighty patients who underwent SNB alone or SNB followed by ALND were registered from 27 participating institutes between 2013 and 2016. Data cleaning is being performed. Patient's background and PSM will be reported.
Citation Format: Imoto S, Saito Oba M, Masuda N, Nagashima T, Wada N, Takashima T, Kitada M, Kawada M, Hayashida T, Taguchi T, Aihara T, Miura D, Toh U, Yoshida M, Sugae S, Yoneyama K, Matsumoto H, Jinno H, Sakamoto J. Observational study of axilla treatment for breast cancer patients with 1 to 3 positive micrometastases or macrometastases in sentinel lymph nodes [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-01-01.
Collapse
Affiliation(s)
- S Imoto
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - M Saito Oba
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - N Masuda
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - T Nagashima
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - N Wada
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - T Takashima
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - M Kitada
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - M Kawada
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - T Hayashida
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - T Taguchi
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - T Aihara
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - D Miura
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - U Toh
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - M Yoshida
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - S Sugae
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - K Yoneyama
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - H Matsumoto
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - H Jinno
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| | - J Sakamoto
- Kyorin University School of Medicine, Mitaka, Japan; Toho University; National Hospital Organization Osaka National Hospital; Chiba University Graduate School of Medicine; Tokyo Dental College Ichikawa General Hospital; Osaka City University Graduate School of Medicine; Asahikawa Medical University; KKR Sapporo Medical Center; Keio University School of Medicine; Kyoto Prefectural University of Medicine; Breast Center, Aihara Hospital; Toranomon Hospital; Kurume University School of Medicine; Seirei Hamamatsu General Hospital; Yokohama City University Graduate School of Medicine; Hiratsuka City Hospita; Saitama Cancer Center; Teikyo University School of Medicine; Tokai Central Hospital
| |
Collapse
|
20
|
Tobolowsky FA, Wada N, Martinez-Maza O, Magpantay L, Koletar SL, Palella FJ, Brown TT, Lake JE. Brief report: Circulating markers of fibrosis are associated with immune reconstitution status in HIV-infected men. PLoS One 2018; 13:e0191606. [PMID: 29381717 PMCID: PMC5790272 DOI: 10.1371/journal.pone.0191606] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 01/08/2018] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Lymphoid tissue fibrosis may contribute to incomplete immune reconstitution on antiretroviral therapy (ART) via local CD4+ T lymphocyte (CD4) depletion. Hyaluronic acid (HA) increases with fibrotic burden. CXCL4 concentrations increase in response to pro-fibrotic stimuli, but lower CXCL4 concentrations in HIV-infected individuals may reflect successful immune evasion by HIV. We investigated relationships between circulating HA and CXCL4 concentrations and immune reconstitution on ART in HIV-infected Multicenter AIDS Cohort Study participants. METHODS HIV-infected men on ART for >1 year with cryopreserved plasma samples and suppressed post-ART HIV-1 RNA were included. Men with post-ART CD4 <200 cells/mm3 were defined as immunologic non-responders (n = 25). Age-/race-matched men with post-ART CD4 >500 cells/mm3 served as controls (n = 49). HA and CXCL4 concentrations were measured via ELISA. RESULTS Median pre-ART CD4 was 297 cells/mm3 for non-responders vs 386 cells/mm3 for controls. Median post-ART CD4 was 141 cells/mm3 for non-responders and 815 cells/mm3 for controls. HIV infection duration was 23 years, with median time on ART 13 years for non-responders vs 11 years for controls. Pre-ART HA and CXCL4 concentrations did not vary by eventual immune reconstitution status. Post-ART HA concentrations tended to be higher (85 vs 36 ng/mL, p = 0.07) and CXCL4 concentrations were lower (563 vs 1459 ng/mL, p = 0.01) among non-responders. Among men with paired pre-/post-ART samples, non-responders had greater HA increases and CXCL4 decreases than controls (HA: 50 vs 12 ng/mL, p = 0.04; CXCL4: -1258 vs -405 ng/mL, p = 0.01). CONCLUSIONS Higher circulating concentrations of HA and lower concentrations of CXCL4 are associated with failure of immune reconstitution on ART.
Collapse
Affiliation(s)
- F. A. Tobolowsky
- Department of Internal Medicine, Division of Infectious Diseases, University of Colorado, Denver, Colorado, United States of America
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- * E-mail:
| | - N. Wada
- Department of Epidemiology, Division of General Epidemiology and Methodology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - O. Martinez-Maza
- Department of Obstetrics and Gynecology, Epidemiology, Microbiology, Immunology & Molecular Genetics, University of California Los Angeles, Los Angeles, California, United States of America
| | - L. Magpantay
- Department of Obstetrics and Gynecology, Epidemiology, Microbiology, Immunology & Molecular Genetics, University of California Los Angeles, Los Angeles, California, United States of America
| | - S. L. Koletar
- Department of Internal Medicine, Division of Infectious Diseases, Ohio State University, Columbus, Ohio, United States of America
| | - F. J. Palella
- Department of Internal Medicine, Division of Infectious Diseases, Northwestern University, Chicago, Illinois, United States of America
| | - T. T. Brown
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - J. E. Lake
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- Department of Internal Medicine, Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, United States of America
| |
Collapse
|
21
|
Yamada H, Terada K, Kikai M, Yamamoto K, Motoyama S, Wada N, Saburi M, Wakana N, Matoba S. 4126Transplantation of periaortic adipose tissue inhibits atherosclerosis in apoE−/− mice by exerting TGF-beta1-mediated anti-inflammatory response in transplanted graft. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.4126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
22
|
Yamada H, Yamamoto K, Terada K, Motoyama S, Wada N, Saburi M, Kikai M, Wakana N, Matoba S. P694Repeated social defeat enhances neutrophil extracellular traps formation in vivo and in vitro: Potential implication in the exaggerated atherosclerosis in chronic social stress-exposed apoE−/− mice. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
23
|
Mitarai H, Wada N, Hasegawa D, Yoshida S, Sonoda M, Tomokiyo A, Hamano S, Serita S, Mizumachi H, Maeda H. Transgelin mediates transforming growth factor-β1-induced proliferation of human periodontal ligament cells. J Periodontal Res 2017; 52:984-993. [PMID: 28590058 DOI: 10.1111/jre.12466] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Human periodontal ligament cells (HPDLCs) express transforming growth factor-β1 (TGF-β1) that regulates differentiation and proliferation, and plays key roles in homeostasis of PDL tissue. Transgelin is a cytoskeleton-associated protein with an Smad-binding element in its gene promoter region. In this study, we examined the localization and potential function of transgelin in PDL tissue and cells. MATERIAL AND METHODS Microarray analysis of HPDLC lines (2-14, 2-23 and 2-52) was performed. Expression of transgelin in HPDLCs was examined by quantitative reverse transcription-polymerase chain reaction, immunofluorescence staining and western blot analysis. Effects of TGF-β1 and its signaling inhibitor, SB431542, on transgelin expression in HPDLCs were examined by western blot analysis. The effects of transgelin knockdown by small interfering RNA (siRNA) on HPDLC proliferation stimulated by TGF-β1 were assessed by WST-1 assay. RESULTS In microarray and quantitative reverse transcription-polymerase chain reaction analyses, the expression levels of transgelin (TAGLN) in 2-14 and 2-23 cells, which highly expressed PDL markers such as periostin (POSTN), tissue non-specific alkaline phosphatase (ALPL), α-smooth muscle actin (ACTA2) and type I collagen A1 (COL1A1), was significantly higher than those in 2-52 cells that expressed PDL markers weakly. Immunohistochemical and immunofluorescence staining revealed expression of transgelin in rat PDL tissue and HPDLCs. In HPDLCs, TGF-β1 treatment upregulated transgelin expression, whereas inhibition of the type 1 TGF-β1 receptor by SB431542 suppressed this upregulation. Furthermore, TAGLN siRNA transfection did not promote the proliferation of HPDLCs treated with TGF-β1. The expression levels of CCNA2 and CCNE1, which regulate DNA synthesis and mitosis through the cell cycle, were also not upregulated in HPDLCs transfected with TAGLN siRNA. CONCLUSION Transgelin is expressed in PDL tissue and might have a role in HPDLC proliferation induced by TGF-β1 stimulation.
