Research activity information

• Recovery trajectories of TAFRO syndrome: a single-center case series highlighting prolonged thrombocytopenia and anasarca.

  Chiharu Miyamoto, Yo Ueda, Hirotaka Yamada, Naoe Jimbo, Takaichi Okano, Keisuke Nishimura, Sho Sendo, Tomoo Itoh, Jun Saegusa

  TAFRO syndrome is a rare systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever or inflammation, reticulin fibrosis or renal dysfunction, and organomegaly. Despite increasing recognition, its natural history, particularly the timeline of organ-specific recovery, remains poorly understood. We retrospectively analyzed seven patients, encompassing nine treatment courses, diagnosed with TAFRO syndrome at our institution. Time to recovery was assessed across four clinical domains-renal dysfunction, systemic inflammation, anasarca, and thrombocytopenia-using predefined objective criteria. The median time to recovery was 7.0 days for renal dysfunction, 21.0 days for systemic inflammation, 24.0 days for anasarca, and 46.0 days for thrombocytopenia. Recovery of thrombocytopenia and anasarca tended to be delayed compared with that of renal dysfunction and systemic inflammation, with thrombocytopenia showing the longest median time to recovery. These findings indicate substantial heterogeneity in organ-specific recovery trajectories in TAFRO syndrome, with hematologic and fluid-related manifestations resolving more slowly than inflammatory or renal abnormalities. Recognition of domain-specific recovery timelines may aid interpretation of treatment responses and support more balanced, individualized management strategies.

  Mar. 2026, Immunological medicine, 1 - 11, English, International magazine

  Scientific journal


• Mode of action-specific and cause-specific retention of biologic and targeted synthetic disease-modifying antirheumatic drugs in anti-SS-A antibody-positive rheumatoid arthritis: The ANSWER cohort study

  Kazuma Nishisaka, Takaichi Okano, Takumi Imai, Masanori Tsubosaka, Tomoyuki Kamenaga, Naoki Nakano, Shinya Hayashi, Wataru Yamamoto, Akira Onishi, Kosaku Murakami, Kohei Tsujimoto, Masao Katsushima, Ayaka Yoshikawa, Takuya Kotani, Hideki Amuro, Yonsu Son, Tetsu Itami, Yuji Nozaki, Yoko Nose, Mai Yamashita, Iku Shirasugi, Hirotaka Yamada, Keisuke Nishimura, Yo Ueda, Sho Sendo, Motomu Hashimoto, Ryosuke Kuroda, Jun Saegusa

  Anti-SS-A (Ro) antibody-positive rheumatoid arthritis (RA) constitutes a clinically important subgroup, but its impact on retention of biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) across different modes of action (MOA) and reasons for discontinuation remains unclear. We conducted a multicenter retrospective analysis of the Japanese ANSWER cohort, including RA patients who started or switched b/tsDMARDs between 2011 and 2024 and had baseline anti-SS-A antibody testing. Among 1,452 patients (2,703 treatment courses), 255 patients (17.6%) were anti–SS-A antibody positive (507 courses, 18.8%). Propensity score matching balanced baseline characteristics, and drug retention was evaluated using Kaplan–Meier and competing risk analyses. Overall discontinuation was analyzed using Cox proportional hazards models, and Fine–Gray subdistribution hazards models were used for discontinuation by reason and for adverse event–related discontinuation stratified by MOA. After matching, 507 treatment courses from 255 anti-SS-A antibody-positive patients and 1,014 courses from 628 antibody-negative patients were analyzed. Anti-SS-A antibody positivity was not associated with overall b/tsDMARD retention (hazard ratio [HR] 1.07, 95% confidence interval [CI] 0.91–1.26, p = 0.382). In MOA-stratified analyses, positivity showed a trend toward increased discontinuation with interleukin-6 (IL-6) receptor inhibitors and cytotoxic T lymphocyte-associated antigen 4-immunoglobulin (CTLA4-Ig). In competing-risk analyses, discontinuation due to adverse events was significantly more frequent in antibody-positive patients (subdistribution hazard ratio [sHR] 1.80, 95% CI 1.28–2.52; p = 0.000685). Among adverse event-related discontinuations, anti-SS-A antibody positivity was associated with higher risks with IL-6 receptor inhibitors (sHR 2.41, 95% CI 1.24–4.71; p = 0.0098) and tumor necrosis factor (TNF) inhibitors (sHR 2.04, 95% CI 1.22–3.40; p = 0.0066), but not with CTLA4-Ig or Janus kinase (JAK) inhibitors. These findings suggest that treatment tolerability, rather than overall efficacy, may be a key determinant of b/tsDMARD survival in anti-SS-A antibody-positive RA and that MOA- and cause-specific profiles should be considered when selecting therapies in this subgroup.

  Public Library of Science (PLoS), Mar. 2026, PLOS One, 21(3) (3), e0344747 - e0344747

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Optimization of Preemptive Therapy for Cytomegalovirus Infections With Valganciclovir Based on Therapeutic Drug Monitoring: Protocol for a Phase II, Single-Center, Single-Arm Trial

  Naoki Tamura, Kotaro Itohara, Yo Ueda, Yumi Kitahiro, Kazuhiro Yamamoto, Tomohiro Omura, Toshiyasu Sakane, Jun Saegusa, Ikuko Yano

  Background Valganciclovir (VGCV) is the first-line drug for preemptive therapy of cytomegalovirus (CMV) infections. However, even when administered at the dose specified in the package insert, there is significant interindividual variability in the plasma concentrations of ganciclovir (GCV). In addition, correlations have been reported between the area under the concentration–time curve and therapeutic efficacy or adverse events. Therefore, therapeutic drug monitoring (TDM) can be used to improve the efficacy and safety of preemptive VGCV therapy. Objective This study aims to evaluate whether the dosage adjustment of VGCV based on TDM in patients undergoing preemptive therapy for CMV infections is associated with the successful completion rate of treatment without severe hematological adverse effects. Methods This phase II, single-center, single-arm trial aims to enroll 40 patients admitted at the Department of Rheumatology and Clinical Immunology, Kobe University Hospital, who will receive oral VGCV as preemptive therapy for CMV infections. Participants will begin treatment with VGCV at the dose recommended in the package insert, with subsequent dose adjustments based on weekly TDM results. The primary end point will be the proportion of patients who achieve CMV antigenemia negativity within 3 weeks without severe hematological adverse events. The secondary end points will include weekly changes in CMV antigen levels, total VGCV dose, and duration of preemptive therapy. For safety evaluation, the occurrence, type, and severity of VGCV-related adverse events will be analyzed. Additionally, this study will explore the correlations between the efficacy and safety of preemptive therapy and the pharmacokinetic parameters of GCV, CMV-polymerase chain reaction values, and nudix hydrolase 15 (NUDT15) genetic polymorphisms. The correlation between GCV plasma concentrations obtained from regular venous blood and blood concentrations will be examined using dried blood spots. Results This study began with patient recruitment in September 2024, with 5 participants enrolled as of June 16, 2025. The target enrollment is 40 participants, and the anticipated study completion is set for July 2027. Conclusions This is the first study to investigate the impact of TDM intervention in patients receiving VGCV as preemptive therapy. The findings are postulated to provide valuable evidence regarding the utility of TDM in patients receiving VGCV as preemptive therapy. Trial Registration Japan Registry of Clinical Trials jRCTs051240080; https://jrct.mhlw.go.jp/latest-detail/jRCTs051240080 International Registered Report Identifier (IRRID) DERR1-10.2196/72549

  JMIR Publications Inc., Jun. 2025, JMIR Research Protocols, 14, e72549 - e72549

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Predicting rheumatoid arthritis progression from seronegative undifferentiated arthritis using machine learning: a deep learning model trained on the KURAMA cohort and externally validated with the ANSWER cohort

  Takayuki Fujii, Koichi Murata, Hirohiko Kohjitani, Akira Onishi, Kosaku Murakami, Masao Tanaka, Wataru Yamamoto, Koji Nagai, Ayaka Yoshikawa, Yuki Etani, Yasutaka Okita, Naofumi Yoshida, Hideki Amuro, Tadashi Okano, Yo Ueda, Takaichi Okano, Ryota Hara, Motomu Hashimoto, Akio Morinobu, Shuichi Matsuda

  Mar. 2025, ARTHRITIS RESEARCH & THERAPY, 27(1) (1), English

  Scientific journal


• 抗SS-A抗体陽性関節リウマチ患者におけるb/tsDMARDs継続率の検討 関西多施設ANSWERコホートを用いた検討

  西坂 一馬, 能瀬 洋子, 山下 真依, 白杉 郁, 山田 啓貴, 仲 郁子, 岡野 隆一, 西村 啓佑, 上田 洋, 千葉 荘, 壷坂 正徳, 亀長 智幸, 中野 直樹, 林 申也, 山本 渉, 大西 輝, 村上 孝作, 辻本 考平, 勝島 將夫, 橋本 求, 吉川 紋佳, 小谷 卓矢, 安室 秀樹, 孫 瑛洙, 伊丹 哲, 野崎 祐史, 黒田 良祐, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 796 - 796, Japanese


