柱本 照 | ![]() |
ハシラモト アキラ | |
大学院保健学研究科 保健学専攻 | |
教授 | |
医学 |
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研究論文(学術雑誌)
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研究論文(学術雑誌)
The cause of systemic lupus erythematosus (SLE) is unknown. IFN-α has been suggested as a causative agent of SLE; however, it was not proven, and to what extent and how IFN-α contributes to the disease is unknown. We studied the contribution of IFN-α to SLE by generating inducible IFN-α transgenic mice and directly show that conditional upregulation of IFN-α alone induces a typical manifestation of SLE in the mice not prone to autoimmunity, such as serum immune complex, autoantibody against dsDNA (anti-dsDNA Ab), and the organ manifestations classical to SLE, such as immune complex-deposited glomerulonephritis, classical splenic onion-skin lesion, alopecia, epidermal liquefaction, and positive lupus band test of the skin. In the spleen of mice, activated effector CD4 T cells, IFN-γ-producing CD8 T cells, B220+CD86+ cells, and CD11c+CD86+ cells were increased, and the T cells produced increased amounts of IL-4, IL-6, IL-17, and IFN-γ and decreased IL-2. In particular, activated CD3+CD4-CD8- double-negative T cells positive for TCRαβ, B220, CD1d-teteramer, PD-1, and Helios (that produced increased amounts of IFN-γ, IL-4, IL-17, and TNF-α) were significantly expanded. They infiltrated into kidney and induced de novo glomerulonephritis and alopecia when transferred into naive recipients. Thus, sole upregulation of IFN-α is sufficient to induce SLE, and the double-negative T cells expanded by IFN-α are directly responsible for the organ manifestations, such as lupus skin disease or nephritis.
2019年08月, J Immunol, 203 (4), 835 - 843, 英語, 国際誌[査読有り]
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研究論文(学術雑誌)
Background: Effects of methotrexate (MTX) on the proliferation of rheumatoid arthritis (RA) synovial fibroblasts are incompletely understood. We explored actions of MTX in view of circadian transcriptions of synovial fibroblasts. Methods: Under treatment with MTX, expression of core circadian clock genes, circadian transcriptional factor proline and acidic amino acid-rich basic leucine zipper (PAR bZIP), and proapoptotic molecule Bcl-2 interacting killer (Bik) was examined by real-time polymerase chain reaction. Protein expression of circadian clock gene PERIOD2 (PER2) and CYTOCHROME C was also examined by western blotting and ELISA. Promoter activities of Per2 and Bik were measured by Luciferase assay. Expression of PER2, BIK, and CYTOCHROME C and morphological changes of the nucleus were observed by fluorescent immunostaining. Synovial fibroblasts were transfected with Per2/Bik small interfering RNA, and successively treated with MTX to determine cell viabilities. Finally, synovial fibroblasts were treated with MTX according to the oscillation of Per2/Bik expression. Results: MTX (10 nM) significantly decreased cell viabilities, but increased messenger RNA expression of Per2, Bik, and PAR ZIP including D site of the albumin promoter binding protein (Dbp), hepatic leukemia factor (Hlf), and thyrotroph embryonic factor (Tef). MTX also increased protein expression of PER2 and CYTOCHROME C, and promoter activities of Per2 and Bik via D-box. Under fluorescent observations, expression of PER2, BIK, and CYTOCHROME C was increased in apoptotic cells. Cytotoxicity of MTX was attenuated by silencing of Per2 and/or Bik, and revealed that MTX was significantly effective in situations where Per2/Bik expression was high. Conclusions: We present here novel unique action of MTX on synovial fibroblasts that upregulates PAR bZIP to transcribe Per2 and Bik, resulting in apoptosis induction. MTX is important in modulating circadian environments to understand a new aspect of pathogenesis of RA.
BioMed Central Ltd., 2018年03月22日, Arthritis Research and Therapy, 20 (1), 55, 英語[査読有り]
研究論文(学術雑誌)
Tumor necrosis factor (TNF)-α is responsible for expressions of several clock genes and affects joint symptoms of rheumatoid arthritis (RA) with diurnal fluctuation. We tried to determine the mechanism involved in over-expression of Bmal1, induced by TNF-α, in primary cultured rheumatoid synovial cells. Cells were incubated with intra-cellular Ca2+ chelator BAPTA-AM, calcineurin inhibitor FK506 and p300/CBP (CREB binding protein) inhibitor C646, respectively, or transfected with p300 and CBP small interfering RNA (siRNA) before stimulation with TNF-α. Oscillation phase and amplitude of Bmal1, transcriptional activator Rorα, transcriptional repressor Rev-erbα, and histone acetyltransferases (p300 and Cbp) were evaluated by quantitative real-time PCR. As results, TNF-α did not influence the oscillation phase of Rev-erbα, while enhanced those of Rorα, resulting in over-expression of Bmal1. When Ca2+ influx was inhibited by BAPTA-AM, TNF-α-mediated up-regulation of Rorα was cancelled, however, that of Bmal1 was still apparent. When we further explored another pathway between TNF-α and Bmal1, TNF-α suppressed the expression of Rev-erbα in the absence of Ca2+ influx, as well as those of p300 and Cbp genes. Finally, actions of TNF-α, in increasing Bmal1/Rorα and decreasing Rev-erbα, were cancelled by C646 treatment or silencing of both p300 and Cbp. In conclusion, we determined a novel role of TNF-α in inducing Bmal1 via dual calcium dependent pathways Rorα was up-regulated in the presence of Ca2+ influx and Rev-erbα was down-regulated in the absence of that. Results proposed that inhibition of p300/CBP could be new therapeutic targets for RA.
Elsevier B.V., 2018年01月08日, Biochem Biophys Res Commun., 495 (2), 1675 - 1680, 英語[査読有り]
研究論文(学術雑誌)
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研究論文(学術雑誌)
Rheumatoid arthritis (RA) is a chronic polyarthritis of unknown etiology. To unravel the molecular mechanisms in RA, we performed targeted DNA sequencing analysis of patients with RA. This analysis identified a variant of the death receptor 3 (DR3) gene, a member of the family of apoptosis-inducing Fas genes, which contains four single-nucleotide polymorphisms (SNPs) and a 14-nucleotide deletion within exon 5 and intron 5. We found that the deletion causes the binding of splicing regulatory proteins to DR3 pre-mRNA intron 5, resulting in a portion of intron 5 becoming part of the coding sequence, thereby generating a premature stop codon. We also found that this truncated DR3 protein product lacks the death domain and forms a heterotrimer complex with wildtype DR3 that dominant-negatively inhibits ligand-induced apoptosis in lymphocytes. Myelocytes from transgenic mice expressing the human DR3 variant produced soluble truncated DR3, forming a complex with TNF-like ligand 1A (TL1A), which inhibited apoptosis induction. In summary, our results reveal that a DR3 splice variant that interferes with ligand-induced T cell responses and apoptosis may contribute to RA pathogenesis.
American Society for Biochemistry and Molecular Biology Inc., 2018年, Journal of Biological Chemistry, 293 (6), 1933 - 1943, 英語[査読有り]
研究論文(学術雑誌)
Aim: To evaluate the correlation between circulating cell-free DNA (ccfDNA) in plasma and clinical disease activities in patients with rheumatoid arthritis (RA). Method: The study group included 30 patients with RA who started biological disease-modifying anti-rheumatic drugs (DMARDs) therapy. The concentration of ccfDNA in plasma was measured by quantitative real-time polymerase chain reaction at baseline to 24 weeks in every 4-week period from 30 patients and 21 healthy individuals. We also evaluated the correlation between ccfDNA and the clinical activity or the therapeutic response for biological DMARDs, using the simplified disease activity index (SDAI), Disease Activity Score of 28 joints (erythrocyte sedimentation rate) and the European League Against Rheumatism (EULAR) response criteria. Synovial fluid samples of knee joints were collected from 13 patients with RA and 12 with osteoarthritis (OA) to measure ccfDNA. Result: The concentration of ccfDNA in RA patients at baseline was higher than healthy controls (P = 0.016). After introducing biological DMARDs, ccfDNA was increased until 8 weeks from the baseline, and decreased after 12 weeks. The average of SDAI was improved in all patients enrolled. At 12 weeks after treatment, 15 patients were good responders to the EULAR response criteria, nine showed moderate response and six showed no response. ccfDNA in good responders was increased until 8 weeks, while those of moderate or no response were not (P = 0.042). In joint fluid of RA patients, ccfDNA was remarkably increased as compared to those from OA (P = 0.00011). Conclusion: After introducing biological DMARDs, increase of ccfDNA at 8 weeks was associated with improvement of disease activities. Compared with biomarkers reported, ccfDNA is able to predict the early therapeutic effects of biological DMARDs in RA patients.
WILEY, 2017年06月, INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, 20 (6), 722 - 730, 英語[査読有り]
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【目的】DNAは細胞傷害やアポトーシスにより末梢血中に放出される.近年,末梢血の遊離DNAがさまざまな疾患のバイオマーカーとして認識されてきているが,関節リウマチ(RA)患者においては,その意義は不明である.今回,RA患者に関して血清遊離DNAと疾患活動性の関連について調べたので報告する.【方法】当院で生物学的製剤を開始したRA患者21例について,投与前から24週まで4週おきに血液検査を行い,リアルタイムPCRを用いて血清遊離DNAを測定し,疾患活動性も同時に評価した.比較対象として,健常人10例でも血清遊離DNAを測定した.加えて,RA患者5例の膝関節液を採取し遊離DNAを測定した.【結果】生物学的製剤投与前のRA患者と健常人で,血清遊離DNAに差はなかった.継時的にみると,投与開始後12週までに遊離DNAが上昇する群(n = 10)と変化しない群(n = 11)に分かれた.2群を比較すると,遊離DNA上昇群では罹病期間が短く(P = 0.012),治療前疾患活動性(SDAI)が高かった(P = 0.041).またΔSDAI(P = 0.021),ΔCDAI(P = 0.027)も高く,疾患活動性が有意に改善していた.DNAは白血球にも含まれるが,この変化に差はなかった.関節液遊離DNAは著増していた.【結論】遊離DNAが血球系とは相関せず,関節液中で著増していたことを考慮すると,血清遊離DNAが滑膜細胞由来であることが示唆される.高疾患活動性のRA患者で遊離DNAが生物学的製剤の治療反応性を予測するマーカーとなるかもしれない.
The Japan Society for Clinical Immunology, 2015年, 日本臨床免疫学会会誌, 38 (4), 361a - 361a, 日本語[査読有り]
研究論文(学術雑誌)
Among the symptoms of patients with rheumatoid arthritis ( RA), joint stiffness is influenced by diurnal rhythm and reaches peak in the morning, which is a common complaint and reflects the circadian nature of disease manifestation. In addition, inflammatory cytokines, which reach peak secretion early in the morning are major players causing the morning stiffness. In this review, we explore the link between the circadian clock and inflammation, focusing on the interactions of various clock genes with the immune-pathways underlying the pathology of rheumatoid arthritis.
HINDAWI PUBLISHING CORPORATION, 2014年, JOURNAL OF IMMUNOLOGY RESEARCH, 2014, 282495, 英語[査読有り]
研究論文(学術雑誌)
Objective: To determine the optimal conditions for inducing rheumatoid arthritis (RA) into disease remission by tocilizumab (TCZ), we analyzed the TCZ therapy carried out in our facility. Method: The study group comprised 116 patients with RA who started TCZ therapy at Kobe University Hospital and Konan-Kakogawa Hospital. The clinical response to TCZ was evaluated by the 2011 Boolean definition and the disease activity score of 28 joints erythrocyte sedimentation rate 4 (DAS28-ESR4). Results: After 24 weeks of TCZ therapy, 25.9 % of the patients achieved a Boolean-defined disease remission (Boolean remission). DAS28-ESR4 was improved from 5.25 ± 1.15 at week 0 to 2.75 ± 1.34 at week 24 (mean ± SD, P < 0.0001), and 57.8 % patients achieved DAS28 remission. Analysis of the relationship between disease duration and remission showed that this odds ratio peaked at 3.0 years. Univariate analyses showed that Boolean remission was associated with baseline ESR levels, Steinbrocker's class and stage, and patient global assessment of disease activity (PGA). Accordingly, we categorized and compared the patient groups referring to the 3.0-year peak. We found significant differences in Steinbrocker's class and stage. Conclusion: TCZ therapy leading to Boolean disease remission is optimal when initiated less than 3.0 years after disease onset. © Japan College of Rheumatology 2013.