Collapse
Affiliation(s)
- H Mitarai
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - N Wada
- Division of General Dentistry, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - D Hasegawa
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - S Yoshida
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - M Sonoda
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - A Tomokiyo
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - S Hamano
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Faculty of Dental Science, OBT Research Center, Kyushu University, Fukuoka, Japan
| | - S Serita
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - H Mizumachi
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - H Maeda
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| |
Collapse
|
24
|
Nomura H, Kase Y, Yamagami J, Wada N, Koyasu S, Takahashi H, Amagai M. 010 FcgRIIb is important for clonal ignorance and prevents pemphigus phenotype in pathogenic anti-desmoglein 3 antibody knock-in mice. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
Nagai T, Uemura O, Kaneda H, Ushijima K, Ohta K, Gotoh Y, Satomura K, Shimizu M, Fujieda M, Morooka M, Yamada T, Yamada M, Wada N, Hashimoto Y. The true distribution volume and bioavailability of mizoribine in children with chronic kidney disease. Clin Exp Nephrol 2016; 21:884-888. [PMID: 27873037 DOI: 10.1007/s10157-016-1353-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mizoribine (MZR) is used kidney transplant and various kidney diseases. However, few studies reported the association between pharmacokinetics and pharmacodynamics. The Pharmacokinetics Study Group for Pediatric Kidney Disease (PSPKD) used population pharmacokinetics (PPK) analysis and Bayesian analysis to investigate the usefulness of MZR. In this study, the fact that almost all MZR are excreted unchanged in urine was used to calculate its bioavailability (F) and true distribution volume (V d), and analyzed these correlation with age. METHODS Ishida et al. reported a PPK analysis by the PSPKD. In the present study, 71 samples extracted from their study population of 105 pediatric chronic kidney disease patients aged between 1 and 20 years were investigated. The bioavailability was calculated by measuring total excreted MZR in 24 h urine samples, and this was compared to the oral dosage. The apparent distribution volume (V d/F) obtained from Bayesian analysis was then used to calculate true distribution volume (V d), and the correlation of each parameter with age was investigated. RESULTS The median dose of MZR per weight was 5.17 mg/kg/day. Median bioavailability was 32.02%. Median V d per weight was 0.46 L/kg. There was a significant, weakly positive correlation between bioavailability and age (p = 0.026). There was also a significant, weakly negative correlation between V d per weight and age (p = 0.003). CONCLUSION Bioavailability and V d per weight tended to decrease depending on age. The younger patient required larger dose required to obtain the maximum effect from MZR, and this is important for immunosuppressive therapy.
Collapse
Affiliation(s)
- Takuhito Nagai
- Division of Pediatric Nephrology, Department of Kidney Center, Aichi Medical University, 1-1, Nagakute City, Aichi, 480-1195, Japan.
| | - Osamu Uemura
- Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Obu, Aichi, Japan
| | - Hisashi Kaneda
- Department of Pediatrics, Toyama City Hospital, Toyama, Japan
| | | | - Kazuhide Ohta
- Department of Pediatrics, Kanazawa Medical Center, Kanazawa, Japan
| | - Yoshimitsu Gotoh
- Kidney Center Pediatrics, Nagoya Daini Red Cross Hospital, Nagoya, Aichi, Japan
| | - Kenichi Satomura
- Department of Pediatric Nephrology and Metabolism, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Masaki Shimizu
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masashi Morooka
- Department of Pediatrics, Fujita Health University, Toyoake, Aichi, Japan
| | - Takuji Yamada
- Department of Pediatrics, Nagoya City West Medical Center, Aichi, Japan
| | - Masayoshi Yamada
- Department of Pediatric Nephrology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Naohiro Wada
- Department of Pediatric Nephrology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Yukiya Hashimoto
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| |
Collapse
|
26
|
Maeda E, Higashi T, Hasegawa T, Yokoya S, Mochizuki T, Ishii T, Ito J, Kanzaki S, Shimatsu A, Takano K, Tajima T, Tanaka H, Tanahashi Y, Teramoto A, Nagai T, Hanew K, Horikawa R, Yorifuji T, Wada N, Tanaka T. Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in Japan. BMC Health Serv Res 2016; 16:602. [PMID: 27769307 PMCID: PMC5073827 DOI: 10.1186/s12913-016-1854-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/03/2016] [Accepted: 10/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Treatment costs for children with growth hormone (GH) deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits (boys: 156.4 cm; girls: 145.4 cm). However, several funding programs, such as a subsidy provided by local governments, can be used by those who exceed the height limits. In this study, we explored the impacts of financial support on GH treatment using this natural allocation. METHODS A retrospective analysis of 696 adolescent patients (451 boys and 245 girls) who reached the height limits was conducted. Associations between financial support and continuing treatment were assessed using multiple logistic regression analyses adjusting for age, sex, height, growth velocity, bone age, and adverse effects. RESULTS Of the 696 children in the analysis, 108 (15.5 %) were still eligible for financial support. The proportion of children who continued GH treatment was higher among those who were eligible for support than among those who were not (75.9 % vs. 52.0 %, P < 0.001). The odds ratios of financial support to continuing treatment were 4.04 (95 % confidence interval [CI]: 1.86-8.78) in boys and 1.72 (95 % CI: 0.80-3.70) in girls, after adjusting for demographic characteristics and clinical factors. CONCLUSIONS Financial support affected decisions on treatment continuation for children with GH deficiency. Geographic variations in eligibility for financial support pose an ethical problem that needs policy attention. An appropriate balance between public spending on continuation of therapy and improved quality of life derived from it should be explored.