• 関節リウマチにおけるJAK阻害薬治療不応例に対する,他のJAK阻害薬,IL-6阻害薬,TNF阻害薬の3群の有効性に関する比較検討 ANSWERコホートによる解析

  矢野 雄也, 藤澤 雄平, 渡部 龍, 吉田 直史, 村上 孝作, 村田 浩一, 秦 健一郎, 武内 徹, 惠谷 悠紀, 沖田 康孝, 孫 瑛洙, 安室 秀樹, 山田 啓貴, 上田 洋, 原 良太, 山本 渉, 富樫 救, 石原 龍平, 勝島 將夫, 福本 一夫, 山田 真介, 橋本 求

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 802 - 802, Japanese


• 関節リウマチの治療:DMARDs・NSAIDs・その他1 Fib-4 indexは関節リウマチ患者のメトトレキサート治療において中断のリスク因子となる

  舩津 拓生, 岡野 隆一, Del Peral Fanjul Alfonso, 山下 真依, 白杉 郁, 千藤 荘, 山田 啓貴, 西村 啓佑, 上田 洋, 松岡 広, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 511 - 511, Japanese


• キャッスルマン病およびTAFRO症候群の病態と治療 TAFRO症候群における治療抵抗性と血小板減少に対する考察 当科で治療した7症例のケースシリーズを通じて

  宮本 千晴, 安井 進太朗, 谷本 幸奈, 藤田 泰佑, 麥谷 道生, 山本 航大, 山田 啓貴, 岡野 隆一, 西村 啓佑, 千藤 荘, 上田 洋, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 525 - 525, Japanese


• 関節リウマチの治療:DMARDs・NSAIDs・その他 3 高ガンマグロブリン血症を有する関節リウマチ患者における治療反応性の検討 ANSWER cohort study

  仲 郁子, 岡野 隆一, 西坂 一馬, 能瀬 洋子, 山下 真依, 白杉 郁, 山田 啓貴, 西村 啓佑, 千藤 荘, 上田 洋, 壷坂 正徳, 亀長 智幸, 中野 直樹, 林 申也, 山本 渉, 村上 孝作, 大西 輝, 田中 晶大, 孫 瑛洙, 吉川 紋佳, 小谷 卓矢, 冨田 大介, 野崎 祐史, 渡部 龍, 橋本 求, 沖田 康孝, 黒田 良祐, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 612 - 612, Japanese


• 腎機能低下が無い高齢関節リウマチ患者に対してJAK阻害薬を減量投与した場合の効果及び継続率の検討 関西多施設ANSWERコホートを用いた検討

  中野 直樹, 林 申也, 立花 章太郎, 壷坂 正徳, 亀長 智幸, 松本 知之, 西坂 一馬, 能瀬 洋子, 山下 真依, 白杉 郁, 山田 啓貴, 仲 郁子, 岡野 隆一, 西村 啓佑, 上田 洋, 千藤 荘, 山本 渉, 村田 浩一, 藤井 貴之, 岡野 匡志, 橋本 求, 野崎 祐史, 冨田 大介, 小谷 卓矢, 和田 裕美子, 孫 瑛洙, 田中 晶大, 蛯名 耕介, 三枝 淳, 黒田 良祐

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 724 - 724, Japanese


• 全身性エリテマトーデス治療中に蛋白漏出性胃腸症を呈したびまん性大細胞型B細胞リンパ腫の1例

  安井 進太朗, 谷本 幸奈, 宮本 千晴, 藤田 泰佑, 麥谷 道生, 山本 航大, 山田 啓貴, 岡野 隆一, 西村 啓佑, 千藤 荘, 上田 洋, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 728 - 728, Japanese


• 全身性強皮症に対するリツキシマブ投与前後の皮膚超音波を用いた皮膚肥厚変化の評価

  藤田 泰佑, 千藤 荘, 安井 進太朗, 谷本 幸奈, 宮本 千晴, 麥谷 道生, 山本 航大, 山田 啓貴, 岡野 隆一, 西村 啓佑, 上田 洋, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 731 - 731, Japanese


• 関節リウマチ患者におけるメトトレキサート投与状況と関節リウマチの疾患活動性および治療薬剤費に与える影響の検討

  山本 航大, 白杉 郁, 山田 啓貴, 岡野 隆一, 西村 啓佑, 千藤 荘, 上田 洋, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2025, 日本リウマチ学会総会・学術集会プログラム・抄録集, 69回, 862 - 862, Japanese


• Musculoskeletal ultrasound findings in adult-onset Still's disease: A case series.

  Eriko Kashihara Yamamoto, Hirotaka Yamada, Sho Sendo, Haruka Yasuba, Keisuke Nishimura, Yo Ueda, Jun Saegusa

  Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology characterized by high spiking fever, salmon-like skin rash, arthritis, and elevated serum ferritin levels. Early detection of AOSD is remarkably difficult because of the lack of serologic biomarkers, nonspecific presentation, and rarity of the disease. Although arthralgia and arthritis are the most frequent symptoms and are correlated with health-related quality of life in patients with AOSD, the inflammatory changes associated with these symptoms have not been elucidated. We performed musculoskeletal ultrasound (MSKUS) in 11 patients between January 1, 2008 and July 31, 2023, seven of whom had abnormalities. MSKUS findings of those cases suggested that some patients with AOSD could present with tenosynovitis, tendonitis/peritendonitis, bursitis, and enthesitis along with synovitis. This case series demonstrate the diversity of inflammatory articular manifestations of AOSD identified by MSKUS.

  Dec. 2024, Joint bone spine, 91(6) (6), 105771 - 105771, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Comparative effects of biological and targeted synthetic DMARDs on incident chronic kidney disease in patients with rheumatoid arthritis

  Nozomi Nishimura, Akira Onishi, Wataru Yamamoto, Koji Nagai, Hideyuki Shiba, Yasutaka Okita, Yonsu Son, Hideki Amuro, Takaichi Okano, Yo Ueda, Ryota Hara, Masaki Katayama, Shinsuke Yamada, Motomu Hashimoto, Yuichi Maeda, Hideo Onizawa, Takayuki Fujii, Koichi Murata, Kosaku Murakami, Masao Tanaka, Shuichi Matsuda, Akio Morinobu

  Oct. 2024, Rheumatology

  Scientific journal


• Three cases of relapsed eosinophilic sinusitis without eosinophilia during mepolizumab maintenance therapy for eosinophilic granulomatosis with polyangiitis.

  Kazuma Nishisaka, Yo Ueda, Mie Inoue, Masaaki Ishikawa, Goichi Kageyama, Jun Saegusa

  We present three cases of eosinophilic granulomatosis with polyangiitis (EGPA) where patients experienced relapse of eosinophilic sinusitis without peripheral eosinophilia while on remission maintenance therapy with mepolizumab (MPZ), an anti-interleukin (IL)-5 monoclonal antibody. Despite the initial control of symptoms with high-dose prednisolone (PSL) and MPZ, patients experienced a relapse of nasal obstruction and eosinophilic infiltration in nasal mucosal biopsies. Notably, relapses occurred despite normal peripheral eosinophil counts, indicating the localized nature of eosinophilic inflammation. While IL-5 inhibitors effectively reduce peripheral blood eosinophils, eosinophilic sinusitis may persist due to local factors such as IL-4-mediated inflammation. IL-4 has been implicated in promoting eosinophil migration into nasal tissues, suggesting that IL-5 inhibitors alone may not sufficiently suppress eosinophilic infiltration in such cases. These findings highlight the importance of considering the possibility of eosinophilic sinusitis relapse in EGPA patients treated with IL-5 inhibitors and reduced glucocorticoid doses. Further research is warranted to elucidate the mechanisms underlying local eosinophilic inflammation and optimize treatment strategies for EGPA patients.

  Sep. 2024, Clinical rheumatology, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Real-world study comparing the efficacy of Janus kinase inhibitors in patients with difficult-to-treat rheumatoid arthritis

  Shinya Hayashi, Naoki Nakano, Masanori Tsubosaka, Tomoyuki Kamenaga, Yuichi Kuroda, Tomoyuki Matsumoto, Hirotaka Yamada, Keisuke Nishimra, Yo Ueda, Jun Saegusa, Ryosuke Kuroda

  Springer Science and Business Media LLC, Sep. 2024, Clinical Rheumatology, 43(11) (11), 3285 - 3292

  Scientific journal


• Subarachnoid Hemorrhaging with Multiple Cerebral Artery Stenoses after Initiating Remission Induction Therapy for Eosinophilic Granulomatosis with Polyangiitis: a Case Report.

  Haruka Yasuba, Hirotaka Yamada, Masaya Togo, Kento Matoba, Eriko Yamamoto Kashihara, Keisuke Nishimura, Sho Sendo, Yo Ueda, Jun Saegusa

  We encountered a 64-year-old Japanese woman who developed subarachnoid hemorrhaging (SAH) with multiple cerebral artery stenoses during remission induction therapy for eosinophilic granulomatosis and polyangiitis (EGPA). The treatment involved intensified steroid pulse therapy and continued intravenous cyclophosphamide pulse therapy, which led to beneficial effects. Given the rarity of multiple EGPA-associated cerebral artery stenoses and SAH, it is crucial to differentiate them from other diseases. The mortality rate of EGPA complicated by intracranial hemorrhagic lesions, including SAH, is high. When headache is present at the onset of EGPA, the possibility of SAH must be considered.