2013年11月, Modern Rheumatology, 23 (6), 1192 - 1197, 英語[査読有り]
研究論文(学術雑誌)
We investigated the role of effector CD8 T cells in the pathogenesis of immune glomerular injury. BALB/c mice are not prone to autoimmune disease, but after 12 immunizations with OVA they developed a variety of autoantibodies and glomerulonephritis accompanied by immune complex (IC) deposition. In these mice, IFN-γ-producing effector CD8 T cells were significantly increased concomitantly with glomerulonephritis. In contrast, after 12 immunizations with keyhole limpet hemocyanin, although autoantibodies appeared, IFN-γ-producing effector CD8 T cells did not develop, and glomerular injury was not induced. In β2-microglobulin-deficient mice lacking CD8 T cells, glomerular injury was not induced after 12 immunizations with OVA, despite massive deposition of IC in the glomeruli. In mice containing a targeted disruption of the exon encoding the membrane-spanning region of the Ig μ-chain (μMT mice), 12 immunizations with OVA induced IFN-γ- producing effector CD8 T cells but not IC deposition or glomerular injury. When CD8 T cells from mice immunized 12 times with OVA were transferred into naive recipients, glomerular injury could be induced, but only when a single injection of OVA was also given simultaneously. Importantly, injection of OVA could be replaced by one injection of the sera from mice that had been fully immunized with OVA. This indicates that deposition of IC is required for effector CD8 T cells to cause immune tissue injury. Thus, in a mouse model of systemic lupus erythematosus, glomerular injury is caused by effector CD8 T cells that recognize Ag presented as IC on the target renal tissue. Copyright © 2013 by The American Association of Immunologists, Inc.
2013年07月01日, J Immunol, 191 (1), 91 - 96, 英語[査読有り]
研究論文(学術雑誌)
Characteristic features of rheumatoid arthritis (RA) include the production of proinflammatory cytokines and disease-specific auto-antibodies and the manifestation of disease symptoms in a circadian pattern, typified by morning stiffness. The pathogenesis of RA involves the activation of the proto-oncogene c-Fos and the cell cycle regulator Wee1 kinase, which cause synovial cellular overgrowth leading to characteristic 'tumor-like' and arthritic joint destruction. It has been reported that in mice genetically deleted for cryptochrome (Cry) 1/2, circadian clock genes that directly regulate circadian rhythm, free-running rhythmicity is abolished and Wee1 kinase is constitutively upregulated. Therefore, to examine more closely the potential circadian regulation of rheumatoid arthritis, we induced experimental arthritis in Cry knockout mice and observed an interplay between Cry gene activity and proinflammatory cytokine tumor necrosis factor-α (TNF-α) production. Thus, the biological clock and arthritis influence each other, and a further understanding of this interplay could lead to treatments that may improve the activity of daily living (ADL) of patients with RA. © 2013-IOS Press and the authors. All rights reserved.
2013年, Advances in Neuroimmune Biology, 4 (1), 7 - 11, 英語[査読有り]
研究論文(学術雑誌)
Objectives: To study the effect of tumour necrosis factor (TNF)-α, responsible for the inflammation and circadian rhythm of rheumatoid arthritis (RA), on the expression of circadian clock genes in primary cultured human rheumatoid synovial cells. Method: The expression of circadian clock genes, including circadian locomotor output cycles kaput (Clock), brain and muscle Arnt-like protein-1 (Bmal1), period (Per)1/2, and cryptochrome (Cry)1/2, and the proline and acidic amino acid-rich basic leucine zipper (PAR bZip) genes, a transcriptional activator of Per2, including D site of albumin promoter binding protein (Dbp), hepatic leukaemia factor (Hlf), and thyrotroph embryonic factor (Tef), and a transcriptional repressor of Per2, E4-binding protein 4 (E4bp4), in TNF-α-stimulated synovial cells was determined by real-time polymerase chain reaction (PCR). The D-box motifs in the Per2 promoter were mutated by site-directed mutagenesis, and the promoter activity of the Per2 gene was examined using the luciferase assay. Results: TNF-α enhanced the mRNA expression of Bmal1 and Cry1 but did not affect that of Clock, Per1, or Cry2. However, TNF-α inhibited the mRNA expression of the Per2 gene, as well as Dbp, Hlf, and Tef, but enhanced the mRNA expression of E4bp4. Furthermore, TNF-α inhibited the transcriptional activity of the wild-type Per2 gene in a manner dependent on the D-box 1 and D-box 2 motifs in the Per2 promoter. Conclusions: TNF-α modulates the expression of the Per2 gene through the D-box binding proteins DBP, HLF, TEF, and E4BP4, in rheumatoid synovial cells, and thereby may contribute to the pathogenesis of RA. © 2013 Taylor & Francis on license from Scandinavian Rheumatology Research Foundation.
2013年, Scand J Rheumatol, 42 (4), 276 - 280, 英語[査読有り]
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Objective To compare reasons for discontinuation and drug retention rates per reason among anticytokine therapies, infliximab, etanercept and tocilizumab, and the risk of discontinuation of biological agents due to adverse events (AE) in patients with rheumatoid arthritis (RA). Method This prospective cohort study included Japanese RA patients who started infliximab (n = 412, 636.0 patient-years (PY)), etanercept (n = 442, 765.3 PY), or tocilizumab (n = 168, 206.5 PY) as the first biological therapy after their enrolment in the Registry of Japanese Rheumatoid Arthritis Patients for Long-term Safety (REAL) database. Drug retention rates were calculated using the Kaplan-Meier method. To compare risks of drug discontinuation due to AE for patients treated with these biological agents, the Cox proportional hazard model was applied. Results The authors found significant differences among the three therapeutic groups in demography, clinical status, comorbidities and usage of concomitant drugs. Development of AE was the most frequent reason for discontinuation of biological agents in the etanercept and tocilizumab groups, and the second most frequent reason in the infliximab group. Discontinuation due to good control was observed most frequently in the infliximab group. Compared with etanercept, the use of infliximab (HR 1.69; 95% CI 1.14 to 2.51) and tocilizumab (HR 1.98; 95% CI 1.04 to 3.76) was significantly associated with a higher risk of discontinuation of biological agents due to AE. Conclusions Reasons for discontinuation are significantly different among biological agents. The use of infliximab and tocilizumab was significantly associated with treatment discontinuation due to AE compared with etanercept.
BMJ PUBLISHING GROUP, 2012年11月, ANNALS OF THE RHEUMATIC DISEASES, 71 (11), 1820 - 1826, 英語[査読有り]
研究論文(学術雑誌)
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Objective. To investigate associations between continuous treatments with tumor necrosis factor (TNF) antagonists and risk for developing serious infections (SIs) over 3 years in Japanese patients with rheumatoid arthritis (RA) enrolled in the Registry of Japanese RA Patients for Long-Term Safety (REAL) database. Methods. We analyzed 727 RA patients who had started either infliximab or etanercept (the anti-TNF group; 1,480.1 patient-years [PY]) and 571 RA patients who had started conventional nonbiologic disease-modifying antirheumatic drugs (the unexposed group; 1,104.1 PY) at the time of enrollment in the REAL. We assessed the occurrence of SIs within a 3-year observation period, including the period after switching to other TNF antagonists, and all SIs, unlimited to the first one in each patient as reported in other studies, to evaluate the real safety of TNF antagonists in daily practice. Results. The incidence rate of SIs per 100 PY was 5.54 (95% confidence interval [95% CI] 4.44-6.84) in the anti-TNF group and 2.72 (95% CI 1.87-3.83) in the unexposed group. Poisson regression analysis revealed that the relative risk (RR) of continuous use of TNF antagonists for SIs after adjusting for baseline and time-dependent covariates was significantly elevated both overall (1.97, 95% CI 1.25-3.19) and for the first year (2.40, 95% CI 1.20-5.03), but not for the second and third years combined (1.38, 95% CI 0.80-2.43). The adjusted RR for SIs of etanercept compared to infliximab was not significantly elevated. Conclusion. Continuous anti-TNF therapy was significantly associated with increased risks for developing SIs during, but not after, the first year.
WILEY-BLACKWELL, 2012年08月, ARTHRITIS CARE & RESEARCH, 64 (8), 1125 - 1134, 英語[査読有り]
研究論文(学術雑誌)
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症例は、いずれもゴットロン徴候やヘリオトロープ疹などの皮膚筋炎(DM)に特有な皮疹を有していた。また、明らかな筋力低下はみられなかったが、筋原性酵素の上昇を認め、Bohanの基準でpossible DMと診断。抗J0-1抗体は陰性で、発症時より間質性肺炎を合併していた。間質性肺炎の進行速度は急性〜亜急性と差はみられたが、ステロイド、シクロスポリン(CsA)、シクロフォスファミド(CPA)などの免疫抑制剤による併用治療が無効であった。剖検の結果、肺病変はdiffuse alveolar damage(DAD)で、感染の合併はなく、DMに伴う急性間質性肺炎による呼吸不全が死因と考えられた。(著者抄録)
(一財)甲南病院, 2012年04月, 甲南病院医学雑誌, 29, 44 - 47, 日本語We evaluated whether or not the effect of adalimumab (ADA) in combination with the disease-modifying antirheumatic drugs (DMARDs) other than methotrexate (MTX) is comparable to the ADA+MTX therapy for the treatment of rheumatoid arthritis (RA). A total of 216 patients with active RA at Kohnan Kakogawa Hospital and Kobe University Hospital were enrolled. Clinical and functional outcomes were compared among 4 groups, ADA alone (A group), ADA + MTX (B group), ADA + MTX + other DMARDs (C group), and ADA + other DMARDs (D group), and the retention rates of ADA were evaluated with or without MTX. CRP was significantly decreased from initial measurement at 1 month in all 4 groups, but the continuous efficacy with the statistical significance at all measurement points were observed only in combination with MTX (P< 0.05), which was reflected by significantly higher retention rates. Similarly, the disease activities were improved, and particularly the remission rates (DAS28-CRP < 2.3) of A, B and C groups (> 42.9%) were higher than that of D group (29.4%) at 2 year. An index of patients' basic activities of daily living, M-HAQ score of A, B and C groups was also better than that of D group. While, looking at the mean changes of M-HAQ from the baseline at 2 years, potential effect of other DMARDs on M-HAQ was also suggested. The results show that ADA + MTX therapy is significantly superior than ADA + other DMARDs in ameliorating RA.
2012年, Kobe Journal of Medical Sciences, 58 (2), 41 - 50, 英語[査読有り]
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Objective. To study the genetic contribution of major histocompatibility complex class I polypeptide-related sequence A (MICA), important in natural killer (NK) cell function, in patients with systemic lupus erythematosus (SLE). Methods. Japanese patients with SLE (n = 716), those with rheumatoid arthritis (RA) (n = 327), and healthy control subjects (n = 351) were genotyped for the Val(129)Met polymorphism (rs1051792) and transmembrane (TM) alanine-encoding GCT repeats, termed A4, A5, A5.1, A6, and A9, in the MICA gene. Recombinant human MICA-GST fusion proteins were tested on the NK cell line NK92MI for the expression of NK group 2, member D (NKG2-D), NK cell-mediated cytotoxicity, and interferon-gamma (IFN gamma) production. Results. The MICA (129)Met allele, TMA9 allele, and (129)Met/Met genotype were positively associated with SLE (corrected P [P-corr] = 0.01 and odds ratio [OR] 1.3, P-corr = 0.003 and OR 1.6, and P-corr = 0.02 and OR 1.8, respectively), while the MICA (129)Val allele was negatively associated with SLE (P-corr = 0.01, OR 0.8). The MICA (129)Met;A9 haplotype was also associated with SLE (P-corr = 0.0006, OR 1.8), and there was an additive genetic effect between the MICA (129)Met; A9 haplotype and HLA-DRB1*15:01. When NK92MI cells were incubated in vitro with recombinant human disease-associated (129)Met; A9 (the combination of polymorphisms at (129)Met and TMA9), expression of NKG2-D on NK92MI cells and cytotoxicity of the NK cells were inhibited, but production of IFN gamma from NK92MI cells was enhanced. Conclusion. The MICA polymorphism is genetically associated with SLE, and MICA appears to contribute to the pathogenesis of SLE by modulating NK cell function.