Collapse
Affiliation(s)
- Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita-shi, Akita, 010-8543, Japan
| | - Takahiro Higashi
- Division of Health Services Research, Center for Cancer Control and Information Services, The National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Tomonobu Hasegawa
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Susumu Yokoya
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takahiro Mochizuki
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tomohiro Ishii
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junko Ito
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Susumu Kanzaki
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Akira Shimatsu
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Koji Takano
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshihiro Tajima
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hiroyuki Tanaka
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yusuke Tanahashi
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Akira Teramoto
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshiro Nagai
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kunihiko Hanew
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Reiko Horikawa
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toru Yorifuji
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Naohiro Wada
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshiaki Tanaka
- GH Treatment Study Committee, The Foundation for Growth Science, 5-1-16 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| |
Collapse
|
27
|
Yoshida S, Wada N, Hasegawa D, Miyaji H, Mitarai H, Tomokiyo A, Hamano S, Maeda H. Semaphorin 3A Induces Odontoblastic Phenotype in Dental Pulp Stem Cells. J Dent Res 2016; 95:1282-90. [DOI: 10.1177/0022034516653085] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In cases of pulp exposure due to deep dental caries or severe traumatic injuries, existing pulp-capping materials have a limited ability to reconstruct dentin-pulp complexes and can result in pulpectomy because of their low potentials to accelerate dental pulp cell activities, such as migration, proliferation, and differentiation. Therefore, the development of more effective therapeutic agents has been anticipated for direct pulp capping. Dental pulp tissues are enriched with dental pulp stem cells (DPSCs). Here, the authors investigated the effects of semaphorin 3A (Sema3A) on various functions of human DPSCs in vitro and reparative dentin formation in vivo in a rat dental pulp exposure model. Immunofluorescence staining revealed expression of Sema3A and its receptor Nrp1 (neuropilin 1) in rat dental pulp tissue and human DPSC clones. Sema3A induced cell migration, chemotaxis, proliferation, and odontoblastic differentiation of DPSC clones. In addition, Sema3A treatment of DPSC clones increased β-catenin nuclear accumulation, upregulated expression of the FARP2 gene (FERM, RhoGEF, and pleckstrin domain protein 2), and activated Rac1 in DPSC clones. Furthermore, in the rat dental pulp exposure model, Sema3A promoted reparative dentin formation with dentin tubules and a well-aligned odontoblast-like cell layer at the dental pulp exposure site and with novel reparative dentin almost completely covering pulp tissue at 4 wk after direct pulp capping. These findings suggest that Sema3A could play an important role in dentin regeneration via canonical Wnt/β-catenin signaling. Sema3A might be an alternative agent for direct pulp capping, which requires further study.
Collapse
Affiliation(s)
- S. Yoshida
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - N. Wada
- Division of General Dentistry, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - D. Hasegawa
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - H. Miyaji
- Department of Periodontology and Endodontology, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - H. Mitarai
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - A. Tomokiyo
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - S. Hamano
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - H. Maeda
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| |
Collapse
|
28
|
Miyano G, Nagano C, Morita K, Yamoto M, Kaneshiro M, Miyake H, Nouso H, Kitayama H, Wada N, Fukumoto K, Koyama M, Urushihara N. A Case of Juxtaglomerular Cell Tumor, or Reninoma, of the Kidney Treated by Retroperitoneoscopy-Assisted Nephron-Sparing Partial Nephrectomy Through a Small Pararectal Incision. J Laparoendosc Adv Surg Tech A 2016; 26:235-8. [PMID: 26866671 DOI: 10.1089/lap.2015.0397] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A 15-year-old girl was found to be hypertensive (230-270/140-170 mm Hg) without any subjective symptoms. Magnetic resonance imaging confirmed the presence of a well-defined 22 mm hypodense lesion in the lower pole of the left kidney, located close to the renal hilum. Plasma rennin activity was elevated (75 ng/mL/h), and reninoma was diagnosed. Retroperitoneoscopy-assisted nephron-sparing surgery was planned. The retroperitoneum was accessed through a 4 cm left pararectal upper abdominal incision. Following blunt dissection, the abdominal wall was elevated with a lifting bar and lifting retractor, inserted below the 12th rib in the anterior axillary line to create sufficient working space in the retroperitoneal cavity without the need for pneumoperitoneum. Three 5 mm trocars were introduced above the superior iliac crest for the camera and the assistant. Gerota's fascia was opened and the kidney exposed. The surgeon dissected the left kidney through the minilaparotomy incision under both direct vision and using the magnified view on the monitor, which was particularly effective for the lateral and posterior sides of the kidney. The posterior peritoneum was incised intentionally next to the diaphragm to allow further mobilization of the kidney. Diathermy was used to remove the tumor and a layer of surrounding normal parenchymal tissue at least 0.5 cm thick. The histopathologic diagnosis was reninoma. Ischemia time was 14 minutes. Postoperatively, both plasma rennin activity and blood pressure were normal (1.9 ng/mL/h and 90-110/70-80 mm Hg, respectively). After follow-up of 12 months, there is no evidence of recurrence.
Collapse
Affiliation(s)
- Go Miyano
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - China Nagano
- 2 Department of Nephrology, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Keiichi Morita
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Masaya Yamoto
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Masakatsu Kaneshiro
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Hiromu Miyake
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Hiroshi Nouso
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Hirotsugu Kitayama
- 2 Department of Nephrology, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Naohiro Wada
- 2 Department of Nephrology, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Koji Fukumoto
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Mariko Koyama
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| | - Naoto Urushihara
- 1 Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan
| |
Collapse
|
29
|
Monnouchi S, Maeda H, Yuda A, Serita S, Wada N, Tomokiyo A, Akamine A. Benzo[a]pyrene/aryl hydrocarbon receptor signaling inhibits osteoblastic differentiation and collagen synthesis of human periodontal ligament cells. J Periodontal Res 2016; 51:779-788. [PMID: 26738610 DOI: 10.1111/jre.12355] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Cigarette smoking has detrimental effects on periodontal tissue, and is known to be a risk factor for periodontal disease, including the loss of alveolar bone and ligament tissue. However, the direct effects of cigarette smoking on periodontal tissue remain unclear. Recently, we demonstrated that benzo[a]pyrene (BaP), which is a prototypic member of polycyclic aryl hydrocarbons and forms part of the content of cigarettes, attenuated the expression of extracellular matrix remodeling-related genes in human periodontal ligament (PDL) cells (HPDLCs). Thus, we aimed to examine the effects of BaP on the osteoblastic differentiation and collagen synthesis of HPDLCs. MATERIAL AND METHODS HPDLCs were obtained from healthy molars of three patients, and quantitative reverse transcription-polymerase chain reaction were performed for gene expression analyses of cytochrome P450 1A1 and 1B1, alkaline phosphatase, bone sialoprotein and aryl hydrocarbon receptor (AhR), a receptor for polycyclic aryl hydrocarbons. We have also analyzed the role of the AhR, using 2-methyl-2H-pyrazole-3-carboxylic acid (2-methyl-4-o-tolylazo-phenyl)-amide (CH-223191), which is an AhR antagonist. RESULTS The treatment of HPDLCs with BaP reduced mRNA expression of osteogenic genes, alkaline phosphatase activity, mineralization and collagen synthesis. The treatment with CH-223191 subsequently restored the observed suppressive effects of BaP on HPDLCs. CONCLUSIONS The present results suggest that BaP exerts inhibitory effects on the maintenance of homeostasis in HPDL tissue, such as osteoblastic differentiation and collagen synthesis of HPDLCs, and that this signaling pathway could be suppressed by preventing the transactivity of AhR. Future studies may unveil a role for the inhibition of AhR as a promising therapeutic agent for periodontal disease caused by cigarette smoking.