  May 2024, Internal medicine (Tokyo, Japan), English, Domestic magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• SLEの患者報告アウトカム Lupus Patient-Reported Outcome tool(LupusPRO)のSLICC/ACR damage indexに対する予測的妥当性 LUNAレジストリ

  能瀬 洋子, 大西 輝, 西村 啓佑, 山本 譲, 山田 啓貴, 千藤 荘, 上田 洋, 佐田 憲映, 一瀬 邦弘, 吉見 竜介, 大野 滋, 矢嶋 宣幸, 梶山 浩, 佐藤 秀三, 下島 恭弘, 藤原 道雄, 木田 節, 宮脇 義亜, 松尾 祐介, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2024, 日本リウマチ学会総会・学術集会プログラム・抄録集, 68回, 561 - 561, Japanese


• Association of large joint involvement at the start of biological disease-modifying antirheumatic drugs and Janus kinase inhibitors with disease activity and drug retention in patients with rheumatoid arthritis: The ANSWER cohort study.

  Iku Shirasugi, Akira Onishi, Keisuke Nishimura, Wataru Yamamoto, Kosaku Murakami, Hideo Onizawa, Yuichi Maeda, Kosuke Ebina, Yonsu Son, Hideki Amuro, Masaki Katayama, Ryota Hara, Koji Nagai, Yuri Hiramatsu, Motomu Hashimoto, Tadashi Okano, Toshihisa Maeda, Shinya Hayashi, Sho Sendo, Sadao Jinno, Yuzuru Yamamoto, Hirotaka Yamada, Yo Ueda, Jun Saegusa

  AIM: To investigate the association of large joint involvement (LJI) with disease activity and drug retention in patients with rheumatoid arthritis (RA) who started receiving a biological disease-modifying antirheumatic drug or Janus kinase inhibitor. METHODS: Patients with RA from a Japanese multicenter observational registry were enrolled. Our definition of large joints included the shoulder, elbow, hip, knee, and ankle joints. Linear mixed-effects models were used to examine changes in the clinical disease activity index (CDAI) score at Week 24 as the primary outcome, and drug retention rates were compared between patients with and without LJI using Cox proportional hazards models. We examined the potential effect modifications of changes in the CDAI by baseline characteristics. RESULTS: Overall, 2507 treatment courses from 1721 patients were included (LJI, 1744; no LJI, 763). Although LJI was associated with significantly higher changes in CDAI from baseline at Week 24 (difference in change in CDAI: -5.84 [-6.65 to -5.03], p < .001), CDAI was significantly higher in patients with LJI over time. Retention rates were similar in both groups. The association of LJI with changes in disease activity was more prominent in patients with a short disease duration, negative anti-citrullinated peptide antibodies, and interleukin-6 receptor inhibitor (IL-6Ri) use. CONCLUSION: Although LJI was associated with a greater reduction in disease activity from baseline, higher disease activity at baseline was not offset over time in patients with LJI, demonstrating that LJI is an unfavorable predictor. An early treat-to-target strategy using an IL-6Ri may be beneficial for patients with LJI.

  Mar. 2024, International journal of rheumatic diseases, 27(3) (3), e15097, English, International magazine

  Scientific journal


• Comparison of retention of biologics in Japanese patients with elderly-onset rheumatoid arthritis-the ANSWER cohort study.

  Sadao Jinno, Akira Onishi, Shuhei Hattori, Maureen Dubreuil, Yo Ueda, Keisuke Nishimura, Takaichi Okano, Hirotaka Yamada, Wataru Yamamoto, Koichi Murata, Hideo Onizawa, Kosuke Ebina, Yuichi Maeda, Yonsu Son, Hideki Amuro, Ryota Hara, Kenichiro Hata, Hideyuki Shiba, Masaki Katayama, Ryu Watanabe, Motomu Hashimoto, Jun Saegusa

  OBJECTIVES: This multicentre, retrospective study aimed to compare retention and reasons for discontinuation between Janus kinase inhibitors (JAKi) and biologic disease-modifying antirheumatic drugs in patients with elderly-onset rheumatoid arthritis (EORA). METHODS: Patients with RA enrolled in a Japanese multicentre observational registry between 2015 and 2022 were included. EORA was defined as RA with onset at 60 or over. To adjust confounding factors by indication for initiation of tumor necrosis factor inhibitors (TNFi), interleukin-6 inhibitors (IL-6i), cytotoxic T-lymphocyte associated antigen 4 immunoglobulin (CTLA4-Ig) blockers, or JAKi, a propensity score based on baseline characteristics was used to compare drug retention. To assess the reasons for discontinuation, retention rates for ineffectiveness, adverse events, and remission were analyzed as secondary outcomes. RESULTS: A total of 572 patients with 835 treatment courses were identified (314 TNFi, 175 IL-6i, 228 CTLA4-Ig, and 118 JAKi). After adjusting for differences in baseline characteristics, drug retention was significantly higher for IL-6i (HR = 0.38, 95%CI = 0.27-0.55, p< 0.01) as compared with TNFi. Discontinuation due to lack of effectiveness was lower with the JAKi (HR = 0.38, 95%CI = 0.22-0.66, p< 0.01) and the IL-6i (HR = 0.29, 95%CI = 0.19-0.46, p< 0.01) as compared with the TNFi although the CTLA4-Ig had a similar HR to TNFi. The adjusted incidence of discontinuation due to adverse event was higher in the JAKi (HR = 2.86, 95%CI = 1.46-5.59, p< 0.01) than the TNFi. CONCLUSIONS: In EORA patients, IL-6i and JAKi had longer retention and less discontinuation due to ineffectiveness than TNFi. The potential risks of JAKi should be approached with an individualized perspective.

  Feb. 2024, Rheumatology (Oxford, England), English, International magazine

  Scientific journal


• Impact of dysregulated microbiota-derived C18 polyunsaturated fatty acid metabolites on arthritis severity in mice with collagen-induced arthritis.

  Katsuhiko Yoneda, Sho Sendo, Takaichi Okano, Hidenori Shimizu, Hirotaka Yamada, Keisuke Nishimura, Yo Ueda, Jun Saegusa

  OBJECTIVE: We aimed to evaluate microbiome and microbiota-derived C18 dietary polyunsaturated fatty acids (PUFAs), such as conjugated linoleic acid (CLA), and to investigate their differences that correlate with arthritis severity in collagen-induced arthritis (CIA) mice. METHODS: On day 84 after induction, during the chronic phase of arthritis, cecal samples were analyzed using 16S rRNA sequencing, and plasma and cecal digesta were evaluated using liquid chromatography-tandem mass spectrometry. Differences in microbial composition between 10 control (Ctrl) and 29 CIA mice or between the mild and severe subgroups based on arthritis scores were identified. The cecal metabolite profile and its correlation with the microbiome were evaluated with respect to arthritis severity. RESULTS: The hydroxy and oxo metabolite levels were higher in CIA mice than in Ctrl mice, some of which, including 10-hydroxy-cis-6-18:1, were positively correlated with arthritis scores. The 9-trans,11-trans CLA levels in CIA mice had a negative linear correlation with arthritis scores. Microbial diversity was lower in severe CIA mice than in mild CIA or Ctrl mice. The abundance of Lactobacillus relatively increased in the severe subgroup of CIA mice compared with that in the mild subgroup and was positively correlated with arthritis severity. CONCLUSION: Alterations in gut microbiota and microbiota-derived C18 PUFA metabolites are associated in CIA mice and correlated with arthritis scores, indicating that plasma or fecal C18 PUFA metabolites can be potential biomarkers for arthritis severity and dysbiosis.

  2024, Frontiers in immunology, 15, 1444892 - 1444892, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Association of anti-β2-glycoprotein I/HLA-DR complex antibody with arterial thrombosis in female patients with systemic rheumatic diseases

  Katsuhiko Yoneda, Yo Ueda, Kenji Tanimura, Hisashi Arase, Hideto Yamada, Jun Saegusa

  Dec. 2023, Arthritis Research and Therapy, 25(1) (1)

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Real-world comparative study of the efficacy of Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study.