WILEY-BLACKWELL, 2011年10月, ARTHRITIS AND RHEUMATISM, 63 (10), 3058 - 3066, 英語[査読有り]
研究論文(学術雑誌)
Objective. To compare tumor necrosis factor-alpha (TNF-alpha) inhibitors to nonbiological disease-modifying antirheumatic drugs (DMARD) for the risk of serious infection in Japanese patients with rheumatoid arthritis (RA). Methods. Serious infections occurring within the first year of the observation period were examined using the records for patients recruited to the Registry of Japanese Rheumatoid Arthritis Patients for Longterm Safety (REAL), a hospital-based prospective cohort of patients with RA. The analysis included 1144 patients, 646 of whom were treated with either infliximab or etanercept [exposed group: 592.4 patient-years (PY)]. The remaining 498 patients received nonbiological DMARD with no biologics (unexposed group: 454.7 PY). Results. In the unexposed group, the incidence rate for all serious adverse events (SAE) was 9.02/100 PY and for serious infections, 2.64/100 PY. In the exposed group, SAE occurred in 16.04/100 PY and serious infections in 6.42/100 PY. The crude incidence rate ratio comparing serious infections in the exposed group with the unexposed group was 2.43 (95% Cl 1.27-4.65), a significant increase. A multivariate analysis revealed that the use of TNF inhibitors is a significant independent risk factor for serious infection (relative risk 2.37, 95% Cl 1.11-5.05, p = 0.026). Conclusion. Our study has provided the first epidemiological data on Japanese patients with RA for the safety of TNF inhibitors compared to nonbiological DMARD for up to 1 year of treatment. Anti-TNF therapy was associated with a significantly increased risk for serious infections, compared to treatment with nonbiological DMARD. (First Release April 15 2011; J Rheumatol 2011; 38:1258-64; doi:10.3899/jrheum.101009)
J RHEUMATOL PUBL CO, 2011年07月, JOURNAL OF RHEUMATOLOGY, 38 (7), 1258 - 1264, 英語[査読有り]
研究論文(学術雑誌)
Methods. Expression of integrin-alpha 5 beta 1 and integrin-linked kinase (ILK) in synovial cells was determined by western blot. The peripheral localization of ILK, reorganization of F-actin, complex formation of ILK with particularly interesting new cysteine-histidine protein (PINCH) and alpha-parvin, and activation of Rac/cdc42 in synovial cells were examined by using immunohistochemistry and immunoprecipitation. Apoptosis induction by GA treatment was analysed by nuclear staining, cell proliferation assay and western blot of caspase. Effects of GA on mitogen-activated protein kinase (MAPK), PI-3K/protein kinase B (Akt) pathway, mitochondrial Bcl-2 pathway and activation of nuclear factor-kappa B (NF-kappa B) were examined by western blot and ELISA. Results. HSP90 was overexpressed in synovial cells while GA decreased the expression of integrin-alpha 5 beta 1 and ILK. The peripheral localization of ILK, reorganization of F-actin, complex formation of ILK with PINCH and alpha-parvin, and activation of Rac/cdc42 in synovial cells were all inhibited by GA treatment. We found that HSP90 stabilized and regulated the MAPK and PI-3K/Akt pathway, thereby inhibiting HSP90-potentiated synovial apoptosis by stimulating caspases and the mitochondrial Bcl-2 pathway on the one hand and inhibiting the activation of NF-kappa B on the other. Conclusion. The contribution of HSP90 is important in the pathogenesis of RA that potentiates a tumour-like synovial overgrowth by stabilizing ILK, extracellular signal-regulated kinase and Akt.
OXFORD UNIV PRESS, 2011年05月, RHEUMATOLOGY, 50 (5), 852 - 861, 英語[査読有り]
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Synovial mesenchymal cells, matrix metalloproteinases (MMPs), and osteoclasts are the three major players directly responsible for the pathogenesis of rheumatoid joint destruction. First, synovial mesenchymal cells, internally driven by a transcription factor c-Fos/AP-1, not only directly invade cartilage and bone as a granulation tissue called "pannus" but also release inflammatory cytokine interleukin (IL)-1 beta. IL-1 beta induces MMPs and activates osteoclasts. Synovial cells can also present antigen to T cells to drive antigen-specific immune responses. Second, cartilaginous joint matrix can only be degraded after the first attack of collagen fibrils by MMPs, and importantly, most of the MMPs are under the control of c-Fos/AP-1 and IL-1 beta as well. Third, differentiation of osteoclast is driven internally by NFATc1, where NFATc1 is under the control of TRAF6, c-Fos/AP-1 and osteoclastogenic signaling complex. IL-1 beta has been shown to induce osteoclastogenesis directly and also indirectly via signaling through RANKL. Therefore, IL-1 beta and c-Fos/AP-1 influence each other's gene expression and activity, resulting in an orchestrated cross-talk that is crucial to arthritic joint destruction, and thus, blockade of IL-1 beta and/or c-Fos/AP-1 can be most promising as a therapeutic target, and in fact, a selective inhibition of c-Fos/AP-1 does resolve arthritic joint destruction.
SPRINGER BASEL AG, 2011年04月, ARCHIVUM IMMUNOLOGIAE ET THERAPIAE EXPERIMENTALIS, 59 (2), 89 - 95, 英語[査読有り]
研究論文(学術雑誌)
血管新生因子Angiopoietin-1(Ang-1)は,ERK/MAPキナーゼ系とPI3キナーゼ/Akt系を介してリウマチ性疾患の病態形成に関与する.関節リウマチ滑膜細胞においては,Ang-1の刺激によってAktおよびNFκBの活性化がもたらされ,滑膜細胞のアポトーシス抵抗性獲得に寄与している.また,Ang-1はRhoファミリー低分子量GTP結合蛋白質群も活性化し,滑膜細胞の遊走能を亢進させて骨軟骨破壊を促進させる.一方,新規に同定された269Gry挿入型ANG-1蛋白は,肺血管内皮細胞のERK/MAPキナーゼ系の活性化とendtohelin-1産生亢進を介して混合性結合組織病や強皮症患者に合併する肺高血圧症の病因となることが示唆された.
一般社団法人 日本臨床リウマチ学会, 2011年, 臨床リウマチ, 23 (1), 11 - 15, 日本語[査読有り]
研究論文(学術雑誌)
The mammalian clock genes, Period and Cryptochrome (Cry), regulate circadian rhythm. We show that circadian rhythmicity and rhythmic expression of Period in the nuclei of inflammatory synovial cells and spleen cells are disturbed in mouse models of experimental arthritis. Expressions of other clock genes, Bmall and Dbp, are also disturbed in spleen cells by arthritis induction. Deletion of Cry1 and Cry2 results in an increase in the number of activated CD3(+) CD69(+) T cells and a higher production of TNF-alpha from spleen cells. When arthritis is induced, Cry1(-/-)Cry2(-/-) mice develop maximal exacerbation of joint swelling, and upregulation of essential mediators of arthritis, including TNF-alpha, IL-1 beta and IL-6, and matrix metalloproteinase-3. Wee-1 kinase is solely upregulated in Cry1(-/-)Cry2(-/-) mice, in line with upregulation of c-Fos and Wee-1 kinase in human rheumatoid arthritis. The treatment with anti-TNF-alpha Ab significantly reduced the severity and halted the progression of the arthritis of Cry1(-/-)Cry2(-/-) mice and vice versa, ectopic expression of Cry1 in the mouse embryonic fibroblast from Cry1(-/-)Cry2(-/-) mice significantly reduced the trans activation of TNF-a gene. Thus, the biological clock and arthritis influence each other, and this interplay can influence human health and disease. The Journal of Immunology, 2010, 184: 1560-1565.
AMER ASSOC IMMUNOLOGISTS, 2010年02月, JOURNAL OF IMMUNOLOGY, 184 (3), 1560 - 1565, 英語[査読有り]
研究論文(学術雑誌)
Clinical squeal of the treatment of rheumatoid arthritis patients with methotrexate (MTX) according to the Japanese government recommended dose of 8 mg/week was evaluated prospectively. A total of 176 patients with active RA attending Konan Kakogawa Hospital and Kobe University Hospital were enrolled. Patients' profile at the start of study was Class 2.0 +/- A 1.1 and X-ray stage 2.6 +/- A 1.0. The effects of MTX treatment were evaluated by the American College of Rheumatology (ACR) core set, disease activity score of 28 joints (DAS28), and European League Against Rheumatism (EULAR) response criteria. A modified Sharp method was used to evaluate the radiographs. The improvement in the clinical signs and symptoms of the ACR core set was maintained for a 24-month period (p < 0.05). The ACR20/50/70 and DAS28 were also improved at the 12- and 24-month assessments. However, 82 of 130 patients (63.5%) were found to be nonresponders at 24 months of MTX therapy, as evaluated by EULAR response criteria. The X-ray study showed that joint destruction progressed despite the treatment. Thus, long-term MTX treatment performed in accordance with the Japanese 8 mg/week regimen appears to be favorable in terms of the signs and symptoms of RA; however, it is clearly insufficient for and cannot halt the progression of rheumatic joint destruction.
SPRINGER, 2009年12月, MODERN RHEUMATOLOGY, 19 (6), 637 - 642, 英語[査読有り]
研究論文(学術雑誌)
Adult-onset Still's disease (AOSD) is an inflammatory disease of unknown etiology. AOSD is typically characterized by a spiking fever, arthritis, rashes, leukocytosis, and involvement of various organs. We report a case of a 59-year-old Japanese male presenting rapid and progressive polyarthritis. He complained of bilateral knee joint pain and swelling of 3 months duration which was accompanied by a fever over 39°C for one month. On admission, he showed arthritis on bilateral MP, PIP, wrist, knee, and foot joints. X-ray study revealed distinct erosion of bilateral wrist joints and PIP joints even a few months after the disease onset. Laboratory tests showed CRP 8.95 mg/dl, FDP 14.0 μg/ml, and ferritin1 143 nm/ml. Rheumatoid factor, anti-CCP antibody or anti-nuclear antibody was negative. The patients' disease was diagnosed as AOSD because his clinical manifestation fulfilled the diagnostic criteria proposed by Cush et al. He was treated successfully with prednisolone and Methotrexate. Recently, anti-cytokine therapy was reported to be introduced for AOSD; i.e. anti-interleukin (IL)-6 receptor antibody or anti-IL-1 antibody, and serum IL-6 level was increased in this patient. We discussed the early progression of arthritic joint destruction in the wrists in a patient with AOSD. We propose that early intervention of arthritis may be useful for such conditions.
一般社団法人 日本臨床リウマチ学会, 2009年09月, 臨床リウマチ, 巻, 213, pp. 261-265 (3), 261 - 265, 日本語研究論文(学術雑誌)
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研究論文(学術雑誌)
Sjogren's syndrome (SS) is a systemic autoimmune disease characterized by sicca symptoms, including dry eyes and dry mouth. Cevimeline is used for the treatment of dry mouth in patients with SS. Here we prospectively tested the clinical effectiveness of cevimeline at increasing saliva secretion in patients with SS, and the results were compared with the clinical parameters of the patients. Saliva secretion was increased > 160% in 17 of 30 (56.7%) patients (P < 0.005). When the clinical parameters were compared between the patients who responded to cevimeline treatment and those who did not respond to the treatment, the frequency of patients presenting with hypergammaglobulinemia was significantly higher in the nonresponder group (P < 0.05). It thus appears that cevimeline is effective in SS patients with milder disease activity.
SPRINGER, 2009年08月, Mod Rheumatol, 19 (4), 416 - 419, 英語[査読有り]
研究論文(学術雑誌)
Behçet's disease (BD) is a systemic disease presenting oral and genital ulceration, other skin lesions, uveitis and manifestations affecting the blood vessels. Among those, entero-Behçet's disease is characterized by bowel inflammation with round and oval ulcers associated with gastro-entero-intestinal symptoms. BD is frequent in the Middle and Far East but is rare in the Europe and Western world, suggesting the contribution of a racial or genetic factor. Indeed, Human leukocyte antigen (HLA)-B 51 is a well-known genetic factor associated with BD. We report a case of a 25-year-old man with a 3-year history of entero-Behçet's disease having surgical treatment three times after the disease onset. This patient was introduced to our hospital presenting with melena and lower abdominal pain, while he has been treated with prednisone, colchicine, mesalazine and infliximab for 3 years. Laboratory test results on admission were as follows; WBC 14000/ml, Hb 9.8 g/ml, CRP 0.55 mg/dl, AST 30 U/ml, ALT 75 U/ml, total protein 5.2 g/dl and albumin 2.6 g/dl. After entering our hospital, despite an additional treatment of neutrophil apheresis (G-CAP) for 5 times, he underwent surgery twice owing to massive hematochezia and sature-failure due to long-term steroid usage. The efficacy and indication of steroid, biologics, neutrophil apheresis and surgical therapy for entero-Behçet's disease were discussed.
一般社団法人 日本臨床リウマチ学会, 2009年08月, 臨床リウマチ, 巻, 175, pp. 495-500 (3), 279 - 283, 日本語研究論文(学術雑誌)
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Immunogenetic mechanisms operating within the immune system are known to influence cytokine profiles and disease susceptibility. Yet the role of the individual's neurohormonal background in these processes remains undefined. Hormonal imbalances are documented in immune-related diseases, but it is unclear whether this represents a secondary phenomenon or a primary "defect" related to specific neurohormonal immune phenotype(s). We report that in a large subpopulation of healthy humans the baseline epinephrine output (but not cortisol and sex steroid hormones) correlated inversely with proinflammatory and positively with anti-inflammatory cytokine production. Thus, low vs high epinephrine excretors had a 2- to 5-fold higher TNF-alpha and IL-12 production but 2-fold lower IL-10 production induced by LPS ex vivo. In alternative settings, we found low baseline levels and profoundly blunted stress-induced epinephrine responses but high TNF-alpha levels in Lewis vs Fischer inbred rats. Additionally, isoproterenol, a beta adrenoreceptor agonist suppressed LPS-induced TNF-alpha production, with more pronounced effect in Lewis than in Fischer rats. In human monocytes, epinephrine and the beta(2) adrenoreceptor agonist fenoterol potently inhibited LPS-induced TNF-a and IL-12, but stimulated IL-10 production. The order of potency for hormones able to inhibit IL-12 production ex vivo was: epinephrine > norepinephrine > = 1,25-(OH)(2) vitamin D(3) > hydrocortisone. This indicates that baseline epinephrine conditions cytokine responsiveness and through this mechanism intrinsic hypo- or hyperactive adrenal medullas in some individuals may shape opposite cytokine profiles. Since Lewis and Fischer rats have opposite susceptibility to experimental immunological diseases, this suggests that the parallel human phenotypes could be linked to differing responsiveness and susceptibility to infections and immune/inflammatory-related conditions.