Collapse
Affiliation(s)
- S Monnouchi
- Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - H Maeda
- Department of Endodontology, Kyushu University Hospital, Fukuoka, Japan
| | - A Yuda
- Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - S Serita
- Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - N Wada
- Department of Endodontology, Kyushu University Hospital, Fukuoka, Japan
| | - A Tomokiyo
- Department of Endodontology, Kyushu University Hospital, Fukuoka, Japan
| | - A Akamine
- Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Department of Endodontology, Kyushu University Hospital, Fukuoka, Japan
| |
Collapse
|
30
|
Hirano D, Ishikura K, Uemura O, Ito S, Wada N, Hattori M, Ohashi Y, Hamasaki Y, Tanaka R, Nakanishi K, Kaneko T, Honda M. Association between low birth weight and childhood-onset chronic kidney disease in Japan: a combined analysis of a nationwide survey for paediatric chronic kidney disease and the National Vital Statistics Report. Nephrol Dial Transplant 2015; 31:1895-1900. [DOI: 10.1093/ndt/gfv425] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 11/22/2015] [Indexed: 01/21/2023] Open
|
31
|
Kaneda H, Shimizu M, Ohta K, Ushijima K, Gotoh Y, Satomura K, Nagai T, Fujieda M, Morooka M, Yamada T, Yamada M, Wada N, Takaai M, Hashimoto Y, Uemura O. Population pharmacokinetics of mizoribine in pediatric patients with kidney disease. Clin Exp Nephrol 2015; 20:757-763. [PMID: 26649561 DOI: 10.1007/s10157-015-1209-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 11/27/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The present study aimed to obtain information enabling optimisation of the clinical effect of mizoribine (MZR) in pediatric patients with kidney disease. METHODS A total of 105 pediatric patients with kidney disease treated at our institutions were enrolled. Kidney transplant patients were excluded. Population pharmacokinetic analysis of MZR was performed based on serum concentration data. Area under the curve from time zero to infinity (AUC∞) and maximal concentration (C max) were calculated by Bayesian analysis. RESULTS In children, the appearance of MZR in the blood tended to be slower and the subsequent rise in blood concentration tended to be more sluggish, compared to healthy adults. Apparent volume of distribution and oral clearance were also higher in children compared to adults. A significant positive correlation was observed between patient age and AUC∞. There were significant differences of AUC∞ and C max by age group. No relationship was observed between the administration method of MZR and serum concentration. CONCLUSION The pharmacokinetics of MZR was different in children compared to adults. To obtain the expected clinical efficacy, the regular MZR dosage schedule (2-3 mg/kg/day) might be insufficient for pediatric patients. In particular, younger patients might require a higher dosage of MZR per unit body weight.
Collapse
Affiliation(s)
- Hisashi Kaneda
- Department of Pediatrics, Toyama City Hospital, 2-1 Imaizui-Hokubu-machi, Toyama, 939-8511, Japan
| | - Masaki Shimizu
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
| | - Kazuhide Ohta
- Department of Pediatrics, Kanazawa Medical Center, 1-1 Shimoishibiki-cho, Kanazawa, 920-8650, Japan
| | - Katsumi Ushijima
- Department of Pediatrics, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, 510-8567, Japan
| | - Yoshimitsu Gotoh
- Kidney Center Pediatrics, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan
| | - Kenichi Satomura
- Department of Pediatric Nephrology and Metabolism, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, 594-1101, Japan
| | - Takuhito Nagai
- Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, 1-2 Osakada, Morioka-cho, Obu, 474-8710, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Oko-cho Kohasu, Nankoku, 783-8505, Japan
| | - Masashi Morooka
- Department of Pediatrics, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Japan
| | - Takuji Yamada
- Kidney Center Pediatrics, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan
| | - Masayoshi Yamada
- Department of Pediatric Nephrology, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan
| | - Naohiro Wada
- Department of Pediatric Nephrology, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan
| | - Mari Takaai
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yukiya Hashimoto
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Osamu Uemura
- Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, 1-2 Osakada, Morioka-cho, Obu, 474-8710, Japan
| |
Collapse
|
32
|
Matsuda S, Takeuchi H, Kawakubo H, Fukuda K, Nakamura R, Takahashi T, Wada N, Kitagawa Y. 192P Clinical significance of fibrinogen classification in esophageal cancer patients receiving neoadjuvant treatment. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
33
|
Tachibana D, Kurihara Y, Wada N, Kitada K, Nakagawa K, Koyama M. Flow velocity waveforms of the ductus venosus and atrioventricular valves in a case of fetal hemangiolymphangioma. Ultrasound Obstet Gynecol 2015; 46:744-745. [PMID: 25766974 DOI: 10.1002/uog.14848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/01/2015] [Accepted: 03/10/2015] [Indexed: 06/04/2023]
Affiliation(s)
- D Tachibana
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abenoku, Osaka, Japan
| | - Y Kurihara
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abenoku, Osaka, Japan
| | - N Wada
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abenoku, Osaka, Japan
| | - K Kitada
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abenoku, Osaka, Japan
| | - K Nakagawa
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abenoku, Osaka, Japan
| | - M Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abenoku, Osaka, Japan
| |
Collapse
|
34
|
Vassiliadis A, Zanoni A, Di Leo A, Zanella S, Lauro E, Moscatelli P, Ricci F, Huang H, Wada N, Furukawa T, Kitagawa Y, Hirukawa H, Takesue Y, Saito K, Sato H, Tada T, Choua O, Fu XJ, Yao QY, Yang S, Wang MG, Zhu YL, Cao JX, Shen YM, Togbe JO, Gbessi DG, Dossou FM, Iawani I, Cijan V, Gencic M, Scepanovic M, Bojovic P, Brankovic M, Agresta F, Verza LA, Prando D, Roveran MA, Azabdaftari A, Rubinato L, Vacca U, Lubrano T, Vidotto C, Falcone A, Grasso L, Ghiglione F, Morino M, Nácul M, Cavazzola L, Loureiro M, Bonin E, Ferreira P, Misra MC, Bansal VK, Subodh K, Krisha A, Bansal D, Ray S, Rajeshwari S, Wang P, Jia Z, Zhang FJ, Yan JJ, Zhu YH, Jiang K, Altinli E, Eroglu E, Sertel HI, Hizli F, Jacob B, Bresnaham E, Reiner M, Bates A. Inguinal Hernia: Lap vs Open. Hernia 2015; 19 Suppl 1:S57-62. [PMID: 26518862 DOI: 10.1007/bf03355327] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Vassiliadis
- Ospedale S. Maria del Carmine, UO Chirurgia, Rovereto, Italy
| | - A Zanoni
- Ospedale S. Maria del Carmine, UO Chirurgia, Rovereto, Italy
| | - A Di Leo
- Ospedale S. Maria del Carmine, UO Chirurgia, Rovereto, Italy
| | - S Zanella
- Ospedale S. Maria del Carmine, UO Chirurgia, Rovereto, Italy
| | - E Lauro
- Ospedale S. Maria del Carmine, UO Chirurgia, Rovereto, Italy
| | - P Moscatelli
- Ospedale S. Maria del Carmine, UO Chirurgia, Rovereto, Italy
| | - F Ricci
- Ospedale S. Maria del Carmine, UO Chirurgia, Rovereto, Italy
| | - H Huang