  Shinya Hayashi, Shotaro Tachibana, Toshihisa Maeda, Mai Yamashita, Iku Shirasugi, Yuzuru Yamamoto, Hirotaka Yamada, Takaichi Okano, Keisuke Nishimura, Yo Ueda, Sadao Jinnno, Jun Saegusa, Wataru Yamamoto, Koichi Murata, Takayuki Fujii, Kenichiro Hata, Ayaka Yoshikawa, Kosuke Ebina, Yuki Etani, Naofumi Yoshida, Hideki Amuro, Motomu Hashimoto, Ryota Hara, Masaki Katayama, Tadashi Okano, Ryosuke Kuroda

  OBJECTIVE: This multicentre, retrospective study compared the efficacy and safety of tofacitinib, baricitinib, peficitinib and upadacitinib in real-world clinical settings after minimizing selection bias and adjusting the confounding patient characteristics. METHOD: The 622 patients were selected from the ANSWER cohort database and treated with tofacitinib (TOF), baricitinib (BAR), peficitinib (PEF) or upadacitinib (UPA). The patient's background was matched using propensity score-based inverse probability of treatment weighting (IPTW) among four treatment groups. The values of Clinical Disease Activity Index (CDAI), C-reactive protein (CRP), and modified Health Assessment Questionnaire (mHAQ) after drug initiation and the remission or low disease activity (LDA) rates of CDAI at 6 months after drug initiation were compared among the four groups. Further, the predictive factor for TOF and BAR efficacy was analysed. RESULTS: The retention and discontinuation rates until 6 months after drug initiations were not significantly different among the four JAK inhibitors treatment groups. Mean CDAI value, CDAI remission rate, and CDAI-LDA rate at 6 months after drug initiation were not significantly different among treatment groups. Baseline CDAI (TOFA: OR 1.09, P < 0.001; BARI: OR 1.07, P < 0.001), baseline CRP (TOFA: OR 1.32, P = 0.049), baseline glucocorticoid dose (BARI: OR 1.18, 95% CI 1.01-1.38, P = 0.035), a number of previous biological or targeted synthetic disease-modifying antirheumatic drugs (biological/targeted synthetic DMARDs) (BARI: OR 1.36, P = 0.004) were predictive factors for resistance to CDAI-LDA achievement to JAK inhibitor treatment. CONCLUSION: The efficacy and safety of TOF, BAR, PEF and UPA were not significantly different for the treatment of patients with rheumatoid arthritis.

  Nov. 2023, Rheumatology (Oxford, England), English, International magazine

  Scientific journal


• Association of anti-β2-glycoprotein I/HLA-DR complex antibody with arterial thrombosis in female patients with systemic rheumatic diseases.

  Katsuhiko Yoneda, Yo Ueda, Kenji Tanimura, Hisashi Arase, Hideto Yamada, Jun Saegusa

  BACKGROUND: β2-glycoprotein I (β2GPI) complexed with human leukocyte antigen DR (β2GPI/HLA-DR) was found to be a major autoantibody target in antiphospholipid syndrome (APS). This study aimed to reveal the association between anti-β2GPI/HLA-DR antibodies and vascular thromboses in women with systemic rheumatic diseases. METHODS: We conducted a retrospective longitudinal study. We measured anti-β2GPI/HLA-DR antibodies and compared them with anti-phospholipid antibody (aPL) profiles and the adjusted global antiphospholipid syndrome score (aGAPSS). Using receiver operating characteristic (ROC) analysis, we determined the best cut-off value for arterial thrombosis. We also evaluated the validity of anti-β2GPI/HLA-DR antibodies by adding to conventional cardiovascular risk factors in multivariate logistic analysis. RESULTS: We evaluated 704 patients, including 66 (obstetric or thrombotic) APS, 13 primary APS, and 78 asymptomatic aPL carriers. Seventy-seven patients had a history of arterial thrombosis, and 14 patients had both arterial and venous thrombosis. These 14 patients, as well as patients with aGAPSS > 10 or triple-positive aPL profiles, displayed high anti-β2GPI/HLA-DR antibody titers. The ROC curve showed a sensitivity, specificity, and area under the curve (AUC) for arterial thrombosis of 33.8%, 91.4%, and 0.6009, respectively, with a cut-off value of 172.359 U/mL. The anti-β2GPI/HLA-DR antibody positivity using this cut-off value yielded an odds ratio of 5.13 (95%CI: 2.85-9.24), significantly improving the AUC from 0.677 to 0.730. CONCLUSION: Anti-β2GPI/HLA-DR antibodies are associated with arterial thrombosis in female patients with systemic rheumatic diseases.

  Oct. 2023, Arthritis research & therapy, 25(1) (1), 195 - 195, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Trends of disease activity in Japanese patients over 75 years with rheumatoid arthritis from 2014 to 2021: the ANSWER cohort study

  Hirotaka Yamada, Sadao Jinno, Toshihisa Maeda, Shinya Hayashi, Wataru Yamamoto, Akira Onishi, Hideo Onizawa, Tohru Takeuchi, Yuri Hiramatsu, Yasutaka Okita, Kosuke Ebina, Yonsu Son, Naofumi Yoshida, Ryu Watanabe, Ryota Hara, Mai Yamashita, Yoko Nose, Yuzuru Yamamoto, Takaichi Okano, Keisuke Nishimura, Yo Ueda, Sho Sendo, Motomu Hashimoto, Ryosuke Kuroda, Jun Saegusa

  Abstract Objectives To investigate if disease activity among elderly RA patients &gt;75 years of age has changed over time in the real-world clinical setting. Methods Data from an observational multicentre registry of RA patients in Japan were analysed. The primary outcome was to evaluate the changes in the proportion of very elderly RA patients (&gt;75 years) who achieved remission and low disease activity (LDA), from 2014 to 2021. The secondary outcome was to identify factors associated with remission and LDA by comparing demographic and clinical characteristics among the patients who had a study visit within the study period, using multivariate logistic regression. Results A total of 32 161 patient visits were identified from 2014 to 2021. The proportion of patients &gt;75 years of age increased from 16.5% to 26.9%, with biologics and targeted synthetic DMARDs (b/tsDMARDs) use increasing and glucocorticoids use decreasing, while conventional synthetic DMARDs use remained relatively stable. The proportion of RA patients &gt;75 years of age achieving remission and LDA significantly increased from 62.2% to 78.2% (P for trend &lt; 0.001). A negative factor associated with achieving remission and LDA was glucocorticoid use, seropositivity and a history of previous b/tsDMARDs use while MTX use was associated positively, independent of other predictors. Conclusions In our cohort, disease activity among very elderly RA patients has improved over time. The study suggests the importance of using a treat-to-target approach in very elderly RA patients to improve clinical outcomes.

  Oxford University Press (OUP), Oct. 2023, Rheumatology, 63(8) (8), 2147 - 2151

  Scientific journal


• Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study.

  Kosuke Ebina, Yuki Etani, Yuichi Maeda, Yasutaka Okita, Makoto Hirao, Wataru Yamamoto, Motomu Hashimoto, Koichi Murata, Ryota Hara, Koji Nagai, Yuri Hiramatsu, Yonsu Son, Hideki Amuro, Takayuki Fujii, Takaichi Okano, Yo Ueda, Masaki Katayama, Tadashi Okano, Shotaro Tachibana, Shinya Hayashi, Atsushi Kumanogoh, Seiji Okada, Ken Nakata

  OBJECTIVES: This multicentre retrospective study in Japan aimed to assess the retention of biological disease-modifying antirheumatic drugs and Janus kinase inhibitors (JAKi), and to clarify the factors affecting their retention in a real-world cohort of patients with rheumatoid arthritis. METHODS: The study included 6666 treatment courses (bDMARD-naïve or JAKi-naïve cases, 55.4%; tumour necrosis factor inhibitors (TNFi) = 3577; anti-interleukin-6 receptor antibodies (aIL-6R) = 1497; cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) = 1139; JAKi=453 cases). The reasons for discontinuation were divided into four categories (ineffectiveness, toxic adverse events, non-toxic reasons and remission); multivariate Cox proportional hazards modelling by potential confounders was used to analyse the HRs of treatment discontinuation. RESULTS: TNFi (HR=1.93, 95% CI: 1.69 to 2.19), CTLA4-Ig (HR=1.42, 95% CI: 1.20 to 1.67) and JAKi (HR=1.29, 95% CI: 1.03 to 1.63) showed a higher discontinuation rate due to ineffectiveness than aIL-6R. TNFi (HR=1.28, 95% CI: 1.05 to 1.56) and aIL-6R (HR=1.27, 95% CI: 1.03 to 1.57) showed a higher discontinuation rate due to toxic adverse events than CTLA4-Ig. Concomitant use of oral glucocorticoids (GCs) at baseline was associated with higher discontinuation rate due to ineffectiveness in TNFi (HR=1.24, 95% CI: 1.09 to 1.41), as well as toxic adverse events in JAKi (HR=2.30, 95% CI: 1.23 to 4.28) and TNFi (HR=1.29, 95%CI: 1.07 to 1.55). CONCLUSIONS: TNFi (HR=1.52, 95% CI: 1.37 to 1.68) and CTLA4-Ig (HR=1.14, 95% CI: 1.00 to 1.30) showed a higher overall drug discontinuation rate, excluding non-toxicity and remission, than aIL-6R.

  Aug. 2023, RMD open, 9(3) (3), English, International magazine

  [Refereed]

  Scientific journal


• Prognostic Factors Affecting Death in Patients with Rheumatoid Arthritis Complicated by Pneumocystis jirovecii Pneumonia and One-Year Clinical Course: The ANSWER Cohort Study.