AMER ASSOC IMMUNOLOGISTS, 2008年08月, JOURNAL OF IMMUNOLOGY, 181 (3), 1737 - 1745, 英語[査読有り]
研究論文(学術雑誌)
Immunogenetic mechanisms operating within the immune system are known to influence cytokine profiles and disease susceptibility. Yet the role of the individual's neurohormonal background in these processes remains undefined. Hormonal imbalances are documented in immune-related diseases, but it is unclear whether this represents a secondary phenomenon or a primary "defect" related to specific neurohormonal immune phenotype(s). We report that in a large subpopulation of healthy humans the baseline epinephrine output (but not cortisol and sex steroid hormones) correlated inversely with proinflammatory and positively with anti-inflammatory cytokine production. Thus, low vs high epinephrine excretors had a 2- to 5-fold higher TNF-alpha and IL-12 production but 2-fold lower IL-10 production induced by LPS ex vivo. In alternative settings, we found low baseline levels and profoundly blunted stress-induced epinephrine responses but high TNF-alpha levels in Lewis vs Fischer inbred rats. Additionally, isoproterenol, a beta adrenoreceptor agonist suppressed LPS-induced TNF-alpha production, with more pronounced effect in Lewis than in Fischer rats. In human monocytes, epinephrine and the beta(2) adrenoreceptor agonist fenoterol potently inhibited LPS-induced TNF-a and IL-12, but stimulated IL-10 production. The order of potency for hormones able to inhibit IL-12 production ex vivo was: epinephrine > norepinephrine > = 1,25-(OH)(2) vitamin D(3) > hydrocortisone. This indicates that baseline epinephrine conditions cytokine responsiveness and through this mechanism intrinsic hypo- or hyperactive adrenal medullas in some individuals may shape opposite cytokine profiles. Since Lewis and Fischer rats have opposite susceptibility to experimental immunological diseases, this suggests that the parallel human phenotypes could be linked to differing responsiveness and susceptibility to infections and immune/inflammatory-related conditions.
AMER ASSOC IMMUNOLOGISTS, 2008年08月, JOURNAL OF IMMUNOLOGY, 181 (3), 1737 - 1745, 英語研究論文(学術雑誌)
To inhibit arthritis upstream of inflammatory cytokine release and matrix metalloproteinase (MMP) action, we designed de novo a small-molecule inhibitor of c-Fos/activator protein-1 (AP-1) using three-dimensional (3D) pharmacophore modeling. This model was based on the 3D structure of the basic region-leucine zipper domain of AP-1-DNA complex. Administration of this inhibitor prevented type II collagen-induced arthritis from day 21, before the onset of arthritis, or from day 27, resolved arthritis after its onset. Suppression of disease was accomplished by reducing the amounts of inflammatory cytokines and MMPs in vivo in sera and joints and in vitro in synovial cell and chondrocyte cultures. The primary action of this molecule was the inhibition of matrix-degrading MMPs and inflammatory cytokines including interleukin 1 beta; this molecule also synergized with anti-tumor necrosis factor a to inhibit arthritis. Thus, selective inhibition of c-Fos/AP-1 resolves arthritis in a preclinical model of the disease.
NATURE PUBLISHING GROUP, 2008年07月, NATURE BIOTECHNOLOGY, 26 (7), 817 - 823, 英語[査読有り]
研究論文(学術雑誌)
Objective. To determine an easy-to-use diagnostic criterion for early rheumatoid arthritis (RA) that may be useful for general physicians, using anti-cyclic citrullinated peptide (CCP) antibody. Methods. We prospectively studied 435 patients who first visited the hospital with arthritic symptoms within 24 months, including 264 visitors within 6 months. The diagnosis was made on their first visit by examination and laboratory tests including anti-CCP antibodies, rheumatoid factor (RF) and C-reactive protein (CRP), and radiograph. Results. The diagnostic specificity and positive predictive value (PPV) of anti-CCP2 assay were 94.9% and 87.8%, respectively, and those of anti-CCP2 plus RF were 96.9% and 90.9% for the patients who first visited having morning stiffness, arthralgia, and/or joint swelling within 3 months from onset (n = 165). For the patients who first visited later, but within 24 months from onset (n = 260), the diagnostic specificity and PPV were extremely high, 98.7% and 95.5%, when anti-CCP2 assay was coevaluated with RF, CRP, and more than 3 swollen joints. Respective combinations of anti-CCP2 assay plus either 2 of 3 measures were also highly specific. Conclusion. A diagnostic criterion including anti-CCP2 assay in combination with RF, CRP, and/or swollen joints is less sensitive but highly specific, and accurately predicts future development of RA among those with arthritic symptoms who first consulted doctors within 2 years after onset. It should be highly useful for the general physician without special techniques or devices.
J RHEUMATOL PUBL CO, 2008年03月, JOURNAL OF RHEUMATOLOGY, 35 (3), 414 - 420, 英語[査読有り]
研究論文(学術雑誌)
Objective. To determine an easy-to-use diagnostic criterion for early rheumatoid arthritis (RA) that may be useful for general physicians, using anti-cyclic citrullinated peptide (CCP) antibody. Methods. We prospectively studied 435 patients who first visited the hospital with arthritic symptoms within 24 months, including 264 visitors within 6 months. The diagnosis was made on their first visit by examination and laboratory tests including anti-CCP antibodies, rheumatoid factor (RF) and C-reactive protein (CRP), and radiograph. Results. The diagnostic specificity and positive predictive value (PPV) of anti-CCP2 assay were 94.9% and 87.8%, respectively, and those of anti-CCP2 plus RF were 96.9% and 90.9% for the patients who first visited having morning stiffness, arthralgia, and/or joint swelling within 3 months from onset (n = 165). For the patients who first visited later, but within 24 months from onset (n = 260), the diagnostic specificity and PPV were extremely high, 98.7% and 95.5%, when anti-CCP2 assay was coevaluated with RF, CRP, and more than 3 swollen joints. Respective combinations of anti-CCP2 assay plus either 2 of 3 measures were also highly specific. Conclusion. A diagnostic criterion including anti-CCP2 assay in combination with RF, CRP, and/or swollen joints is less sensitive but highly specific, and accurately predicts future development of RA among those with arthritic symptoms who first consulted doctors within 2 years after onset. It should be highly useful for the general physician without special techniques or devices.
J RHEUMATOL PUBL CO, 2008年03月, JOURNAL OF RHEUMATOLOGY, 35 (3), 414 - 420, 英語[査読有り]
研究論文(学術雑誌)
Objective. To determine whether angiopoietin 1 (Ang-1) potentiates overgrowth of the synovium and joint degradation in rheumatoid arthritis (RA), and to clarify the cell-signaling mechanisms of Ang-1 in the rheumatoid joint. Methods. Expression of Ang-1, TIE-2 (a receptor for Ang-1), and matrix metalloproteinase 3 (MMP-3) was studied by immunohistochemistry. Activation of the ERK/MAPK and phosphatidylinositol (PI) 3-kinase/Akt pathways and of NF-kappa B was determined by Western blotting and an NF-kappa B p65 DNA binding activity assay, respectively. Induction of apoptosis was evaluated by nuclear staining, cell viability assay, and Western blotting of caspases. Synovial cell migration was evaluated by actin polymerization, Western blotting of Rho family proteins, and affinity purification with Rhotekin-Rho and p21-activated kinase 1. Matrix degradation was examined by induction of proMMP-3 secretion from synovial cells followed by in vitro cartilaginous matrix degradation assay. Results. Ang-1 stimulated the ERK/MAPK and PI 3-kinase/Akt pathways in a cooperative but independent manner, which enhanced rheumatoid synovium overgrowth and joint destruction. In addition, Ang-1 activated NF-kappa B via Akt to promote cell growth, but also inhibited cell apoptosis via ERK and Akt. Ang-1 directly potentiated the extension of synovial cells in an ERK-and Akt-dependent manner by up-regulating Rho family proteins, which attenuated Rac signaling and led to membrane ruffling. Ang-1 induced proMMP-3 secretion from synovial cells, which resulted in direct degradation of the cartilaginous matrix. Conclusion. Ang-1 stimulates the ERK/MAPK and PI 3-kinase/Akt pathways cooperatively, but in a manner independent of each other, to directly potentiate synovium overgrowth and joint destruction in RA. In addition to inflammatory cytokines, Ang-1/TIE-2 signaling appears to be an independent factor that contributes to the destruction of the rheumatoid joint.
WILEY-LISS, 2007年07月, ARTHRITIS AND RHEUMATISM, 56 (7), 2170 - 2179, 英語[査読有り]
研究論文(学術雑誌)
Objective. Decoy receptor 3 (DcR3), a newly identified member of the tumor necrosis factor receptor (TNFR) superfamily, is a soluble receptor that binds to members of the TNF family, including FasL, LIGHT, and TNF-like molecule 1A. DcR3 is mostly expressed in tumor cells, and it competitively inhibits binding of TNF to TNFRs. The present study was undertaken to investigate DcR3 expression in fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA) and osteoarthritis (OA), and to analyze the effects of DcR3 on Fas-induced apoptosis in RA FLS. Methods. Expression of DcR3 in FLS was measured by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blotting. FLS were incubated with DcR3-Fc chimera protein or transfected with DcR3 small interfering RNA (siRNA) using the lipofection method, before induction of apoptosis. Apoptosis induced by Fas in FLS was detected with TUNEL staining and Western blotting of caspase 8 and poly(ADP-ribose) polymerase. Finally, FLS were incubated with TNF alpha prior to Fas-induced apoptosis, expression of DcR3 was analyzed by quantitative RT-PCR, and apoptosis was measured. Results. DcR3 was expressed in both RA FLS and OA FLS. DcR3-Fc protein inhibited Fas-induced apoptosis in FLS. Down-regulation of DcR3 in FLS by siRNA increased Fas-induced apoptosis. TNF alpha increased DcR3 expression and inhibited Fas-induced apoptosis in RA FLS, but not in OA FLS. Conclusion. DcR3 expressed in RA FLS is increased by TNF alpha and protects the cells against Fas-induced apoptosis. These findings indicate that DcR3 may be a possible therapeutic target in RA.
WILEY-LISS, 2007年04月, ARTHRITIS AND RHEUMATISM, 56 (4), 1067 - 1075, 英語[査読有り]
研究論文(学術雑誌)
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Background: Rheumatoid synovial cells are resistant to apoptosis induction in vivo, whereas, fibroblast-like synovial cells in rheumatoid arthritis (RA-FLS) are vulnerable to Fas-induced apoptosis in vitro. Objective: To clarify this discrepancy by studying the contribution of the interaction between cellular integrin and matrix fibronectin (Fn), which is significantly increased in the rheumatoid joints, to the induction of apoptosis in RA-FLS. Methods: Integrin and Fas mRNAs were measured by reverse transcription-polymerase chain reaction in RA-FLS. Integrins expressed in rheumatoid synovial tissues were analysed by immunohistochemistry. RA-FLS plated either on Fn or on control poly-L-lysine were incubated with agonistic anti-Fas monoclonal antibodies (mAbs). Apoptosis induction was evaluated using terminal deoxynucleotidyl transferase mediated UTP nick end labelling (TUNEL) and immunoblotting for caspase-3 and poly (ADP-ribose) polymerase in the presence or absence of anti-VLA-5 mAb. Results: VLA-5 (alpha 5 beta 1 integrin), a major integrin expressed on RA-FLS, was required for the adhesion of RA-FLS on Fn. RA-FLS plated on Fn were more resistant to Fas-induced apoptosis than those plated on control poly-L-lysine. This protection by Fn was reversed by anti-VLA-5 mAb. Conclusion: Anchorage of RA-FLS on matrix Fn via VLA-5 protects RA-FLS from Fas-induced apoptosis, and Fn abundantly present in rheumatoid synovium appears to afford RA-FLS resistance against apoptosis induction in vivo.
B M J PUBLISHING GROUP, 2006年06月, ANNALS OF THE RHEUMATIC DISEASES, 65 (6), 721 - 727, 英語[査読有り]
研究論文(学術雑誌)
Gangliosides have been proposed as modulators of transmembrane signaling. Recently, GM3, a glycosphingolipid containing monosaialic acids, is thought to be one of the key molecules of signal transduction in mammalian cells. In this study, we used mouse embryonic fibroblast cell lines (MEFs) established from sialyltransferase-I knockout mice (GM3 synthase KO mice) to evaluate the regulation of mitogenic signals by gangliosides. Cell proliferation assay revealed a higher growth potential of GM3 KO MEFs. Immunoblots showed upregulation of Ras/Raf/MEK/ERK pathway in GM3 KO MEFs, and these signals resulted in enhanced translocation of ERK into the nuclei. Further, both exogenous and endogenous add-back of GM3 decreased the activities of MAPK in GM3 KO MEFs. In addition, GM3 KO MEFs formed foci in high-density culture condition, and analyses of cell cycle modulators revealed the resistance of GM3 KO MEFs for entering cell cycle arrest. Finally, sustained expressions of c-Fos in GM3 KO MEFs were shown to correlate with DNA-binding activity between c-Fos and AP-1. These results demonstrate that the deletion of sialyltransferase-I changes the character of MEFs to a highly activated state of the MAPK pathway, indicating the critical role of GM3 as a regulator of membrane-transmitted signals.