- Union Hospital, Fujian Medical University, Fuzhou, China
| | - N Wada
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - T Furukawa
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Y Kitagawa
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - H Hirukawa
- Tachikawa General Hospital, Nagaoka, Japan
| | - Y Takesue
- Tachikawa General Hospital, Nagaoka, Japan
| | - K Saito
- Tachikawa General Hospital, Nagaoka, Japan
| | - H Sato
- Tachikawa General Hospital, Nagaoka, Japan
| | - T Tada
- Tachikawa General Hospital, Nagaoka, Japan
| | - O Choua
- N'Djaména School of Medecine, N'Djaména, Chad
| | | | - Q Y Yao
- Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | | | - M G Wang
- Department of Hernia and Abdominal Wall Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | | | | | | | | | | | | | | | - V Cijan
- Surgery department, Clinical Hospital Center Zvezdara, Belgrade, Serbia
| | | | | | | | | | - F Agresta
- Dept. of General Surgery, ULSS19 del Veneto, Adria, RO, Italy
| | - L A Verza
- Dept. of General Surgery, ULSS19 del Veneto, Adria, RO, Italy
| | - D Prando
- Dept. of General Surgery, ULSS19 del Veneto, Adria, RO, Italy
| | - M A Roveran
- Dept. of General Surgery, ULSS19 del Veneto, Adria, RO, Italy
| | - A Azabdaftari
- Dept. of General Surgery, ULSS19 del Veneto, Adria, RO, Italy
| | - L Rubinato
- Dept. of General Surgery, ULSS19 del Veneto, Adria, RO, Italy
| | - U Vacca
- Dept. of General Surgery, ULSS19 del Veneto, Adria, RO, Italy
| | - T Lubrano
- Azienda Ospedaliera Città della Salute e della Scienza, SCDU Chirurgia Generale I, Università degli Studi di Torino, Torino, Italy
| | - C Vidotto
- Azienda Ospedaliera Città della Salute e della Scienza, SCDU Chirurgia Generale I, Università degli Studi di Torino, Torino, Italy
| | - A Falcone
- Azienda Ospedaliera Città della Salute e della Scienza, SCDU Chirurgia Generale I, Università degli Studi di Torino, Torino, Italy
| | - L Grasso
- Azienda Ospedaliera Città della Salute e della Scienza, SCDU Chirurgia Generale I, Università degli Studi di Torino, Torino, Italy
| | - F Ghiglione
- Azienda Ospedaliera Città della Salute e della Scienza, SCDU Chirurgia Generale I, Università degli Studi di Torino, Torino, Italy
| | - M Morino
- Azienda Ospedaliera Città della Salute e della Scienza, SCDU Chirurgia Generale I, Università degli Studi di Torino, Torino, Italy
| | - M Nácul
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - L Cavazzola
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - E Bonin
- Universidade Positivo, Curitiba, Brazil
| | | | - M C Misra
- All India Institute of Medical Sciences, New Delhi, India
| | - V K Bansal
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - P Wang
- Center of Hernia Surgery Department of Nanjing Medical, University associated HangZhou Hospital, Hangzhou, China
| | | | | | | | | | | | - E Altinli
- Dept. of General Surgery, TC Istanbul Bilim University, Istanbul, Turkey
| | - E Eroglu
- Dept. of General Surgery, TC Istanbul Bilim University, Istanbul, Turkey
| | - H I Sertel
- Florence Nightingale Kadikoy Hospital, Istanbul, Turkey
| | - F Hizli
- Florence Nightingale Kadikoy Hospital, Istanbul, Turkey
| | - B Jacob
- Mount Sinai Medical Center, New York, USA
| | | | | | | |
Collapse
|
35
|
Nakamura N, Arahira S, Wada N, Yoneyama K, Mukai H, Motegi A, Zenda S, Onozawa M, Toshima M, Hirano Y, Hojo H, Akimoto T. Postmastectomy Radiation Therapy Without a Bolus May Not Increase the Risk of Local Recurrence. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
36
|
Wada N, Tachibana D, Kurihara Y, Nakagawa K, Nakano A, Terada H, Tanaka K, Fukui M, Koyama M, Hecher K. Alterations in time intervals of ductus venosus and atrioventricular flow velocity waveforms in growth-restricted fetuses. Ultrasound Obstet Gynecol 2015; 46:221-226. [PMID: 25366537 DOI: 10.1002/uog.14717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/14/2014] [Accepted: 10/22/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate time intervals of the ductus venosus (DV) flow velocity waveform (FVW) and those of the cardiac cycle that correspond with each DV-FVW component in fetuses with intrauterine growth restriction (IUGR) due to placental insufficiency. METHODS Women with a pregnancy complicated by IUGR were recruited into the study, as was a normal control group. Time intervals for systolic (S) and diastolic (D) components were measured in DV-FVW as follows: S(DV), from the nadir of the a-wave during atrial contraction to the nadir between the S-wave and D-wave; D(DV), from the nadir between S-wave and D-wave to the nadir of the a-wave. Regarding cardiac cycles, the following variables were measured from ventricular inflow through the tricuspid valve (TV) and mitral valve (MV): S(TV) and S(MV), from the second peak of ventricular inflow caused by atrial contraction (A-wave) to the opening of the atrioventricular valve; D(TV) and D(MV), from the opening of the atrioventricular valve to the peak of the A-wave. In the IUGR group, only the last examination performed within 1 week of delivery was used for analysis. All variables were analyzed statistically using Z-scores. RESULTS Data were obtained from 249 normal fetuses and 26 fetuses with IUGR. Compared to normal fetuses, S(DV) showed a significant decrease (P < 0.001), while D(DV) showed a significant increase (P < 0.001) in the IUGR group. Regarding cardiac cycles, S(TV) and S(MV) showed significant decreases (P = 0.014 and P < 0.001, respectively) and D(TV) and D(MV) showed significant increases (P = 0.008 and P = 0.002, respectively) in fetuses with IUGR. CONCLUSION Time-interval alterations of DV-FVW in growth-restricted fetuses reflect the hemodynamic events caused by placental insufficiency.
Collapse
Affiliation(s)
- N Wada
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - D Tachibana
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Kurihara
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Nakagawa
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Nakano
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Terada
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Tanaka
- Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan
| | - M Fukui
- Laboratory of Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
37
|
Hoxha J, Morosi J, Shimizu S, Martelli P, Boffi P, Wada N, Cincotti G. Spectrally-efficient all-optical OFDM by WSS and AWG. Opt Express 2015; 23:10986-10996. [PMID: 25969193 DOI: 10.1364/oe.23.010986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report on the transmission experiment of seven 12.5-GHz spaced all optical-orthogonal frequency division multiplexed (AO-OFDM) subcarriers over a 35-km fiber link, using differential quadrature phase shift keying (DQPSK) modulation and direct detection. The system does not require chromatic dispersion compensation, optical time gating at the receiver (RX) or cyclic prefix (CP), achieving the maximum spectral efficiency. We use a wavelength selective switch (WSS) at the transmitter (TX) to allow subcarrier assignment flexibility and optimal filter shaping; an arrayed waveguide grating (AWG) AO-OFDM demultiplexer is used at the RX, to reduce the system cost and complexity.