  Hideyuki Shiba, Takuya Kotani, Koji Nagai, Kenichiro Hata, Wataru Yamamoto, Ayaka Yoshikawa, Yumiko Wada, Yuri Hiramatsu, Hidehiko Makino, Yo Ueda, Akira Onishi, Koichi Murata, Hideki Amuro, Yonsu Son, Ryota Hara, Toru Hirano, Kosuke Ebina, Masaki Katayama, Motomu Hashimoto, Tohru Takeuchi

  This multicenter retrospective study aimed to clarify the prognostic factors for mortality and changes in treatment modalities and disease activities after the onset of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA). Data regarding the clinical background, treatment modalities, and disease activity indicators of RA at the onset of PCP (baseline), and 6 months and 12 months after treatment were extracted. Of the 37 patients with RA-PCP (median age, 69 years; 73% female), chemical prophylaxis was administered to 8.1%. Six patients died during PCP treatment. The serum C-reactive protein (CRP) levels and the prednisolone (PDN) dose at baseline in the PCP death group were significantly higher than those in the survivor group. Multivariate analysis using a Cox regression model showed that PDN dose at baseline was a predictor of death from PCP in patients with RA. During the 12 months from baseline, the RA disease activity significantly decreased. A high dose of corticosteroids for RA may result in a poor prognosis when PCP is complicated. In the future, preventive administration techniques must be established for patients with RA who need PCP prevention.

  Apr. 2023, International journal of molecular sciences, 24(8) (8), English, International magazine

  Scientific journal


• Severe Lupus Myocarditis Preceded by Mesalazine-induced Lupus.

  Mai Yamashita, Keisuke Nishimura, Iku Shirasugi, Yoshihide Ichise, Yo Ueda, Jun Saegusa

  In drug-induced lupus (DIL), symptoms similar to those of systemic lupus erythematosus (SLE) usually resolve after discontinuation of the offending drug. A 41-year-old-woman with a history of ulcerative colitis presented with polyarthritis and myositis and was positive for anti-double stranded (ds) DNA IgG antibody. After discontinuation of mesalazine, the symptoms resolved, and the antibody titer decreased. The patient was diagnosed with DIL. Six months later, lupus myocarditis developed. After treatment with glucocorticoids, cyclophosphamide, intravenous immunoglobulin, and an intra-aortic balloon pump, she showed dramatic improvement. Patients with DIL and an immunological predisposition, such as anti-dsDNA antibodies, may have SLE and should be carefully monitored.

  Mar. 2023, Internal medicine (Tokyo, Japan), 62(6) (6), 929 - 933, English, Domestic magazine

  Scientific journal


• 疫学1:RA/関節型JIAの治療 高齢関節リウマチ患者における疾患活動性の年次変化に関する検討 関西多施設共同研究ANSWER Cohort study

  山田 啓貴, 神野 定男, 前田 俊恒, 林 申也, 山本 渉, 大西 輝, 鬼澤 秀夫, 武内 徹, 平松 ゆり, 沖田 康孝, 蛯名 耕介, 孫 瑛洙, 吉田 直史, 渡部 龍, 原 良太, 片山 昌紀, 山下 真依, 能瀬 洋子, 山本 譲, 岡野 隆一, 西村 啓佑, 上田 洋, 千藤 荘, 橋本 求, 黒田 良祐, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67回, 526 - 526, Japanese


• JAK阻害薬-2 JAK阻害薬4剤の有効性比較と有効性に影響を与える因子の探索 関西多施設ANSWERコホートによる解析

  林 申也, 前田 俊恒, 山下 真依, 白杉 郁, 山本 譲, 山田 啓貴, 岡野 隆一, 西村 啓佑, 上田 洋, 神野 定男, 三枝 淳, 山本 渉, 村田 浩一, 藤井 貴之, 秦 健一郎, 吉川 紋佳, 蛯名 耕介, 惠谷 悠紀, 吉田 直史, 安室 秀樹, 原 良太, 片山 昌紀, 橋本 求, 岡野 匡志, 立花 章太郎, 黒田 良祐

  (一社)日本リウマチ学会, Mar. 2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67回, 551 - 551, Japanese


• JAK阻害薬-4 tsDMARDsとbDMARDsにより関節リウマチ患者の非炎症性疼痛へ及ぼす効果の比較 関西多施設共同研究ANSWER Cohortを用いた検討

  山下 真依, 岡野 隆一, 白杉 郁, 山田 啓貴, 西村 啓佑, 千藤 荘, 上田 洋, 前田 俊恒, 林 申也, 山本 渉, 大西 輝, 村上 孝作, 斯波 秀行, 秦 健一郎, 辻本 考平, 蛯名 耕介, 孫 瑛洙, 吉田 直史, 原 良太, 渡部 龍, 橋本 求, 黒田 良祐, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67回, 621 - 621, Japanese


• Demographic, Physical, and Psychological Determinants of Patient Experience with Subcutaneous Self-Injection in Patients with Rheumatoid Arthritis: Structural Equation Modeling Approach.

  Akira Onishi, Maiko Kaizu, Iku Shirasugi, Tomoko Yagyu, Yo Ueda, Yoshitada Sakai, Yasushi Miura, Jun Saegusa

  PURPOSE: To achieve a better patient experience with self-injection, an assessment of potential demographic, physical, and psychological barriers is necessary. The aim of this study was to examine the demographic, physical, and psychological characteristics associated with the experiences of self-injection in patients with rheumatoid arthritis (RA). PATIENTS AND METHODS: In this study, overall patient experience with subcutaneous self-injection was assessed using the Self-Injection Assessment Questionnaire. Upper limb function was assessed using the three domains of the Health Assessment Questionnaire associated with upper extremity disability (dressing and grooming, eating, and grip). Structural equation modeling was used to estimate the association between the demographic and clinical characteristics of patients with RA and their experiences with self-injection in the theoretical model. RESULTS: Data from 83 patients with RA were analyzed. Compared with younger patients, elderly patients were more likely to experience lower self-confidence, self-image, and ease of use. Female patients had lower ease of use than male patients. In terms of upper limb function, patients with more difficulty in performing activities of daily living were more likely to have a lower self-image. Self-injection perceptions before learning the method of injection, such as fear of needles and anxiety about self-injection, were associated with post-injection feelings, injection site reactions, self-confidence, and ease of use. CONCLUSION: To optimize patients' experiences with self-injection, healthcare workers should assess each patient's age, sex, upper limb function, and pre-self-injection perceptions as demographic, physical, and psychological barriers.

  2023, Patient preference and adherence, 17, 1551 - 1559, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• JAK阻害薬:治療の工夫、基礎 関節リウマチに対する分子標的治療薬のステロイド減量効果について 関西多施設ANSWER cohortでの検討

  原 良太, 山本 渉, 村田 浩一, 藤井 貴之, 秦 健一郎, 槇野 秀彦, 蛯名 耕介, 沖田 康孝, 孫 瑛洙, 安室 秀樹, 岡野 隆一, 上田 洋, 片山 昌紀, 橋本 求, 岡野 匡志, 尾崎 裕亮, 岡村 建祐, 川島 浩正, 松岡 秀俊, 巽 恵美子, 大野 史郎, 鮫島 謙一, 新名 直樹, 藤本 隆, 城戸 顕, 赤井 靖宏, 西尾 健治, 田中 康仁

  (一社)日本リウマチ学会, Mar. 2022, 日本リウマチ学会総会・学術集会プログラム・抄録集, 66回, 368 - 368, Japanese


• アバタセプト継続率と血球分画の関連 ANSWERコホートを用いた研究

  藤井 貴之, 村田 浩一, 鬼澤 秀夫, 大西 輝, 村上 孝作, 中山 洋一, 稲葉 竜太, 西村 望美, 山本 渉, 前田 悠一, 沖田 康孝, 岡野 隆一, 上田 洋, 武内 徹, 斯波 秀行, 原 良太, 孫 瑛洙, 安室 秀樹, 片山 昌紀, 橋本 求, 渡部 龍, 田中 真生, 森信 暁夫, 松田 秀一

  (一社)日本リウマチ学会, Mar. 2022, 日本リウマチ学会総会・学術集会プログラム・抄録集, 66回, 584 - 584, Japanese


• 関節リウマチの治療(csDMARDs) MTXの継続率と生活習慣病の関連 関西多施設ANSWERコホートを用いた検討

  岡野 隆一, 上田 洋, 山田 啓貴, 白杉 郁, 山本 譲, 神野 定男, 西村 啓佑, 山本 渉, 沖田 康孝, 蛯名 耕介, 藤井 貴之, 村上 孝作, 安室 秀樹, 孫 瑛洙, 斯波 秀行, 武内 徹, 原 良太, 片山 昌紀, 山田 真介, 橋本 求, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2022, 日本リウマチ学会総会・学術集会プログラム・抄録集, 66回, 376 - 376, Japanese


• Effect of resolvin D5 on T cell differentiation and osteoclastogenesis analyzed by lipid mediator profiling in the experimental arthritis.