NATURE PUBLISHING GROUP, 2006年06月, ONCOGENE, 25 (28), 3948 - 3955, 英語研究論文(学術雑誌)
Background: Rheumatoid synovial cells are resistant to apoptosis induction in vivo, whereas, fibroblast-like synovial cells in rheumatoid arthritis (RA-FLS) are vulnerable to Fas-induced apoptosis in vitro. Objective: To clarify this discrepancy by studying the contribution of the interaction between cellular integrin and matrix fibronectin (Fn), which is significantly increased in the rheumatoid joints, to the induction of apoptosis in RA-FLS. Methods: Integrin and Fas mRNAs were measured by reverse transcription-polymerase chain reaction in RA-FLS. Integrins expressed in rheumatoid synovial tissues were analysed by immunohistochemistry. RA-FLS plated either on Fn or on control poly-L-lysine were incubated with agonistic anti-Fas monoclonal antibodies (mAbs). Apoptosis induction was evaluated using terminal deoxynucleotidyl transferase mediated UTP nick end labelling (TUNEL) and immunoblotting for caspase-3 and poly (ADP-ribose) polymerase in the presence or absence of anti-VLA-5 mAb. Results: VLA-5 (alpha 5 beta 1 integrin), a major integrin expressed on RA-FLS, was required for the adhesion of RA-FLS on Fn. RA-FLS plated on Fn were more resistant to Fas-induced apoptosis than those plated on control poly-L-lysine. This protection by Fn was reversed by anti-VLA-5 mAb. Conclusion: Anchorage of RA-FLS on matrix Fn via VLA-5 protects RA-FLS from Fas-induced apoptosis, and Fn abundantly present in rheumatoid synovium appears to afford RA-FLS resistance against apoptosis induction in vivo.
B M J PUBLISHING GROUP, 2006年06月, ANNALS OF THE RHEUMATIC DISEASES, 65 (6), 721 - 727, 英語研究論文(学術雑誌)
Objective. To examine the promoter activity and protein expression of the death receptor 3 gene DR3, a member of the apoptosis-inducing Fas gene family, with particular reference to the methylation status of its promoter region in rheumatoid arthritis (RA). Methods. Genomic DNA was prepared from peripheral blood mononuclear cells obtained from healthy individuals and from patients with RA and synovial cells obtained from patients with RA and osteoarthritis. The methylation status of the DR3 promoter was analyzed by bisulfite genomic sequencing and methylation-specific polymerase chain reaction techniques. Gene promoter activity and protein expression were examined using the luciferase reporter and Western blotting techniques. Results. The promoter region of the DR3 gene contained many CpG motifs, including one CpG island that was specifically hypermethylated in synovial cells from patients with RA. Promoter assays showed that the promoter CpG island was essential for the transactivation of the DR3 gene and that forced hypermethylation of the CpG island with the bacterial methylase Sss 1 in vitro resulted in inhibition of the DR3 gene expression. Furthermore, the expression of DR-3 protein was down-modulated in association with methylation of the promoter CpG island in RA synovial cells. Conclusion. The CpG island in the DR3 gene promoter was specifically methylated to down-modulate the expression of DR-3 protein in rheumatoid synovial cells, which may provide resistance to apoptosis in RA synovial cells.
WILEY-LISS, 2006年03月, ARTHRITIS AND RHEUMATISM, 54 (3), 779 - 787, 英語[査読有り]
研究論文(学術雑誌)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
Objective. To examine the promoter activity and protein expression of the death receptor 3 gene DR3, a member of the apoptosis-inducing Fas gene family, with particular reference to the methylation status of its promoter region in rheumatoid arthritis (RA). Methods. Genomic DNA was prepared from peripheral blood mononuclear cells obtained from healthy individuals and from patients with RA and synovial cells obtained from patients with RA and osteoarthritis. The methylation status of the DR3 promoter was analyzed by bisulfite genomic sequencing and methylation-specific polymerase chain reaction techniques. Gene promoter activity and protein expression were examined using the luciferase reporter and Western blotting techniques. Results. The promoter region of the DR3 gene contained many CpG motifs, including one CpG island that was specifically hypermethylated in synovial cells from patients with RA. Promoter assays showed that the promoter CpG island was essential for the transactivation of the DR3 gene and that forced hypermethylation of the CpG island with the bacterial methylase Sss 1 in vitro resulted in inhibition of the DR3 gene expression. Furthermore, the expression of DR-3 protein was down-modulated in association with methylation of the promoter CpG island in RA synovial cells. Conclusion. The CpG island in the DR3 gene promoter was specifically methylated to down-modulate the expression of DR-3 protein in rheumatoid synovial cells, which may provide resistance to apoptosis in RA synovial cells.
WILEY-LISS, 2006年03月, ARTHRITIS AND RHEUMATISM, 54 (3), 779 - 787, 英語[査読有り]
研究論文(学術雑誌)
Methotrexate (MTX) is the first-choice drug for rheumatoid arthritis (RA); however, the pharmacodynamics of MTX in Japanese patients with RA treated legitimately according to the government recommended dosage, 6 mg per week, are unknown. Methotrexate and its metabolite, 7-hydroxy MTX (7-OH MTX), were measured in sera of 16 outpatients with active RA in the first week of MTX treatment and 4-12 weeks after the introduction at 0, 1, 2, 4, and 8 h after administration of the first and the third 2-mg capsule, followed by sampling at 48, 96, and 168 h. The mean maximal serum drug concentration (mean C(max)) of MTX attained at 1-2 h after ingestion of the first capsule was 0.215 and 0.252 microM, respectively, in the first and the follow-up week. The mean C(max) after ingestion of the third capsule was 0.223 microM and 0.357 microM. The mean C(max) of 7-OH MTX was 0.0334 and 0.0289 microM for the first capsule, and 0.0495 and 0.0672 microM for the third capsule. The results indicate that MTX does not accumulate or deposit in the body of Japanese patients with RA when treated with 6 mg per week, and pharmacodynamics of MTX are comparable to those in overseas patients treated with 7.5 mg per week.
2006年, Mod Rheumatol, 15 (6), 405 - 9, 英語, 国際誌[査読有り]
研究論文(学術雑誌)
[査読有り]
研究論文(学術雑誌)
Methotrexate (MTX) is the first-choice drug for rheumatoid arthritis (RA) however, the pharmacodynamics of MTX in Japanese patients with RA treated legitimately according to the government recommended dosage, 6mg per week, are unknown. Methotrexate and its metabolite, 7-hydroxy MTX (7-OH MTX), were measured in sera of 16 outpatients with active RA in the first week of MTX treatment and 4-12 weeks after the introduction at 0, 1, 2, 4, and 8h after administration of the first and the third 2-mg capsule, followed by sampling at 48, 96, and 168h. The mean maximal serum drug concentration (mean Cmax) of MTX attained at 1-2h after ingestion of the first capsule was 0.215 and 0.252μM, respectively, in the first and the follow-up week. The mean Cmax after ingestion of the third capsule was 0.223μM and 0.357μM. The mean Cmax of 7-OH MTX was 0.0334 and 0.0289μM for the first capsule, and 0.0495 and 0.0672μM for the third capsule. The results indicate that MTX does not accumulate or deposit in the body of Japanese patients with RA when treated with 6mg per week, and pharmacodynamics of MTX are comparable to those in overseas patients treated with 7.5mg per week. © Japan College of Rheumatology and Springer-Verlag Tokyo 2005.
2005年12月, Modern Rheumatology, 15 (6), 405 - 409, 英語[査読有り]
研究論文(学術雑誌)
We studied the effects of estrogen on human fibroblast-like synovial cells in rheumatoid arthritis (RA-FLS) focusing on receptor activator of NF-kappa B ligand (RANKL) and its decoy receptor osteoprotegerin (OPG), the osteoclast formation and function regulators that have a substantial role in bone erosion of RA. Estrogen influences osteoporosis and the onset of RA clinically. The cellular responses of RA-FLS to estrogen are initiated via two high-affinity estrogen receptors (ERs). Culture of RA-FLS in the presence of 10(-6) M 17 beta-estradiol (E2) increased expression of estrogen receptor (ER)-alpha, but not ER-beta. OPG mRNA expression was significantly increased. whereas RANKL mRNA was unaffected. E2 treatment also significantly increased the amount of OPG released in the culture supernatant. The increase of OPG and ER-alpha was specifically antagonized by the pure estrogen antagonist ICI 182780. Tamoxifen, a selective ER moderator, did not increase OPG. The results indicate that estrogen stimulates secretion of OPG front RA-FLS by acting on ER-a, which likely prevents bone erosion in RA.
SPANDIDOS PUBL LTD, 2005年05月, INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE, 15 (5), 827 - 832, 英語[査読有り]
研究論文(学術雑誌)
We studied the effects of estrogen on human fibroblast-like synovial cells in rheumatoid arthritis (RA-FLS) focusing on receptor activator of NF-kappa B ligand (RANKL) and its decoy receptor osteoprotegerin (OPG), the osteoclast formation and function regulators that have a substantial role in bone erosion of RA. Estrogen influences osteoporosis and the onset of RA clinically. The cellular responses of RA-FLS to estrogen are initiated via two high-affinity estrogen receptors (ERs). Culture of RA-FLS in the presence of 10(-6) M 17 beta-estradiol (E2) increased expression of estrogen receptor (ER)-alpha, but not ER-beta. OPG mRNA expression was significantly increased. whereas RANKL mRNA was unaffected. E2 treatment also significantly increased the amount of OPG released in the culture supernatant. The increase of OPG and ER-alpha was specifically antagonized by the pure estrogen antagonist ICI 182780. Tamoxifen, a selective ER moderator, did not increase OPG. The results indicate that estrogen stimulates secretion of OPG front RA-FLS by acting on ER-a, which likely prevents bone erosion in RA.
SPANDIDOS PUBL LTD, 2005年05月, INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE, 15 (5), 827 - 832, 英語[査読有り]
研究論文(学術雑誌)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
[査読有り]
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
We have studied the DNA binding profiles of activator protein-1 (AP-1) involved in synovial overgrowth and osteoporosis in rheumatoid arthritis (RA) in relation to the molecular chaperon heat shock protein 90 (HSP90). The AP-1 binding activity of the nuclear extracts of rheumatoid synovial cells was basically increased as compared with osteoarthritic synovial cells. Upon stimulation with inflammatory cytokines IL-1 beta or TNF alpha, the AP-1 binding activity was further increased in rheumatoid synovial cells, and increased AP-1 protein was composed as heterodimers of Fos and JunD which was not known before as a major component of AP-1 in rheumatoid synovial cells. The increase of AP-1 binding activity as induced by inflammatory cytokines was specifically inhibited by geldanamycin, radicicol or herbimycin A, specific inhibitors of HSP90, while AP-1 protein was not decreased by geldanamycin. Further, HSP90 protein was not decreased by the inhibitors. The findings indicate that HSP90 is required for increased AP-1 binding activity of rheumatoid synovial cells under inflammatory stimuli and that AP-1 binding activity is inhibited by functionally inactivating HSP90 with the inhibitors.
PROFESSOR D A SPANDIDOS, 2005年04月, INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE, 15 (4), 649 - 653, 英語[査読有り]
研究論文(学術雑誌)
31歳女.患者は20歳時にレイノー症状,発熱,脱毛,日光過敏で全身性エリトマトーデスを発症した.26歳時に肺高血圧の合併もあったが,プレドニゾロン内服で経過は安定していた.今回,Moschcowitzの5徴のうち精神症状と発熱以外の腎機能障害・血小板減少・微小血管障害性溶血性貧血の3つを満たしており,血栓性血小板減少性紫斑病(TTP)を強く疑われた.当初ステロイドパルス療法と血漿輸注療法を行ったが無効で,第5病日からは意識障害と失語が出現し,インヒビター陽性とADAMTS13活性の著減も判明したためTTPと確定診断した.血漿交換療法を開始した結果,第6病日には意識レベルは正常となり,血液検査上も著明な改善を認め,第8病日に血漿交換を中止した.その後,新鮮凍結血漿輸注だけを3日間継続したが悪化はせず,ステロイド減量後,軽快退院となった.尚,ADAMTS13活性は入院から約1ヵ月後に84%と正常化していた
(一社)日本臨床リウマチ学会, 2005年03月, 臨床リウマチ, 17巻, 1号, pp. 48-52 (1), 48 - 52, 日本語[査読有り]
研究論文(学術雑誌)
[査読有り]
研究論文(学術雑誌)
研究論文(国際会議プロシーディングス)
The death receptor 3 (DR3) gene is a member of the apoptosis-inducing Fas gene family. In the current study, fluorescence in situ hybridization (FISH) and Fiber-FISH revealed the existence of a second DR3 gene similar to200 kb upstream of the original DR3 gene. The existence of the duplicated DR3 gene was confirmed by sequencing the corresponding human artificial chromosome clones as well as with quantitative PCR that measured the ratio of the DR3 gene mutation (Rm), intrinsic to rheumatoid arthritis ( RA) patients, by simultaneous amplification of the normal and mutated DR3 sequences. The DR3 gene duplication measured by FISH was found to be more frequent in patients with RA as compared to healthy individuals. We therefore surmise that the human DR3 gene can be duplicated and that this gene duplication is more prevalent in patients with RA.