Collapse
|
38
|
Tachibana D, Glosemeyer P, Diehl W, Nakagawa K, Wada N, Kurihara Y, Fukui M, Koyama M, Hecher K. Time-interval analysis of ductus venosus flow velocity waveforms in twin-to-twin transfusion syndrome treated with laser surgery. Ultrasound Obstet Gynecol 2015; 45:544-550. [PMID: 24975921 DOI: 10.1002/uog.13449] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/15/2014] [Accepted: 06/19/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To investigate time-interval variables of ductus venosus (DV) flow velocity waveforms (FVWs) in twin-to-twin transfusion syndrome (TTTS), comparing the results with reference ranges from normal singleton fetuses. The impact of laser surgery and the effect of prognostic factors were also evaluated. METHODS In 107 TTTS cases, DV-FVWs of both recipients and donors were recorded 1 day before and 2 days after laser therapy. Time intervals for systolic (S) and early diastolic (D) peaks were analyzed retrospectively with regard to acceleration time (acc-S and acc-D for S and D, respectively) and deceleration time (dec-S and dec-D for S and D, respectively). For each variable, Z-scores were calculated with respect to previously reported normal reference ranges. RESULTS Z-scores for all variables showed statistically significant differences from those observed previously in normal fetuses, with the exception of dec-S of donors. The most striking differences were observed in longer dec-S of recipients (P < 0.001) and longer dec-D of donors (P < 0.001). Laser therapy showed significant impact on dec-S and acc-D in recipients and on all variables in donors. Regarding the short-term prognosis, acc-S and dec-S showed significant differences for the prediction of intrauterine fetal demise in donors (P = 0.009 and P = 0.011, respectively). CONCLUSION This study demonstrates that time-interval variables of DV-FVWs may differentiate the characteristic hemodynamic changes caused by unbalanced blood volume between recipients and donors.
Collapse
Affiliation(s)
- D Tachibana
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan; Department of Obstetrics and Fetal Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Yamazaki N, Wada N, Yamauchi C, Yoneyama K. High expression of post-treatment Ki-67 status is a risk factor for locoregional recurrence following breast-conserving surgery after neoadjuvant chemotherapy. Eur J Surg Oncol 2015; 41:617-24. [PMID: 25771264 DOI: 10.1016/j.ejso.2015.01.036] [Citation(s) in RCA: 16] [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: 11/27/2014] [Revised: 01/23/2015] [Accepted: 01/28/2015] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION During the past decade, neoadjuvant chemotherapy (NAC) has been increasingly used in patients to reduce large tumors to a size eligible for breast-conserving therapy (BCT). However, the association between NAC and Ki-67 has not yet been fully elucidated. The aim of this study was to evaluate the prognostic significance of Ki-67, specifically after NAC followed by BCT, particularly in terms of locoregional recurrence (LRR). METHODS A total 217 patients who received BCT after NAC were retrospectively analyzed. In these patients, immunohistochemistry analyses defined four tumor subtypes, Luminal A, Luminal B, Triple negative, and HER2 type. Ki-67 was examined by immunohistochemistry in both pretreatment core needle samples and post-treatment surgical excision specimens. High Ki-67 expression was defined as >20%. The prognostic factors LRR, locoregional relapse-free survival (LRRFS), and overall survival (OS) were analyzed. RESULTS In total, LRR developed in 14 patients, and the 5 year-LRRFS was 94.2%. Post-treatment high Ki-67 expression, triple negative, the presence of lymphovascular invasion, and histological grade 3 were significantly high in LRR for prognostic factors (P < 0.05). There were significant differences in Kaplan-Meier method for LRRFS curves according to these three factors for patients receiving BCT following NAC (P < 0.05). There was a significant difference in the 5 year-OS for patients with and without LRR (41.7% vs. 93.9%, P < 0.001). CONCLUSION Post-treatment high Ki-67 expression could be one of the important prognostic factors of LRR, and require careful follow-up on LRR at the time of surveillance.
Collapse
Affiliation(s)
- N Yamazaki
- Department of Breast Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - N Wada
- Department of Breast Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
| | - C Yamauchi
- Department of Breast Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - K Yoneyama
- Department of Breast Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| |
Collapse
|
40
|
Hamasaki Y, Ishikura K, Uemura O, Ito S, Wada N, Hattori M, Ohashi Y, Tanaka R, Nakanishi K, Kaneko T, Honda M. Growth impairment in children with pre-dialysis chronic kidney disease in Japan. Clin Exp Nephrol 2015; 19:1142-8. [PMID: 25715867 DOI: 10.1007/s10157-015-1098-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 05/14/2014] [Accepted: 02/15/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND Growth impairment is a major complication of chronic kidney disease (CKD) in children. However, no cohort studies have examined the growth of Asian children with pre-dialysis CKD. METHODS We sent cross-sectional surveys to 113 Japanese medical institutions that were treating 447 children with CKD stages 3-5 in 2010 and 2011. Of 447 children included in our survey conducted in 2010, height and CKD stage were evaluable for 297 children in 2011, and height standard deviation score (height SDS) was calculated in these children. RESULTS Height SDS decreased with increasing CKD stage (P < 0.001) in boys and girls. Height SDS also decreased significantly with increasing CKD stage among patients with congenital anomalies of the kidney and urinary tract (P < 0.001). Risk factors for growth impairment included CKD stages 4 and 5 (relative to stage 3), being small-for-date, and asphyxia at birth. Among children with a height SDS ≤-2.0, growth hormone was used in 19.5, 31.0, and 25.0 % of children with CKD stages 3, 4, and 5, respectively. CONCLUSIONS This prospective cohort study revealed marked growth impairment in Japanese children with CKD stages 3-5 relative to healthy children. CKD-related risk factors for growth impairment included advanced CKD (stages 4 and 5), being small-for-date, and asphyxia at birth. Growth hormone was infrequently used in this cohort of children with pre-dialysis CKD.