  Hirotaka Yamada, Jun Saegusa, Sho Sendo, Yo Ueda, Takaichi Okano, Masakazu Shinohara, Akio Morinobu

  Resolvins, are specialized pro-resolving mediators (SPMs) derived from n-3 polyunsaturated fatty acids. They contribute actively to the resolution of inflammation, but little is known concerning their role in chronic inflammation, such as in rheumatoid arthritis (RA). Here, we performed lipid mediator (LM) profiling in tissues from the paws of SKG arthritic mice using lipid chromatography (LC)/mass spectrometry (MS)/MS-based LM metabololipidomics. We found elevated levels of SPMs including resolvin D5 (RvD5) in these tissues. Moreover, RvD5 levels were significantly correlated with arthritis disease activity. From experiments to assess the role of RvD5 in the pathology of RA, we concluded that RvD5 suppressed Th17 cell differentiation and facilitated regulatory T cell differentiation, as well as inhibiting CD4+ T cell proliferation. Furthermore, RvD5 attenuated osteoclast differentiation and interfered with osteoclastogenesis. Targeting the resolution of inflammation could be promising as a novel treatment for RA.

  Aug. 2021, Scientific reports, 11(1) (1), 17312 - 17312, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Soluble guanylate cyclase stimulator reduced the gastrointestinal fibrosis in bleomycin-induced mouse model of systemic sclerosis.

  Yuzuru Yamamoto, Takaichi Okano, Hirotaka Yamada, Kengo Akashi, Sho Sendo, Yo Ueda, Akio Morinobu, Jun Saegusa

  BACKGROUND: Systemic sclerosis (SSc) is a chronic autoimmune-mediated connective tissue disorder. Although the etiology of the disease remains undetermined, SSc is characterized by fibrosis and proliferative vascular lesions of the skin and internal organs. SSc involves the gastrointestinal tract in more than 90 % of patients. Soluble guanylate cyclase (sGC) stimulator is used to treat pulmonary artery hypertension (PAH) and has been shown to inhibit experimental skin fibrosis. METHODS: Female C57BL/6J mice were treated with BLM or normal saline by subcutaneous implantation of osmotic minipump. These mice were sacrificed on day 28 or day 42. Gastrointestinal pathologies were examined by Masson Trichrome staining. The expression of fibrosis-related genes in gastrointestinal tract was analyzed by real-time PCR, and the levels of collagen in the tissue were measured by Sircol collagen assay. To evaluate peristaltic movement, the small intestinal transport (ITR%) was calculated as [dyeing distance × (duodenum - appendix)] - 1 × 100 (%). We treated BLM-treated mice with sGC stimulator or DMSO orally and analyzed them on day 42. RESULTS: Histological examination revealed that fibrosis from lamina propria to muscularis mucosa in the esophagus was significantly increased in BLM-treated mice, suggesting that BLM induces esophageal hyperproliferative and prefibrotic response in C57BL/6J mice. In addition, the gene expression levels of Col3a1, CCN2, MMP-2, MMP-9, TIMP-1, and TIMP-2 in the esophagus were significantly increased in BLM-treated mice. More severe hyperproliferative and prefibrotic response was observed in the mice sacrificed on day 42 than the mice sacrificed on day 28. The ITR% was found to be significantly lower in BLM-treated mice, suggesting that gastrointestinal peristaltic movement was reduced in BLM-treated mice. Furthermore, we demonstrated that sGC stimulator treatment significantly reduced hyperproliferative and prefibrotic response of esophagus and intestine in BLM-treated mice, by histological examination and Sircol collagen assay. CONCLUSIONS: These findings suggest that BLM induces gastrointestinal hyperproliferative and prefibrotic response in C57BL/6J mice, and treatment with sGC stimulator improves the BLM-induced gastrointestinal lesion.

  May 2021, Arthritis research & therapy, 23(1) (1), 133 - 133, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• SLE・抗リン脂質抗体症候群(臨床):バイオマーカー 当院における抗DNA抗体検出法についての検討 Farr法とCLIA法の比較について

  岡野 隆一, 明石 健吾, 山田 啓貴, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 381 - 381, Japanese


• 多発性筋炎・皮膚筋炎:ケースプレゼンテーション 皮膚硬化を呈した抗ミトコンドリア抗体陽性筋炎の1例

  岩倉 伸昴, 山田 啓貴, 市川 晋也, 向原 沙紀, 白杉 郁, 明石 健吾, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 401 - 401, Japanese


• 異所性石灰化病変を合併した全身性エリテマトーデス患者に対してテリパラチドにより異所性石灰化と骨粗鬆症を同時に治療しえた一例

  岡野 隆一, 明石 健吾, 山田 啓貴, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 612 - 612, Japanese


• 中型血管炎による難治性多発消化管潰瘍を呈した顕微鏡的多発血管炎の一例

  白杉 郁, 向原 沙紀, 市川 晋也, 山田 啓貴, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 665 - 665, Japanese


• 間質性肺炎を有するRA患者におけるDMARDsの安全性に関する系統的レビュー

  大西 輝, 岡野 隆一, 上田 洋, 明石 健吾, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 634 - 634, Japanese


• 悪性腫瘍を有するRA患者におけるDMARDsの安全性に関する系統的レビュー

  大西 輝, 岡野 隆一, 上田 洋, 明石 健吾, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 636 - 636, Japanese


• 高用量ステロイド治療中の膠原病患者におけるニューモシスティス肺炎(PCP)予防薬の効果

  明石 健吾, 神野 定男, 大西 輝, 米田 勝彦, 白杉 郁, 岡野 隆一, 上田 洋, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 697 - 697, Japanese


• ステロイド、DMARDs加療中のRA患者へのワクチン接種の有効性、安全性に関する系統的レビュー

  大西 輝, 岡野 隆一, 上田 洋, 明石 健吾, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 763 - 763, Japanese


• Subjective well-being among rheumatoid arthritis patients.

  Goichi Kageyama, Akira Onishi, Yo Ueda, Ikuko Naka, Kosaku Tsuda, Takaichi Okano, Kengo Akashi, Keisuke Nishimura, Sho Sendo, Jun Saegusa, Akio Morinobu

  AIM: Subjective well-being (SWB) is a psychological construct that is synonymous with happiness. Many variables including age, sex, income, employment, and marital status are related to SWB. Health is also an important determinant of SWB that can be adversely affected in patients with chronic conditions such as rheumatoid arthritis (RA). In this study, we evaluate the SWB of RA patients and compare it with that of healthy controls. METHODS: We obtained the original dataset from the "Quality of Life Survey, 2013", which was conducted by the Economic and Social Research Institute, Cabinet Office, Government of Japan. In this survey, SWB was determined by asking participants to rate their happiness between 0 (very unhappy) and 10 (very happy). The survey also included a 56-point questionnaire regarding well-being-related variables. This questionnaire was administered to RA patients recruited from Kobe University Hospital, and clinical and treatment data were simultaneously collected. RESULTS: Multivariate analysis revealed that RA patients with high or moderate disease activity had SWB scores that were similar to those of controls. However, the SWB scores of RA patients in remission or with low disease activity were higher than those of controls (P = .013). SWB was associated with household income, self-assessment of living costs, self-assessment of health, depression/ anxiety, and social connection. CONCLUSIONS: For RA patients, achieving the therapeutic target can result in better SWB than that of healthy controls. Financial status, self-assessment of health, psychological stress, and social network are also important determinants for the SWB of RA patients.

  Oct. 2019, International journal of rheumatic diseases, 22(10) (10), 1863 - 1870, English, International magazine

  [Refereed]

  Scientific journal


• Additive effects of inhibiting both mTOR and glutamine metabolism on the arthritis in SKG mice.

  Yo Ueda, Jun Saegusa, Takaichi Okano, Sho Sendo, Hirotaka Yamada, Keisuke Nishimura, Akio Morinobu

  Glutamine metabolism and the mechanistic target of rapamycin (mTOR) pathway are activated cooperatively in the differentiation and activation of inflammatory immune cells. But the combined inhibition of both pathways was rarely investigated. This study investigated how inhibiting both glutamine metabolism with 6-diazo-5-oxo-L-norleucine (DON) and mTOR with rapamycin affects immune cells and the arthritis in a mouse model. We revealed that rapamycin and DON additively suppressed CD4+ T cell proliferation, and both of them inhibited Th17 cell differentiation. While DON inhibited the differentiation of dendritic cells and macrophages and facilitated that of Ly6G+ granulocytic (G)-MDSCs more strongly than did rapamycin, G-MDSCs treated with rapamycin but not DON suppressed CD4+ T cell proliferation in vitro. The combination of rapamycin and DON significantly suppressed the arthritis in SKG mice more strongly than did each monotherapy in vivo. The numbers of CD4+ T and Th17 cells in the spleen were lowest in mice treated with the combination therapy. Thus, combined treatment with rapamycin and DON additively ameliorated the arthritis in SKG mice, possibly by suppressing CD4+ T cell proliferation and Th17 differentiation. These results suggest the combination of rapamycin and DON may be a potential novel therapy for arthritis.

  Apr. 2019, Scientific reports, 9(1) (1), 6374 - 6374, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Immunometabolism in rheumatoid arthritis.