NATURE PUBLISHING GROUP, 2004年09月, GENES AND IMMUNITY, 5 (6), 439 - 443, 英語[査読有り]
研究論文(学術雑誌)
The death receptor 3 (DR3) gene is a member of the apoptosis-inducing Fas gene family. In the current study, fluorescence in situ hybridization (FISH) and Fiber-FISH revealed the existence of a second DR3 gene similar to200 kb upstream of the original DR3 gene. The existence of the duplicated DR3 gene was confirmed by sequencing the corresponding human artificial chromosome clones as well as with quantitative PCR that measured the ratio of the DR3 gene mutation (Rm), intrinsic to rheumatoid arthritis ( RA) patients, by simultaneous amplification of the normal and mutated DR3 sequences. The DR3 gene duplication measured by FISH was found to be more frequent in patients with RA as compared to healthy individuals. We therefore surmise that the human DR3 gene can be duplicated and that this gene duplication is more prevalent in patients with RA.
NATURE PUBLISHING GROUP, 2004年09月, GENES AND IMMUNITY, 5 (6), 439 - 443, 英語[査読有り]
研究論文(学術雑誌)
A 55-year-old woman with well-controlled systemic lupus erythematosus (SLE) suffered from the abrupt onset of massive intractable ascites, which did not respond to conventional diuretic therapy. While treatment with methylprednisolone pulse therapy ameliorated this lupus peritonitis, neuropsychiatric symptoms then appeared. After a diagnosis of the central nervous system (CNS) lupus, pulse therapy was continued and the patient recovered from the lupus psychosis. We discuss the differential diagnosis between CNS lupus and steroid-induced psychosis with particular references to recent diagnostic methods for CNS lupus. © Japan College of Rheumatology and Springer-Verlag Tokyo 2004.
2004年09月, Modern Rheumatology, 14 (4), 323 - 326, 英語[査読有り]
研究論文(学術雑誌)
A 55-year-old woman with well-controlled systemic lupus erythematosus (SLE) suffered from the abrupt onset of massive intractable ascites, which did not respond to conventional diuretic therapy. While treatment with methylprednisolone pulse therapy ameliorated this lupus peritonitis, neuropsychiatric symptoms then appeared. After a diagnosis of the central nervous system (CNS) lupus, pulse therapy was continued and the patient recovered from the lupus psychosis. We discuss the differential diagnosis between CNS lupus and steroid-induced psychosis with particular references to recent diagnostic methods for CNS lupus. © Japan College of Rheumatology and Springer-Verlag Tokyo 2004.
2004年09月, Modern Rheumatology, 14 (4), 323 - 326, 英語[査読有り]
研究論文(学術雑誌)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
[査読有り]
研究論文(学術雑誌)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
研究論文(国際会議プロシーディングス)
Features characteristic to rheumatoid arthritis (RA) including synovial overgrowth and joint destruction are experimentally produced by augmenting c-fos gene expression. We show that cyclin dependent kinase inhibitor p21(waf1/cip1),, that inhibits cell proliferation, is down-regulated in conjunction with up-regulation of c-fos in the lymphocytes of patients with RA. As to the mechanism of down-regulation of p21(waf1/cip1) gene expression, transfection studies in U937 cells showed that c-fos down-regulated phosphorylation and dimerization of signal transducers and activators of transcription (STAT) 1, thereby inhibiting interferon gamma-induced transactivation of p21(waf1/cip1). Phosphorylation of STAT1 was indeed decreased in the lymphocytes of patients with RA. Thus, under overexpression of c-fos gene, c-Fos inactivates STAT1 to down-regulate p21(waf1/cip1) gene expression in the lymphocytes of patients with RA, and in this way may enhance proliferation of lymphocytes. (C) 2003 Elsevier Science (USA). All rights reserved.
ACADEMIC PRESS INC ELSEVIER SCIENCE, 2003年04月, BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 304 (1), 143 - 147, 英語[査読有り]
研究論文(学術雑誌)
Features characteristic to rheumatoid arthritis (RA) including synovial overgrowth and joint destruction are experimentally produced by augmenting c-fos gene expression. We show that cyclin dependent kinase inhibitor p21(waf1/cip1),, that inhibits cell proliferation, is down-regulated in conjunction with up-regulation of c-fos in the lymphocytes of patients with RA. As to the mechanism of down-regulation of p21(waf1/cip1) gene expression, transfection studies in U937 cells showed that c-fos down-regulated phosphorylation and dimerization of signal transducers and activators of transcription (STAT) 1, thereby inhibiting interferon gamma-induced transactivation of p21(waf1/cip1). Phosphorylation of STAT1 was indeed decreased in the lymphocytes of patients with RA. Thus, under overexpression of c-fos gene, c-Fos inactivates STAT1 to down-regulate p21(waf1/cip1) gene expression in the lymphocytes of patients with RA, and in this way may enhance proliferation of lymphocytes. (C) 2003 Elsevier Science (USA). All rights reserved.
ACADEMIC PRESS INC ELSEVIER SCIENCE, 2003年04月, BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 304 (1), 143 - 147, 英語[査読有り]
研究論文(学術雑誌)
Gangliosides are sialic acid-containing glycosphingolipids that are present on all mammalian plasma membranes where they participate in recognition and signaling activities. We have established mutant mice that lack GM3 synthase (CMP-NeuAc:lactosylceramide alpha2,3-sialyltransferase; EC 2.4.99.-). These mutant mice were unable to synthesize GM3 ganglioside, a simple and widely distributed glycosphingolipid. The mutant mice were viable and appeared without major abnormalities but showed a heightened sensitivity to insulin. A basis for the increased insulin sensitivity in the mutant mice was found to be enhanced insulin receptor phosphorylation in skeletal muscle. Importantly, the mutant mice were protected from high-fat diet-induced insulin resistance. Our results show that GM3 ganglioside is a negative regulator of insulin signaling, making it a potential therapeutic target in type 2 diabetes.
NATL ACAD SCIENCES, 2003年03月, PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 100 (6), 3445 - 3449, 英語[査読有り]
研究論文(学術雑誌)
[査読有り]
研究論文(学術雑誌)
[査読有り]
研究論文(学術雑誌)
Osteopetrosis is caused by a heterogenous group of bone diseases that result in an increase in skeletal mass because of inadequate osteoclastic bone resorption. In the op osteopetrotic rat, the disease has been linked to a single genetic locus located at the proximal end of rat chromosome 10. In this study, we identified a 1.5-cM genetic interval that contains the mutation. We then generated an improved radiation hybrid (RH) map of this region to identify potential functional and positional candidates for the op gene. Using the rat genome radiation hybrid panel, we mapped 57 markers including 24 genes (14 that have not yet been mapped in the rat) and 10 expressed sequence tag markers. Included in the mapped genes are several candidate genes that might significantly influence the biochemical pathways involved in osteopetrosis. These include genes involved in osteoclast differentiation, apoptosis, and the functional capabilities of mature osteoclasts to resorb bone. Further analysis of the genes and expressed transcripts mapped to this region may yield important insights into the multifactorial control of osteoclast function and the mechanisms of failed bone homeostasis in diseases such as osteopetrosis, osteoporosis, and rheumatoid arthritis in which failed bone homeostasis is an instigating or exacerbating circumstance of the disease process.
AMER SOC BONE & MINERAL RES, 2002年10月, JOURNAL OF BONE AND MINERAL RESEARCH, 17 (10), 1761 - 1767, 英語[査読有り]
研究論文(学術雑誌)
Objective. Collagen-induced arthritis (CIA) is a model of inflammatory arthritis with many similarities to rheumatoid arthritis (RA). We previously mapped in F-2 offspring of CIA-susceptible DA and CIA-resistant F344 rats, 5 quantitative trait loci (QTLs) for which F344 alleles were associated with reduced CIA severity. In the present study, we sought to characterize the independent arthritis-modulating effects of these 5 QTLs. Methods. CIA-regulatory regions were transferred from the F344 genome to the DA background or vice versa by repeated backcrossing. The arthritis-modulating effects of the transferred alleles were determined by comparing the severity of experimentally induced arthritis in congenic rats with that in DA rats. Results. Congenic lines with either the F344 major histocompatibility complex (MHC) on the DA background or the DA MHC on the F344 background were resistant to CIA, confirming both MHC and non-MHC contributions to the genetic regulation of CIA. F344 alleles at the Cia3 and Cia5 regions of chromosomes 4 and 10 reduced CIA severity relative to that observed in DA rats. F344 Cia4 and Cia6 regions of chromosomes 7 and 8 failed to significantly alter CIA severity. Arthritis-modifying effects of Cia4 and Cia6 were, however, detected in pristane-induced and/or Freund's incomplete adjuvant oil-induced arthritis. The arthritis-modifying effects of the non-MHC CIA-regulatory loci differed in males and females. Conclusion. These congenic lines confirmed the existence and location of genes that regulate the severity of experimental arthritis in rats. Mechanisms responsible for the sex-specificity of individual arthritis-regulatory loci may explain some of the sex differences observed in RA and other autoimmune diseases in humans.
WILEY-LISS, 2002年08月, ARTHRITIS AND RHEUMATISM, 46 (8), 2225 - 2234, 英語[査読有り]
研究論文(学術雑誌)
Osteopetrosis results from a heterogeneous group of congenital bone diseases that display inadequate osteoclastic bone resorption. We recently mapped tl (toothless), a mutation that causes osteopetrosis in rats, to a genetic region predicted to include the rat Csf1 gene. In this study, we sequenced the coding sequence of the rat Csf1 gene to determine if a mutation in Csf1 could be responsible for the tl phenotype. Sequencing revealed a 10-base insertion in the coding sequence of mutant animals that produces a frameshift and generates a stop codon early in the mutant Csf1 coding sequence. The 41 amino acid polypeptide predicted to be produced from the Csf1 promoter would have only the first nine amino acids of the wild-type rat protein. These data suggest that osteopetrosis develops in tl/tl rats because they cannot produce functional mCsf, a growth factor required for osteoclast differentiation and activation. (C) 2002 Published by Elsevier Science (USA).
ACADEMIC PRESS INC ELSEVIER SCIENCE, 2002年06月, BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 294 (5), 1114 - 1120, 英語[査読有り]
研究論文(学術雑誌)
[査読有り]
研究論文(学術雑誌)
Adrenocorticotropic hormone (ACTH) and another pro-opiomelanocortin-derived neuropeptide, β-endorphin (β-End), are stimulated by corticotropin-releasing hormone (CRH) at the anterior pituitary. CRH and β-End have predominantly proinflammatory effects in peripheral inflammatory sites. We have supposed that inflammatory stimuli develop ACTH as well as β-End. In this study, we investigated the expression of ACTH in inflamed synovial tissue from patients with rheumatoid arthritis (RA) and osteoarthritis (OA), and at inflammatory joints with adjuvant-induced arthritis (AA) in female Lewis (LEW/N) rats. The expression of ACTH immunostaining was significantly greater in synovium of RA patients than in that of OA patients (P < 0.0001), and correlated with the extent of inflammatory mononuclear cell infiltration. Extensive and intense intracellular ACTH immunostaining, which correlated with the advance in arthritis score, was observed in the synovial lining layer, inflammatory mononuclear cells, and fibroblast-like cells of synovium and chondrocytes in LEW/N rats with AA. In addition, we performed double immunostaining of the same sections from arthritic joints in rats with anti-ACTH and anti-CRH anti-bodies. ACTH and CRH colocalized in inflammatory mononuclear cells and fibroblast-like cells. ACTH may play a role in the pathogenesis of RA as well as CRH.
2002年, Modern Rheumatology, 12 (3), 206 - 212, 英語[査読有り]
研究論文(学術雑誌)
Objective. To investigate the mechanism of the immunosuppressive effect of T-614 [N-(3-formylamino-4-oxo-6-phenoxy-4H-chromen-7-yl)methanesulfonamide], a new antirheumatic drug whose clinical efficacy has been determined for the treatment of patients with rheumatoid arthritis (RA), Methods. RA synovial fibroblast-like cells were cultured with tumor necrosis factor-alpha (TNF-alpha, 10 ng/ml) in the presence or absence of T-614. After incubation, cytokine production was measured by ELISA. Expression of interleukin 6 (IL-6) and IL-8 mRNA was examined by real-time quantitative reverse transcriptase-polymerase chain reaction analysis and TNF-alpha induced nuclear factor-kappaB (NF-kappaB) activation was observed using immunostaining with an antibody against NF-kappaB p65. Results. T-614 suppressed TNF-alpha induced production of IL-6, IL-8, and monocyte chemoattractant protein 1, and also reduced the accumulation of IL-6 and IL-8 mRNA in a concentration dependent manner. T-614 interfered with the TNF-alpha induced translocation of NF-kappaB to the nucleus from the cytoplasm, Conclusion. Inhibition of NF-kappaB activation and transcription of proinflammatory cytokines by T-614 contributes to its clinical antirheumatic effect.