Collapse
Affiliation(s)
- Yuko Hamasaki
- Department of Pediatric Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
| | - Kenji Ishikura
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.,Division of Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Osamu Uemura
- Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Naohiro Wada
- Department of Pediatric Nephrology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Motoshi Hattori
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Technology for Sustainable Society, Chuo University, Tokyo, Japan
| | - Ryojiro Tanaka
- Department of Nephrology, Hyogo Prefectural Children's Hospital, Hyogo, Japan
| | - Koichi Nakanishi
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Tetsuji Kaneko
- Division of Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Masataka Honda
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| |
Collapse
|
41
|
Inoue M, Minami M, Wada N, Nakagiri T, Funaki S, Kawamura T, Shintani Y, Okumura M. Results of surveillance bronchoscopy after cadaveric lung transplantation: a Japanese single-institution study. Transplant Proc 2015; 46:944-7. [PMID: 24767387 DOI: 10.1016/j.transproceed.2013.10.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 10/01/2013] [Indexed: 01/23/2023]
Abstract
BACKGROUND The prevention and early detection of post-transplantation rejection and infection are key clinical points to achieve long-term survival after lung transplantation. Although surveillance bronchoscopy (SB) is performed in many transplantation centers, it is still controversial because of its undefined clinical significance and its possible complications. We evaluated the clinical utility of SB after cadaveric lung transplantation in Japan, where bilateral transplantation is officially limited to patients medically requiring bilateral grafts. PATIENTS AND METHODS Twenty-eight patients who underwent cadaveric lung transplantation followed by SB were retrospectively analyzed with reference to the results of bronchoscopy. SB is routinely performed at 1, 2, 3, 6, and 12 months after lung transplantation and annually thereafter. Clinically indicated bronchoscopy (CIB) is considered in patients with suspected rejection or airway infection, and for follow-up examination after treatment for acute rejection. RESULTS There were 206 bronchoscopies, including 189 SBs and 17 CIBs, performed in 28 patients who underwent cadaveric lung transplantation between 2000 and 2013 at Osaka University Hospital. Among SBs, 92 (49%) showed positive results of transbronchial lung biopsy (TBLB) or bronchoalveolar lavage (BAL), and intervention was applied following 34 SBs (18%). Among CIBs, 8 (47%) showed positive results of TBLB or BAL, with intervention performed in 3 patients (18%). A2-3 and B2R findings according to the revised International Society for Heart and Lung Transplantation (ISHLT) rejection score and airway infection/colonization were frequently observed within a year following lung transplantation. Cytomegalovirus infection was found in 7 SBs (6%) by TBLB only within 2 months after transplantation. Regarding complications, moderate bleeding occurred in 21 (11%), pneumothorax in 2 (1%), prolonged hypoxemia in 1 (0.5%), and pneumonia in 1 (0.5%) among the 189 SBs. CONCLUSION SB frequently detects rejection and airway infection or colonization with minimum complications, especially within 12 months after cadaveric lung transplantation.
Collapse
Affiliation(s)
- M Inoue
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - M Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - N Wada
- Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Nakagiri
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - S Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Kawamura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - M Okumura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
42
|
Kitayama H, Wada N. [Pediatric AKI in critical care nephrology]. Nihon Jinzo Gakkai Shi 2015; 57:321-338. [PMID: 25939157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
43
|
Horiuchi N, Endo J, Wada N, Nozaki K, Nakamura M, Nagai A, Katayama K, Yamashita K. Dielectric properties of fluorine substituted hydroxyapatite: the effect of the substitution on configuration of hydroxide ion chains. J Mater Chem B 2015; 3:6790-6797. [DOI: 10.1039/c5tb00944h] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dielectric properties of fluoridated hydroxyapatite (F-HAp; Ca5(PO4)3(OH)1−xFx) were measured. The results show that the F-substitution induces the specific configuration that contains hydrogen bonds in F-HAp.
Collapse
Affiliation(s)
- N. Horiuchi
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - J. Endo
- Department of Applied Chemistry
- Tokai University
- Hiratsuka
- Japan
| | - N. Wada
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - K. Nozaki
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - M. Nakamura
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - A. Nagai
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| | - K. Katayama
- Department of Applied Chemistry
- Tokai University
- Hiratsuka
- Japan
| | - K. Yamashita
- Department of Inorganic Materials
- Institute of Biomaterials & Bioengineering
- Tokyo Medical and Dental University
- Tokyo 101-0062
- Japan
| |
Collapse
|
44
|
Puttnam BJ, Eriksson TA, Mendinueta JMD, Luís RS, Awaji Y, Wada N, Karlsson M, Agrell E. Modulation formats for multi-core fiber transmission. Opt Express 2014; 22:32457-32469. [PMID: 25607208 DOI: 10.1364/oe.22.032457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We investigate high dimensional modulation formats for multi-core fibers (MCFs) and spatial superchannels. We show that the low skew variations between MCF cores maybe exploited to generate 'multi-core' formats that offer significant advantages over independently transmitting conventional 4-dimensional formats in each core. We describe how pulse position modulation formats may be transposed to the spatial domain and then investigate a family of modulation formats referred to as core-coding, one of which has the same power and spectral efficiency as polarization switched quaternary phase shift keying but with half of the optical power, potentially improving non-linear tolerance for long distance transmission, albeit at the cost of implementation challenges. Finally, we investigate the application of set-partitioning to multi-core formats using a single-parity check bit transmitted in one quadrature of one polarization in one of the cores and polarization-division multiplexing quadrature phase shift keying data in all remaining cores. We observe that for high core counts, an advantage of almost 3 dB in asymptotic power efficiency may be obtained with negligible impact on spectral efficiency, which translates into experimentally measured reduction in the required optical signal-to-noise ratio of up to 1.8 dB at a bit-error-rate of 10-5 and the same data-rate, and additional transmission reach of up to 20%.
Collapse
|
45
|
Zakaria MN, Takeshita T, Shibata Y, Maeda H, Wada N, Akamine A, Yamashita Y. Microbial community in persistent apical periodontitis: a 16S rRNA gene clone library analysis. Int Endod J 2014; 48:717-28. [PMID: 25088120 DOI: 10.1111/iej.12361] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 03/07/2014] [Accepted: 07/31/2014] [Indexed: 12/19/2022]
Abstract
AIM To characterize the microbial composition of persistent periapical lesions of root filled teeth using a molecular genetics approach. METHODOLOGY Apical lesion samples were collected from 12 patients (23-80 years old) who visited the Kyushu University Hospital for apicectomy with persistent periapical lesions associated with root filled teeth. DNA was directly extracted from each sample and the microbial composition was comprehensively analysed using clone library analysis of the 16S rRNA gene. Enterococcus faecalis, Candida albicans and specific fimA genotypes of Porphyromonas gingivalis were confirmed using polymerase chain reaction (PCR) analysis with specific primers. RESULTS Bacteria were detected in all samples, and the dominant findings were P. gingivalis (19.9%), Fusobacterium nucleatum (11.2%) and Propionibacterium acnes (9%). Bacterial diversity was greater in symptomatic lesions than in asymptomatic ones. In addition, the following bacteria or bacterial combinations were characteristic to symptomatic lesions: Prevotella spp., Treponema spp., Peptostreptococcaceae sp. HOT-113, Olsenella uli, Slackia exigua, Selemonas infelix, P. gingivalis with type IV fimA, and a combination of P. gingivalis, F. nucleatum, and Peptostreptococcaceae sp. HOT-113 and predominance of Streptococcus spp. On the other hand, neither Enterococcus faecalis nor C. albicans were detected in any of the samples. CONCLUSION Whilst a diverse bacterial species were observed in the persistent apical lesions, some characteristic patterns of bacterial community were found in the symptomatic lesions. The diverse variation of community indicates that bacterial combinations as a community may cause persistent inflammation in periapical tissues rather than specific bacterial species.