  Takaichi Okano, Jun Saegusa, Soshi Takahashi, Yo Ueda, Akio Morinobu

  Recent studies have revealed a relationship between cellular metabolism and cell function in immune cells. Cellular metabolism not only provides supplemental ATP, but also supports dynamic changes in cell proliferation and differentiation. For example, T cells exhibit subset-specific metabolic profiles, and require certain types of metabolism for their functions. Determining the metabolic profiles that support inflammatory immune responses may lead to novel treatment strategies for chronic inflammatory diseases such as rheumatoid arthritis (RA). However, the mechanisms by which metabolism modulates cell function have been unclear. Recent studies have begun to unveil unexpected non-metabolic functions for metabolic enzymes in the context of inflammation, including roles in signaling and gene regulation. Here we describe recent findings related to immunometabolism, the metabolome of RA patients, and the metabolically independent functions of glycolytic enzymes. We discuss how metabolic processes impact immune cells, especially T cells and fibroblast like synoviocytes, which are considered the orchestrators of autoimmune arthritis.

  Sep. 2018, Immunological medicine, 41(3) (3), 89 - 97, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 3-bromopyruvate ameliorate autoimmune arthritis by modulating Th17/Treg cell differentiation and suppressing dendritic cell activation.

  Takaichi Okano, Jun Saegusa, Keisuke Nishimura, Soshi Takahashi, Sho Sendo, Yo Ueda, Akio Morinobu

  Recent studies have shown that cellular metabolism plays an important role in regulating immune cell functions. In immune cell differentiation, both interleukin-17-producing T (Th17) cells and dendritic cells (DCs) exhibit increased glycolysis through the upregulation of glycolytic enzymes, such as hexokinase-2 (HK2). Blocking glycolysis with 2-deoxyglucose was recently shown to inhibit Th17 cell differentiation while promoting regulatory T (Treg) cell generation. However, 2-DG inhibits all isoforms of HK. Thus, it is unclear which isoform has a critical role in Th17 cell differentiation and in rheumatoid arthritis (RA) pathogenesis. Here we demonstrated that 3-bromopyruvate (BrPA), a specific HK2 inhibitor, significantly decreased the arthritis scores and the histological scores in SKG mice, with a significant increase in Treg cells, decrease in Th17 cells, and decrease in activated DCs in the spleen. In vitro, BrPA facilitated the differentiation of Treg cells, suppressed Th17 cells, and inhibited the activation of DCs. These results suggested that BrPA may be a therapeutic target of murine arthritis. Although the role of IL-17 is not clarified in the treatment of RA, targeting cell metabolism to alter the immune cell functions might lead to a new therapeutic strategy for RA.

  Feb. 2017, Scientific reports, 7, 42412 - 42412, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Successful tocilizumab therapy in seven patients with refractory adult-onset Still's disease.

  Ei Bannai, Hiroyuki Yamashita, Shunta Kaneko, Yo Ueda, Takashi Ozaki, Haruka Tsuchiya, Yuko Takahashi, Hiroshi Kaneko, Toshikazu Kano, Akio Mimori

  To evaluate the effects of tocilizumab (TCZ) on adult-onset Still's disease (AOSD), we reviewed medical records of seven patients with refractory AOSD treated with TCZ at our institution. TCZ therapy might allow rapid corticosteroid tapering and help maintain remission status, that is, resolution of clinical symptoms and normalization of biomarkers such as CRP and ferritin. Patients, however, should be monitored for the development of macrophage activation syndrome when TCZ is administered for active AOSD.

  2016, Modern rheumatology, 26(2) (2), 297 - 301, English, International magazine

  [Refereed]

  Scientific journal


• Interstitial cystitis associated with primary Sjögren's syndrome successfully treated with a combination of tacrolimus and corticosteroid: A case report and literature review.

  Yo Ueda, Hikaru Tomoe, Hiroyuki Takahashi, Yuko Takahashi, Hiroyuki Yamashita, Hiroshi Kaneko, Toshikazu Kano, Akio Mimori

  We report a case of interstitial cystitis (IC) associated with primary Sjögren's syndrome (SS) successfully controlled with combination therapy of tacrolimus and a corticosteroid. In 2011, a 69-year-old female, who had been diagnosed with primary SS 23 years ago, developed IC and was successfully treated with tacrolimus and prednisolone combination therapy. The mechanism of IC, including the involved autoimmunity, has not been elucidated. Clinical observation studies suggest a potential association between SS and IC. However, IC is currently thought to be underdiagnosed in patients with SS as well as in the general population. Based on our case and others reported previously, IC associated with SS responds well to immunosuppressive therapy. In particular, a combination of a calcineurin inhibitor (tacrolimus or cyclosporine) with a corticosteroid seems to be highly effective. The possibility of IC in patients with SS complaining of lower urinary tract symptoms without features of infection or other identifiable causes should be given attention.

  2016, Modern rheumatology, 26(3) (3), 445 - 9, English, International magazine

  [Refereed]


• Utility of fluorodeoxyglucose positron emission tomography/computed tomography for early diagnosis and evaluation of disease activity of relapsing polychondritis: a case series and literature review.

  Hiroyuki Yamashita, Hiroyuki Takahashi, Kazuo Kubota, Yo Ueda, Takashi Ozaki, Hideki Yorifuji, Ei Bannai, Ryogo Minamimoto, Miyako Morooka, Yoko Miyata, Momoko Okasaki, Yuko Takahashi, Hiroshi Kaneko, Toshikazu Kano, Akio Mimori

  OBJECTIVE: Relapsing polychondritis (RPC) is relatively rare and early diagnosis is difficult. We investigated the utility of fluorodeoxyglucose (FDG)-PET/CT for the diagnosis of RPC and evaluation of disease activity. METHODS: Five RPC patients undergoing FDG-PET/CT in our hospital between 2006 and 2012 were studied. Eight RPC cases examined by PET reported in the literature were also assessed. Data from a total of 13 patients were analysed. RESULTS: Typical FDG accumulation was noted in the tracheobronchial trees of nine patients, the costal cartilage of five, joints of five, larynx of four, nasal cavity/paranasal sinuses of three, auricles of three, lymph nodes of three and the aorta of one. One patient showed nasal chondritis on a PET scan despite the absence of nasal changes on physical examination. Of five patients with costochondritis, four remained asymptomatic. Of nine patients with airway FDG accumulation, eight developed respiratory symptoms and all had CT abnormalities. In the other patient, airway FDG accumulation was evident despite the absence of airway symptoms and a lack of abnormalities in the respiratory function test and CT. PET also revealed bronchial chondritis in asymptomatic patients. The mean maximum standardized uptake values (SUVmax) of the upper and lower airways was 5.79 (s.d. 2.87) and 6.47 (s.d. 4.08), respectively. In five patients with a PET after treatment, FDG accumulation had diminished with symptomatic and inflammatory improvement. CONCLUSION: FDG-PET/CT is a potentially powerful tool for the early diagnosis of RPC, especially in patients without easily biopsied organ involvement. This modality also facilitates evaluation of disease extent and disease activity during treatment.

  Aug. 2014, Rheumatology (Oxford, England), 53(8) (8), 1482 - 90, English, International magazine

  [Refereed]

  Scientific journal


• [A miliary tuberculosis case without lung involvement difficult to distinguish from autoimmune hepatitis exacerbation].

  Hiroyuki Yamashita, Yo Ueda, Yuko Takahashi, Akio Mimori

  A 48-year-old female with a past history of systemic lupus erythematosus had developed autoimmune hepatitis (AIH) at the age of 45 years, and administration of PSL 30 mg/day was initiated. However, AIH exacerbation was suspected based on elevation of hepatic and biliary tract enzymes such as ALP (1207U/L) with a fever of 38 degrees C after tapering off the steroids to PSL 7.5 mg daily, and she was thus hospitalized. A liver biopsy was recommended, but she refused. Thus, we suspected concomitant AIH and autoimmune cholangitis (AIC). Although high-dose steroid treatment including steroid pulse therapy was administered, there was no improvement. We performed a liver biopsy on the 66th hospital day, after obtaining the patient's consent. Epithelioid granuloma was detected in the liver leaflet as the background of the AIH and AIC findings. In addition, acid fast bacteria were detected with auramine and Ziehl-Neelsen staining, raising the possibility of tuberculosis. Additionally, granuloma was also seen in her bone marrow, and miliary tuberculosis was suspected. Anti-tuberculous therapy with isoniazid, rifampicin, ethambutol and pyrazinamide was initially administered, but the regimen was changed to levofloxacin, ethambutol, and streptomycin due to the side effects of the earlier medications. Liver functions improved and the inflammatory reaction became negative. The patient was discharged on the 138th hospital day. Ultimately, no acid fast bacteria were detected with culture, PCR of her bone marrow, or liver biopsy. However, miliary tuberculosis was definitively diagnosed from the pathological findings and her clinical course. AIH was an underlying disease, and the discrimination from AIH exacerbation was difficult. Consequently, the diagnosis was miliary tuberculosis without the lung involvement and the main lesion was in the liver. It is important to take account of miliary tuberculosis in the differential diagnosis of fevers of unknown origin with elevation of hepatic and biliary tract enzymes, and to make a definitive diagnosis with a liver biopsy.

  Jul. 2014, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 88(4) (4), 459 - 62, Japanese, Domestic magazine

  [Refereed]

  Scientific journal


• Characteristics of 10 patients with paraneoplastic rheumatologic musculoskeletal manifestations.