J RHEUMATOL PUBL CO, 2001年12月, JOURNAL OF RHEUMATOLOGY, 28 (12), 2591 - 2596, 英語[査読有り]
研究論文(学術雑誌)
Peripherally produced CRH acts as a local auto/paracrine proinflammatory agent. Urocortin is a new member of the CRH family that acts through the family of CRH receptors. In this study, we demonstrated that the expression of urocortin mRNA in synovia of patients with rheumatoid arthritis was greater than that of patients with osteoarthritis. Also, we detected urocortin and CRH receptor immunoreactivity in the synovial lining cell layer, subsynovial stromal cells, blood vessel endothelial cells, and mononuclear inflammatory cells from the joints of rheumatoid arthritis and osteoarthritis patients. The expression of immunoreactive urocortin was significantly greater in rheumatoid arthritis than ostcoarthritis (P<0.0001) and correlated with the extent of inflammatory infiltrate. CRH receptor immunoreactivity was strong in mononuclear inflammatory cells of rheumatoid arthritis synovia. Urocortin stimulated <beta>IL-1 and IL-6 secretion by human peripheral blood mononuclear cells in vitro. These findings suggest that, like CRH, urocortin is present in peripheral inflammatory sites, such as rheumatoid synovium, and acts as an immune-inflammatory mediator.
ENDOCRINE SOC, 2001年09月, JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 86 (9), 4344 - 4352, 英語[査読有り]
研究論文(学術雑誌)
[査読有り]
研究論文(学術雑誌)
Inbred rat strains manifest remarkable differences in susceptibility/severity to autoimmune disease. MHC alleles strongly influence the pathogenesis of autoimmune disease in rats, but the precise mechanism(s) remain inadequately defined. The TNF alpha gene is located in the class III region of the MHC. Polymorphisms, influencing either the structure or expression of the TNF protein, might contribute to differences in autoimmune disease susceptibility/severity. We therefore sequenced the Tnf locus using genomic DNA from ACI, BB(DR), BN, DA, F344, and LEW rats that vary in susceptibility/severity to autoimmune diseases. We found 42 polymorphisms among these six strains. Although none of these polymorphisms are predicted to change the amino acid sequence of the TNF protein, several reside in potential non-coding regulatory regions and may influence expression levels. These polymorphisms may serve as good candidates for analysis of TNF expression to elucidate the mechanism(s) by which the MHC regulates susceptibility and/or severity of autoimmune diseases.
NATURE PUBLISHING GROUP, 2001年06月, GENES AND IMMUNITY, 2 (4), 229 - 232, 英語[査読有り]
研究論文(学術雑誌)
Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear hormone receptor superfamily and have a dominant regulatory role in adipocyte and monocyte differentiation. PPAR-gamma agonists are also negative regulators of macrophage activation and have modulatory effects on tumorigenesis. In this study we demonstrate that synovial tissue localized expression of PPAR-gamma in patients with rheumatoid arthritis (RA). We detected markedly enhanced expression of PPAR-gamma in macrophages, as well as modestly enhanced expression in the synovial lining layer, fibroblasts, and endothelial cells. Activation of the PPAR-gamma by 15-deoxy-Delta(12,14)-prostaglandin J(2) (15d-PGJ(2)) and the synthetic PPAR-gamma ligand (troglitazone) induced RA synoviocyte apoptosis in vitro. Moreover, intraperitoneal administration of these PPAR-gamma ligands ameliorated adjuvant-induced arthritis with suppression of pannus formation and mononuclear cell infiltration in female Lewis rats. Antiinflammatory effects of 15d-PGJ(2) were more potent than troglitazone. These findings suggest that PPAR-gamma may be an important immunoinflammatory mediator and its ligands, especially 15d-PGJ(2), may be useful in the treatment of RA.
AMER SOC CLINICAL INVESTIGATION INC, 2000年07月, JOURNAL OF CLINICAL INVESTIGATION, 106 (2), 189 - 197, 英語[査読有り]
研究論文(学術雑誌)
Objective. Collagen-induced arthritis (CIA) is a polygenic model of experimentally induced autoimmunity and chronic joint inflammation. This study maps genetic loci that regulate CW susceptibility in DA/Bkl (Dt) and BN/SsNHsd (BN) rats. Methods. Genome scans covering chromosomes 1-20 and internal mapping techniques using 159 simple sequence-length polymorphism markers were used to identify quantitative trait loci (QTLs) that regulate CIA in (DA x BN)F-2 hybrids. Serum antibody titers to type II collagen were determined by enzyme-linked immunosorbent assay. Results. DA rats were high responders to porcine type II collagen (PII) and developed severe CIA (100%). BN rats were low responders to PII and resistant to CIA (0%). BN genes strongly repressed PII-induced CIA. Only 12% of (DA x BN)F-I rats (7 of 60) and 31% of (DA x BN)F-2 rats (307 of 1,004) developed CIA. Three new QTLs (Cia11, Cia12, and Cia13) with significant logarithm of odds (LOD) scores of 5.6, 4.6, and 4.5, respectively plus a suggestive QTL (Cia14*, LOD 3.0) regulating arthritis severity were identified on chromosomes,7, 12, 1, and 19, A new QTL, Ciaa3, associating with anticollagen antibody titer (antibody to PII LOD 6.5; antibody to rat type Il collagen LOD 5.2) mapped to chromosome 9. Of 10 CIA QTLs previously identified in (DA x F344) and (DA x ACI) rats, only Cia1 in the major histocompatibility complex and a region coincident to Cia5 on chromosome 10 (LOD >8.0) influenced CIA severity in (DA x BN)F-2 rats. Conclusion. Since CIA. exhibits many of the pathologic features of rheumatoid arthritis, the data indicate that the variety of genetic elements regulating human autoimmune and rheumatic diseases may be much larger and more varied than originally envisioned.
LIPPINCOTT WILLIAMS & WILKINS, 2000年06月, ARTHRITIS AND RHEUMATISM, 43 (6), 1278 - 1289, 英語[査読有り]
研究論文(学術雑誌)
The aim of this study was to evaluate the anti-inflammatory effect of 4-hydroxy-2-methyl-N-[5-methyl-2-thiazolyl]-2H-1,2-benzothiazine-3-carboxamide-1,l-dioxide (meloxicam) using cultured rheumatoid synovial fibroblast-like cells (synoviocytes). Synoviocytes were treated with meloxicam in the presence or absence of interleukin-1 beta. Meloxicam had no effect on both cyclooxygenase-l and -2 expression as determined by Western blot analysis, immunohistochemical staining, and reverse transcription polymerase chain reaction (RT-PCR). Even the lower doses of meloxicam inhibited cyclooxygenase-2 activity, but only the higher doses of meloxicam inhibited cyclooxygenase-l activity as determined by prostaglandin E(2) synthesis assay. So meloxicam had a preferential inhibitory effect of cyclooxygenase-2 relative to cyclooxygenase-l on cultured rheumatoid synoviocytes without affecting cyclooxygenase expression. On the other hand, indomethacin had no selectivity and dexamethasone inhibited the expression of cyclooxygenase-2. Our data indicate that clinical efficacy and safety of meloxicam for rheumatoid arthritis may result from its preferential inhibition of cyclooxygenase-2 activity relative to cyclooxygenase-l on rheumatoid synoviocytes. (C) 2000 Elsevier Science B.V. All rights reserved.
ELSEVIER SCIENCE BV, 2000年05月, EUROPEAN JOURNAL OF PHARMACOLOGY, 395 (3), 255 - 263, 英語[査読有り]
研究論文(学術雑誌)
The effects of cyclooxygenase (COX)-2 antisense oligodeoxynucleotide (ODN) in induction of adjuvant-induced arthritis were investigated. Female Lewis rats were injected with Mycobacterium butyricum intradermally at the base of tails to induce arthritis. Synthetic 18 mer phosphorothioate ODNs corresponding to the translation initiation site of rat COX-2 mRNA were prepared. The antisense (AS), sense (S), and "scrambled" (Sc) ODNs were intraperitoneally administered. Arthropathy was evaluated with arthritis score, paw edema, and histological examination. Expression of COX-1 and -2 protein and mRNA were examined with immunostaining and reverse-transcription polymerase chain reaction, respectively. COX-2 AS ODN significantly suppressed induction of arthritis in a dose-dependent manner without severe adverse effects, whereas S and Sc ODNs did not show significant inhibitory effects. COX-2 mRNA and protein expression were also suppressed only by COX-2 AS ODN without any alteration of COX-I expression. These data suggest that selective inhibition of COX-2 with AS ODN may have a therapeutic potency in the treatment of rheumatoid arthritis. (C) 2000 Academic Press.
ACADEMIC PRESS INC, 2000年03月, BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 269 (2), 415 - 421, 英語[査読有り]
研究論文(学術雑誌)
The aim of this study was to characterize the effects of auranofin (2,3,4,6-tetra-O-acetyl-l-thio-beta-D-gluco-pyranosato-S) on cyclooxygenase expression and prostaglandin E-2 synthesis on cultured human synovial fibroblast-like cells (synoviocytes). Synoviocytes were treated with auranofin in the presence or absence of interleukin-1 beta. Cultured supernatants were harvested for prostaglandin E-2 synthesis. Cyclooxygenase-l and -2 expression was analyzed with Western and Northern blotting. Translocation of nuclear factor-kappa B p65 was determined by immunostaining. Cytotoxicity was measured with Cr-51 release assay. Auranofin attenuated interleukin-1 beta-induced prostaglandin E-2 production of the cells in a dose-dependent fashion. Auranofin selectively suppressed interleukin-1 beta-induced cyclooxygenase-2 mRNA and protein expression of the cells without alteration of cyclooxygenase-1 expression. Also, auranofin interfered with interleukin-1 beta-induced translocation of nuclear factor-kappa B. These inhibitory effects did not originate in the cytotoxicity of the agent. Our data indicate that auranofin inhibits interleukin-1 beta-induced prostaglandin E-2 synthesis and cyclooxygenase-2 expression via suppression of nuclear factor-kappa B activation on synoviocytes. (C) 1999 Elsevier Science B.V. All rights reserved.
ELSEVIER SCIENCE BV, 1999年11月, EUROPEAN JOURNAL OF PHARMACOLOGY, 385 (1), 71 - 79, 英語[査読有り]
研究論文(学術雑誌)
Objective. To investigate the role of c-myc in the pathogenesis of rheumatoid arthritis (RA) and the mechanism of synovial apoptosis. Methods. Using cultured human synoviocytes from patients with RA and c-myc antisense oligodeoxynucleotides (AS ODN), we examined the inhibition of cell proliferation by the MTI assay and the induction of apoptosis with TUNEL staining and fluorescence microscopy, In addition, the effect of c-myc on downregulation of Fas expression was analyzed by now cytometry, cytotoxicity assay, and reverse transcriptase-polymerase chain reaction. Results. Treatment with c-myc AS ODN induced inhibition of cell proliferation, along with downregulation of c-Myc protein and c-myc messenger RNA (mRNA) expression. The morphologic changes of synovial cell death were typical of apoptosis. In addition, c-myc AS ODN treatment down-regulated expression of Fas mRNA but not Fas antigen. Analysis of the involvement of the caspase cascade revealed that the cytotoxic activity of c-myc AS ODN was completely blocked by inhibitors of both caspase 1 (YVAD-FMK) and caspase 3 (DEVD-FMK). Conclusion. Our results strongly suggest that c-myc AS ODN might be a useful therapeutic tool in RA and clarify that cell death by c-myc AS ODN is induced through the caspase cascade, similar to Fas-induced apoptosis, In addition, combination therapy with anti-Fas antibody and c-myc AS ODN reduced Fas-dependent cytotoxicity.
LIPPINCOTT WILLIAMS & WILKINS, 1999年05月, ARTHRITIS AND RHEUMATISM, 42 (5), 954 - 962, 英語[査読有り]
研究論文(学術雑誌)
Fibroblast growth factor-1 (FGF-1) is an inducer of angiogenesis, the growth of new blood vessels. The expression and localization of FGF-1 (acidic FGF) and FGF receptor (FGFR)-1 in mammary tissues from patients with breast cancer was investigated using Western blot analysis and immunohistochemistry. The affinity-purified FGF-1 antibody which did not have cross-reactivity to FGF-2 (basic FGF) was used in this study, Western blot analysis demonstrated the presence of FGF-1 protein in all of the samples from breast cancer, but not benign tumors such as mastopathy and fibroadenoma. To assess the localization of FGF-1 in cancer tissues, immunostaining with specific antibody was performed. AU samples from breast cancer displayed significantly intense staining with FGF-1 antibody. The extent and intensity of immunoreactive FGF-1 polypeptides in cancer cells was statistically much greater than those of cells from fibroademoma or mastopathy. Control immunostaining with normal rabbit serum or anti-FGF-1 antibody adsorbed with the recombinant FGF-1 polypeptide was completely negative. In contrast to PGF-1, Western blot analysis demonstrated the presence of FGFR-1 protein in all of the samples from breast cancer and benign tumors. By immunohistochemical analysis, the enhanced expression of FGFR-1 was observed in breast cancer cells. Benign tumor cells or interstitial cells displayed a faint expression of FGFR-1. These results demonstrated that breast cancer cells not only generated FGF-1, but also expressed FGFR-1, and FGF-1 might play a role in the proliferation of breast cancer cells not only by paracrine but also by autocrine mechanism. (C) 1998 Academic Press.