Collapse
Affiliation(s)
- M N Zakaria
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Faculty of Medicine, Jenderal Achmad Yani University, Bandung, Indonesia
| | - T Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Y Shibata
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - H Maeda
- Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - N Wada
- Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - A Akamine
- Division of Oral Rehabilitation, Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Y Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| |
Collapse
|
46
|
Kaneko M, Hosono A, Sasaki M, Matsubara N, Naito Y, Saito S, Yamanaka T, Wada N, Mukai H. Transition of Recurrence-Free Survival for Early-Stage Breast Cancer at National Cancer Center Hospital East. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
47
|
Monnouchi S, Maeda H, Yuda A, Hamano S, Wada N, Tomokiyo A, Koori K, Sugii H, Serita S, Akamine A. Mechanical induction of interleukin-11 regulates osteoblastic/cementoblastic differentiation of human periodontal ligament stem/progenitor cells. J Periodontal Res 2014; 50:231-9. [DOI: 10.1111/jre.12200] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2014] [Indexed: 12/15/2022]
Affiliation(s)
- S. Monnouchi
- Division of Oral Rehabilitation; Department of Endodontology and Operative Dentistry; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - H. Maeda
- Department of Endodontology; Kyushu University Hospital; Fukuoka Japan
| | - A. Yuda
- Division of Oral Rehabilitation; Department of Endodontology and Operative Dentistry; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - S. Hamano
- Division of Oral Rehabilitation; Department of Endodontology and Operative Dentistry; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - N. Wada
- Department of Endodontology; Kyushu University Hospital; Fukuoka Japan
| | - A. Tomokiyo
- Division of Oral Rehabilitation; Department of Endodontology and Operative Dentistry; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - K. Koori
- Division of Oral Rehabilitation; Department of Endodontology and Operative Dentistry; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - H. Sugii
- Division of Oral Rehabilitation; Department of Endodontology and Operative Dentistry; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - S. Serita
- Department of Endodontology; Kyushu University Hospital; Fukuoka Japan
| | - A. Akamine
- Division of Oral Rehabilitation; Department of Endodontology and Operative Dentistry; Faculty of Dental Science; Kyushu University; Fukuoka Japan
- Department of Endodontology; Kyushu University Hospital; Fukuoka Japan
| |
Collapse
|
48
|
Kibe T, Sobajima T, Yoshimura A, Uno Y, Wada N, Ueta I. Secondary pseudohypoaldosteronism causing cardiopulmonary arrest and cholelithiasis. Pediatr Int 2014; 56:270-2. [PMID: 24730631 DOI: 10.1111/ped.12267] [Citation(s) in RCA: 8] [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] [Received: 02/19/2013] [Revised: 09/26/2013] [Accepted: 10/25/2013] [Indexed: 11/27/2022]
Abstract
A 4-month-old boy presented with cardiopulmonary arrest on arrival after a brief period of lethargy. Laboratory examination indicated severe hyperkalemia, hyponatremia, metabolic acidosis, and slightly elevated C-reactive protein. Whole body computed tomography identified left-dominant hydronephrosis, hydroureter and cholelithiasis. Despite cardiac arrest >30 min, he was successfully resuscitated and treated with therapeutic hypothermia. Escherichia coli was detected on urine culture. Renal ultrasound showed bilateral hydronephrosis, grade II in the right and grade IV in the left. Retrospective analysis of the blood sample at admission indicated a high level of aldosterone. The patient recovered almost fully with no electrolyte imbalance and normal plasma renin and aldosterone, leading to the diagnosis of secondary pseudohypoaldosteronism associated with bilateral infected hydronephrosis. In this case, cholelithiasis, which may account for chronic dehydration, was a diagnostic clue in the absence of information of pre-existing situations.
Collapse
Affiliation(s)
- Tetsuya Kibe
- Department of Pediatrics, Seirei-Mikatahara General Hospital, Shizuoka, Japan
| | | | | | | | | | | |
Collapse
|
49
|
Amaya N, Yan S, Channegowda M, Rofoee BR, Shu Y, Rashidi M, Ou Y, Hugues-Salas E, Zervas G, Nejabati R, Simeonidou D, Puttnam BJ, Klaus W, Sakaguchi J, Miyazawa T, Awaji Y, Harai H, Wada N. Software defined networking (SDN) over space division multiplexing (SDM) optical networks: features, benefits and experimental demonstration. Opt Express 2014; 22:3638-3647. [PMID: 24663655 DOI: 10.1364/oe.22.003638] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We present results from the first demonstration of a fully integrated SDN-controlled bandwidth-flexible and programmable SDM optical network utilizing sliceable self-homodyne spatial superchannels to support dynamic bandwidth and QoT provisioning, infrastructure slicing and isolation. Results show that SDN is a suitable control plane solution for the high-capacity flexible SDM network. It is able to provision end-to-end bandwidth and QoT requests according to user requirements, considering the unique characteristics of the underlying SDM infrastructure.
Collapse
|
50
|
Ishikura K, Uemura O, Hamasaki Y, Ito S, Wada N, Hattori M, Ohashi Y, Tanaka R, Nakanishi K, Kaneko T, Honda M. Progression to end-stage kidney disease in Japanese children with chronic kidney disease: results of a nationwide prospective cohort study. Nephrol Dial Transplant 2014; 29:878-84. [PMID: 24516225 DOI: 10.1093/ndt/gfu012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The risk of progressing to end-stage kidney disease (ESKD) and factors associated with progression in children with chronic kidney disease (CKD) are unclear, especially in Asian children. METHODS We started a nationwide, prospective cohort study of 447 Japanese children with pre-dialysis CKD in 2010, with follow-up in 2011. Progression to ESKD was analyzed by Kaplan-Meier analysis according to CKD stage. Cox regression analysis was used to identify risk factors for progression. RESULTS Data were analyzed for 429/447 children. Five patients died, of which four died before progression to ESKD. Fifty-two patients progressed to ESKD (median follow-up 1.49 years), including 9/315 patients with stage 3 CKD, 29/107 with Stage 4 CKD and 14/25 with Stage 5 CKD. One-year renal survival rates were 98.3, 80.0 and 40.9%, for Stages 3, 4 and 5 CKD, respectively. Risk factors for progression to ESKD included CKD stage [versus Stage 3; Stage 4: hazard ratio (HR) 11.12, 95% confidence interval (CI) 4.22-29.28, P < 0.001; Stage 5: HR 26.95, 95% CI 7.71-94.17, P < 0.001], heavy proteinuria (>2.0 g/g urine creatinine; HR 7.56, 95% CI 3.22-17.77, P < 0.001) and age ( < 2 years: HR 9.06; 95% CI 2.29-35.84, P = 0.002; after starting puberty: HR 4.88; 95% CI 1.85-12.85, P = 0.001). CONCLUSIONS In this cohort, 12.5% of children with pre-dialysis CKD progressed to ESKD with a median-follow-up of 1.49 years. Children with advanced (Stage 4/5) CKD were particularly likely to progress. To our knowledge, this is the first, nationwide, prospective cohort study of children with pre-dialysis CKD in Asia.
Collapse
Affiliation(s)
- Kenji Ishikura
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|