ACADEMIC PRESS INC, 1998年10月, CLINICAL IMMUNOLOGY AND IMMUNOPATHOLOGY, 89 (1), 28 - 34, 英語[査読有り]
研究論文(学術雑誌)
患者は27歳女性, 1996年6月,蝶形紅斑,関節痛,微熱が続き, SLEの診断にてステロイド投与を開始した. 7月末,高熱が出現し,ステロイドを増量するが反応せず, 8月,ステロイドパルス療法を施行したところ,せん妄,見当識障害等の精神症状が出現,意識は一時昏迷状態を示した. 9月には両下肢麻痺,直腸膀胱障害が明らかとなった.血清抗リボゾームP抗体2833U/ml,髄液IL-6107pg/mlと高値であった.シクロフォスファミドパルス療法を行ったが,嗜眠傾向や発熱は治まらず,肝機能障害および骨髄抑制に続いてカリニ肺炎による呼吸不全を呈した.このため, 10月から血漿交換療法を施行し,以後,精神神経症状は改善し,発熱も認めなくなった.また,抗リボゾームP抗体,髄液IL-6は正常値となった.
ステロイドパルス療法を施行中に顕在化したCNSループスに対し,血漿交換療法が有効であった.また,診断には血清抗リボゾームP抗体,髄液IL-6が有用であった.
43歳,女性.昭和58年に発症のSLE.以後,少量ステロイドにより,外来治療中であった.平成7年9月より腹痛,下痢を認め,麻痺性イレウスの診断にて入院.超音波検査により,著明な腸管浮腫を認めた.保存的治療に加え,ステロイドパルス療法,ステロイド増量を行うも,症状は改善せず,血清クレアチニン値(s-CRE)は上昇した.SLE腎症の悪化,薬剤性腎障害が疑われたため, pravastatin (PS)等の薬剤投与を中止し,免疫抑制剤の変更,パルス療法,血漿交換療法を行った.その結果, s-CREは正常化し,同時にイレウスも改善した.腸管浮腫を伴う麻痺性イレウスの原因として,上腸間膜動脈末梢での血管病変が考えられた.高CRE血症の原因としては,PSによる横紋筋融解症が考えられるが,診断には至っていない.本例は, SLEに著明な腸管浮腫と麻痺性イレウスを併発し,パルス療法や血漿交換が有効であった興味深い症例である.
The Japan Society for Clinical Immunology, 1998年02月28日, 日本臨床免疫学会会誌 = Japanese journal of clinical immunology, 21 (1), 48 - 56, 日本語The morphologic changes in PMNs induced by an i.p. injection of PSK, a polysaccharide from the mycelia of Coriolus versicolor, and tumor cells undergoing cell death, were evaluated by immunohistochemical staining and electron microscopy. Male C3H/He mice, 8-10-weeks old, received an i.p. injection of 125 mg/kg of PSK. Their PMNs were obtained 6 h after the PSK injection by peritoneal lavage. N-CWS (Nocardia rubra cell wall skeleton) was added at the start of the chromium release assay using the MM46 mammary carcinoma cell line, which is syngeneic to C3H/He mice, as target cells. During the cytotoxic assay, the cells were fixed at various time points. The MM46 cells expressed ICAM-1 while the PMNs expressed both ICAM-1 and LFA-1 as determined by immunohistochemical staining and immunoelectron microscopy using anti-ICAM-1 and anti-LFA-1 antibodies. PMNs with ruffle-like microvilli adhered to the MM46 tumor cells 30 min after the addition of N-CWS. Immunoelectron microscopic findings suggested that the adhesion molecules were LFA-1 on the PMNs and ICAM-1 on the MM46 tumor cells, but cell fusion between the PMNs and tumor cells was not observed. The MM46 tumor cells gradually lost their microvilli, which showed cell damage, and died 6-7 h after the addition of the N-CWS. This time course of tumor cell death is compatible with the results of the cytotoxic assay. Pretreatment of PMNs by anti-LFA-1 antibody suppressed % lysis of MM46 tumor cells from 90% to 10% (p < 0.01). These data suggest that adhesion molecule on the surface of PMNs such as LFA-1 might play an important role on signal transduction of these PMNs cytotoxic function in this experimental system.
KLUWER ACADEMIC PUBL, 1996年, BIOTHERAPY, 9 (4), 229 - 239, 英語[査読有り]
研究論文(学術雑誌)
Several studies indicate that nonsteroidal anti-inflammatory drugs including indomethacin, aspirin, sulindac, and piroxicam reduce the risk of colon cancer. Furthermore, nonsteroidal anti-inflammatory drugs that inhibit the cyclooxygenase (COX) enzyme were shown to inhibit the development of colon cancer in animal models of carcinogenesis. Nonsteroidal anti-inflammatory drugs inhibit the enzymatic activity of both the constitutive (COX-1) and inducible (COX-2) isoforms of COX enzyme. We have investigated the expression of COX-1 and COX-2 polypeptides in human colon cancer tissues using immunohistochemistry. Enhanced COX-2 expression was observed in colon cancer tissues from 15 subjects with clinically diagnosed colorectal cancer. Marked COX-2 expression was observed in cancer cells, inflammatory cells, vascular endothelium, and fibroblasts of the lesional tissues compared with the nonlesional and normal colon tissues. The extent and intensity of the immunoreactive COX-2 in cancer cells was much greater than that of the other cell types, In contrast, the expression of COX-1 polypeptide was weak in both normal and cancerous specimens. These data suggest that the enhanced expression of the COX-2 gene in colon cancer tissues may contribute to the enhanced synthesis of prostaglandin E(2) by the colon cancer tissues. Enhanced expression of COX-2 may play a role in the pathogenesis of colon cancer. Furthermore, selective inhibition of COX-2 may prove to be more efficacious in the retardation of colon cancer development.
AMER ASSOC CANCER RESEARCH, 1995年09月, CANCER RESEARCH, 55 (17), 3785 - 3789, 英語[査読有り]
研究論文(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
[査読有り][招待有り]
記事・総説・解説・論説等(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
[査読有り][招待有り]
記事・総説・解説・論説等(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
研究発表ペーパー・要旨(国際会議)
[招待有り]
記事・総説・解説・論説等(学術雑誌)
目的:関節リウマチ(RA)患者に対するアダリムマブ(ADA)の臨床成績を検討する.<br>方法:2008年6月~2010年8月までの2年3カ月間に甲南加古川病院と神戸大学リウマチセンターで新規にADAを投与されたRA患者159名(年齢57.8±12.8,女性129名,男性30名,クラス2.1±0.6,ステージ2.9±1.0)を対象に治療成績を検討した.同時に,生物製剤初回導入患者群(ナイーブ群)と他の生物製剤からの変更患者群(スイッチ群)の治療成績,MTXの併用効果,関節破壊抑制効果を調査した.<br>結果:⑴159例中115例(72.3%)はナイーブ群,44例(27.7%)はスイッチ群であった.ADA開始1年の時点でCRP,ESR,MMP-3はナイーブ群・スイッチ群とも前値より有意に改善したが,改善の度合いはナイーブ群が良かった.ADA継続率に関して,ナイーブ群(115例)およびインフリキシマブからの切り替え例(17例)は6ケ月後約80%が継続していたが,エタネルセプトからの切り替え例(17例)は38%,2剤以上生物学的製剤を処方後の切り替え例(8例)は62%であり,ADA継続率はナイーブ群がスイッチ群に較べて良好であった.⑵159例中108例(67.9%)はADA/MTX併用群,51例(32.1%)はADA単独投与群であった.全経過を通じ,DAS28/CRP4は両群とも前値より有意に改善したが,MTX併用群はCRPが3~9カ月後ADA単独群に比べ有意に低下した.⑶159例中ADA開始後1年を経過した46例のうち14例(30.4%)は,手レントゲン写真で評価したHeijde変法シャープスコアが悪化しなかった.同様に46例中39例について年間関節破壊進行度(ΔTSS)を評価したところ,ADAは関節破壊を有意に抑制した.<br>結語:ADAはナイーブ群で有効性と継続率が高く,その効果はMTX併用によって増強された.また,ADAは関節破壊を抑制することが示された.
一般社団法人 日本臨床リウマチ学会, 2011年, 臨床リウマチ, 23 (1), 37 - 47, 日本語[査読有り]
睡眠評価のアンケートとアクチグラフを併用して、関節リウマチ(RA)患者の睡眠障害について客観的な評価を試みた。ピッツバーグ睡眠質問票(Pittsburgh sleep quality index:PQSI)とEpsworth sleepiness scale(ESS)を用いたアンケートの解析より、RA患者の34%に睡眠障害の存在が示唆され、血清MMP-3値、PSL服用量、朝のこわばりの各項目で睡眠障害との相関を認めた。アクチグラフの解析からは、腫脹関節数、疼痛関節数、血清RF値が、RA患者の睡眠の質の低下に影響することがわかった。RA患者のADL改善に向けて、概日リズム障害を含めた睡眠障害と関節炎の関わりについての更なる検討が必要である。(著者抄録)
(株)金芳堂, 2008年10月20日, 脳21, 11 (4), 465 - 470, 日本語[査読有り]
[査読有り]
[査読有り]
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
[査読有り]
[査読有り]
研究発表ペーパー・要旨(国際会議)
[査読有り]
研究発表ペーパー・要旨(国際会議)
記事・総説・解説・論説等(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
記事・総説・解説・論説等(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
[査読有り]
記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
進化は遺伝子重複を前提として,一定の確率で生起するDNAレベルでの突然変異と,これを選択する自然淘汰の圧力(フィルター)によって構成され,優性の変異は子孫を残すことによって固定される.進化上の成功は個体の数nが増えることを意味する.進化からみれば,自らの種族の子孫を残すことのみが重要であるから抗体物質のなかった時代には感染を排除できて生殖年齢にまで生き延びることのできるような強い生体防御機構を備えた個体が選抜(自然淘汰)され,人類は世代を経るごとに感染症に強くなっていったと考えられる
医歯薬出版(株), 2004年07月, 医学のあゆみ, 210巻, 4号, pp. 308-310 (4), 308 - 310, 日本語記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
多発性筋炎・皮膚筋炎の診断は必ずしも困難ではないが,筋炎としての独立疾患を呈するもののほかに,他の膠原病に合併して隠れながら,その膠原病の病態の難治性の一つの基盤をなしている場合があり,治療も常に型どおりというわけではない.典型的な臨床所見を呈するものから,筋症状が判然とせず精査の末に本症と診断されるものまであるし,またクレアチンキナーゼ(CK)が正常値のままである例も少なくない.治療についても,筋炎そのもの,或いは併発する間質性肺炎の中の一部には,ステロイド剤や種々の免疫抑制剤に抵抗性を示すものがあり,しばしば治療に難渋する.したがって,治療による副作用を防止しながら,しかも適切な量で必要最小限の治療が望まれる
(株)医薬ジャーナル社, 2003年12月, 医薬ジャーナル, 39巻, 12号, pp. 3251-3261 (12), 3251 - 3261, 日本語記事・総説・解説・論説等(学術雑誌)
記事・総説・解説・論説等(学術雑誌)
Wee1 kinase downregulates the M-phase promoting factor, a complex of cdc2 and cyclin B kinase, that controls mitotic cell division. We isolated human wee1 kinase gene promoter and found that it contained one AP-1-binding motif in its promoter region (5'-CGAGTCA-3'; -823/-817), through which wee1 kinase gene was directly transactivated by c-Fos/AP-1. In rheumatoid synovial cells, wee1 kinase was increased in conjunction with the increase of c-Fos/AP-1 and the substrate of wee1, cdc2, was phosphorylated. The amount of wee1 and c-Fos and the phosphorylation of cdc2 were decreased after treatment of the cells with an inhibitor of AP-1, curcumin. A significant proportion of cultured synovial cells of the patients with rheumatoid arthritis, but not those of osteoarthritis, shifted to a tetraploid (4C) state upon long-term culture. Thus, human wee1 kinase gene is directly transactivated by and increased in association with c-Fos/AP-1, and rheumatoid synovial cells over-expressing these genes go into aberrant mitosis.
NATURE PUBLISHING GROUP, 2003年10月, ONCOGENE, 22 (44), 6839 - 6844, 英語記事・総説・解説・論説等(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
記事・総説・解説・論説等(学術雑誌)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
研究発表ペーパー・要旨(国際会議)
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公開講演,セミナー,チュートリアル,講習,講義等
公開講演,セミナー,チュートリアル,講習,講義等
シンポジウム・ワークショップパネル(公募)
シンポジウム・ワークショップパネル(公募)
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口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
ポスター発表
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
ポスター発表
口頭発表(一般)
口頭発表(一般)
ポスター発表
口頭発表(一般)
ポスター発表
ポスター発表
口頭発表(一般)
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
ポスター発表
口頭発表(一般)
ポスター発表
ポスター発表
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
口頭発表(一般)
ポスター発表
ポスター発表
口頭発表(一般)
口頭発表(一般)
ポスター発表
ポスター発表
ポスター発表
[招待有り]
口頭発表(招待・特別)
口頭発表(一般)