  Hiroyuki Yamashita, Yo Ueda, Takashi Ozaki, Haruka Tsuchiya, Yuko Takahashi, Hiroshi Kaneko, Toshikazu Kano, Akio Mimori

  OBJECTIVES: To evaluate the possible correlation of malignant neoplasms and paraneoplastic rheumatologic syndromes. METHODS: We studied a series of 10 patients with paraneoplastic rheumatological syndromes collected from our Division of Rheumatic Disease between 2006 and 2012. RESULTS: Our series consisted of four males and six females, with a mean age of 65.5 years (range, 57-78 years). Of the 10 patients recruited, six had hematological malignancies and four had solid cancers. Malignancies were diagnosed after rheumatic symptoms were reported in all patients. Compared to solid tumors, hemopathy was diagnosed at a later time point (16.2 vs. 7.3 months). Extra-articular symptoms were associated with rheumatologic musculoskeletal manifestations in 100% of the patients. Polyarthritis was the main rheumatologic musculoskeletal manifestation (50% of the patients). The other manifestations were oligopolyarthritis and polymyalgia rheumatic-like symptoms (20% of the patients). Symmetric arthritis was present in 60% of the patients, and the remaining patients developed asymmetric arthritis. Musculoskeletal manifestations completely regressed in 66.7% of the patients after cancer therapy. When tumor relapse was observed, rheumatic symptoms did not recur in any of our patients (100%). CONCLUSIONS: Rheumatic disorders with atypical clinical presentation in older patients, poor response to usual treatment and systemic features such as weight loss and clinical findings compatible with well-recognized paraneoplastic syndromes should alert clinicians to the possible coexistence of an occult malignancy. Especially in cases of paraneoplastic rheumatic/musculoskeletal manifestations associated with hemopathy, the primary disease is unlikely to have manifested yet, making the diagnosis difficult. Thus, caution is required.

  May 2014, Modern rheumatology, 24(3) (3), 492 - 8, English, International magazine

  [Refereed]

  Scientific journal


• [Obstructive pneumonia and brain abscess due to Nocardia elegans in a patient with systemic lupus erythematosus].

  Yo Ueda, Kei Yamamoto, Koji Watanabe, Hiroyuki Yamashita, Norio Ohmagari, Akio Mimori

  We herein report on a 69-year-old male who developed lung nocardiosis and brain abscessation. In April 2011, he was diagnosed as having systemic lupus erythematosus complicated by peripheral neuropathy. Immunosuppressive therapy with high-dose prednisolone was begun. In November 2011, he developed cryptococcal pneumonia and meningitis, which was treated with liposomal amphotericin and flucytosine for 4 weeks and was maintained with fluconazole. In April 2012, consolidation and peripheral atelectasis in the right middle lobe appeared. Bronchoscopy revealed edematous mucosa in the right middle bronchus and occlusive change of the right B4 and B5, but biopsy and culture results provided no etiological information. In late June, he developed an intermittent fever, and obstructive pneumonia of the right middle lobe was suspected. Nocardia species were detected from the sputum culture and were thought to be the causative pathogen. Brain CT and MRI revealed a contrast-enhanced lesion in the right cerebellar hemisphere. The patient was diagnosed as having lung nocardiosis and brain abscessation. Considering that the nocardiosis had developed under prophylaxis for Pneumocystis jirovecii pneumonia using one tablet per day of a sulfamethoxazole-trimethoprim combination, meropenem and amikacin were administered in addition to the sulfamethoxazole-trimethoprim combination for 6 and 4 weeks, respectively. After N. elegans had been identified from the sputum, antibiotics were switched to a sulfamethoxazole-trimethoprim combination and clarithromycin based on the susceptibility results. The patient's clinical and radiological findings were improved and have been well sustained.

  May 2014, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 88(3) (3), 282 - 7, Japanese, Domestic magazine

  [Refereed]

  Scientific journal


• Refractory hemophagocytic syndrome in systemic lupus erythematosus successfully treated with intermittent intravenous cyclophosphamide: three case reports and literature review.

  Yo Ueda, Hiroyuki Yamashita, Yuko Takahashi, Hiroshi Kaneko, Toshikazu Kano, Akio Mimori

  We experienced three patients with refractory or severe hemophagocytic syndrome associated with the activity of systemic lupus erythematosus, so-called acute lupus hemophagocytic syndrome (ALHS). All patients were successfully treated with intermittent intravenous injections of cyclophosphamide (IVCY). In each patient, hemophagocytosis was found during bone marrow examination, and infectious causes of hemophagocytic syndrome were carefully excluded. Patients 1 and 2 were refractory to combination therapy with a high-dose corticosteroid and rituximab or cyclosporine and were successfully treated with additive IVCY. Patient 3 had very severe ALHS that developed after cardiac surgery but was successfully treated with a high-dose corticosteroid and IVCY. We conducted a literature review of adult ALHS and analyzed 54 cases reported from 2006 to 2013. Although the clinical and laboratory features were diverse, fever, bicytopenia or pancytopenia, and hyperferritinemia were almost universal. Including our 3 patients, a total of 16 have reportedly been treated with IVCY-containing regimens, and ALHS was successfully controlled in most of them without switching or adding other therapies. We suggest that combination therapy with IVCY and corticosteroids may be useful to treat severe or refractory ALHS.

  Feb. 2014, Clinical rheumatology, 33(2) (2), 281 - 6, English, International magazine

  [Refereed]


• Cytomegalovirus disease of the upper gastrointestinal tract in patients with rheumatic diseases: a case series and literature review.

  Takashi Ozaki, Hiroyuki Yamashita, Shunta Kaneko, Hideki Yorifuji, Hiroyuki Takahashi, Yo Ueda, Yuko Takahashi, Hiroshi Kaneko, Toshikazu Kano, Akio Mimori

  Cytomegalovirus disease of the upper gastrointestinal tract (CMV-UGT) is a rare but significant complication in patients with rheumatic diseases. We reviewed records for January 2004 to December 2012 and investigated the occurrence of CMV-UGT in patients with rheumatic diseases to evaluate clinical characteristics, the value of the CMV antigenemia assay, and the association between immunosuppressive therapy and CMV-UGT. Ten CMV-UGT events (six gastric ulcer, two esophagitis, one gastritis, and one duodenal ulcer) in nine patients (three rheumatoid arthritis, three systemic lupus erythematosus, one dermatomyositis, one systemic sclerosis, and one overlap syndrome) were identified based on pathology. Mean age was 66.5 (range, 53-76) years. The CMV antigenemia assay was negative in five cases (50 %). All ten cases received glucocorticoids and six (60 %) received pulsed glucocorticoids. Mean prednisolone dose was 31.3 (range, 7.5-40) mg/day at diagnosis. Concomitant immunosuppressive agents were used in eight cases (80 %). Considering other published cases, the most common immunosuppressive drug was cyclophosphamide (ten cases; 45 %). Notably, two of our patients who were treated with low-dose glucocorticoids plus other milder immunosuppressive drugs (methotrexate and cyclosporine) also developed CMV-UGT. Life-threatening complications such as massive bleeding or perforated ulcer occurred in two patients. These results suggest that patients receiving intensive immunosuppressive therapy such as high-dose glucocorticoids and cyclophosphamide are at higher risk for developing CMV-UGT. Moreover, CMV-UGT can occur even with low-dose glucocorticoid therapy and relatively mild immunosuppressive agents. The value of the CMV antigenemia assay for predicting CMV-UGT appears to be limited.

  Nov. 2013, Clinical rheumatology, 32(11) (11), 1683 - 90, English, International magazine

  [Refereed]

  Scientific journal


• [A rapidly progressive case of mediastinitis in which the patient developed inflammation of the soft tissue surrounding the pulmonary artery].

  Hiroyuki Yamashita, Yo Ueda, Yuko Takahashi, Akio Mimori

  A 51-year-old male patient with no underlying illness developed a fever of 38-39 degrees C in June 2009. The fever persisted for 4 days and, because elevated hepatobiliary enzymes, leukocytopenia and thrombocytopenia were observed, along with chest CT findings of inflammation of the soft tissues surrounding the left pulmonary artery, the patient was admitted for further examination. Three days after admission, the patient's blood pressure rapidly decreased, resulting in respiratory failure. Rapid proliferation of the soft tissue surrounding the pulmonary artery and mediastinum was observed on an emergency chest CT. Malignant lymphoma was initially considered as a possible differential diagnosis; however, neither pleural effusion nor infiltration of malignant cells could be observed on bone marrow examination. In addition, because the patient responded well to antibiotics, a diagnosis of acute mediastinitis was reached. Mediastinal drainage was not performed because the quantity of accumulated fluid was small and because the patient, both in terms of his clinical symptoms and imaging results, showed improvement with the continuation of antibiotics alone. The patient was ambulatory and was discharged after 24 days of hospitalization. Acute mediastinitis often follows a rapidly progressive and fatal course without specific symptoms. In the event of unknown infection following an aggressive course, as in the present case, acute mediastinitis must be considered with the goal of early diagnosis and treatment.

  Nov. 2013, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 87(6) (6), 746 - 51, Japanese, Domestic magazine

  [Refereed]

  Scientific journal


• Diagnosis and treatment of primary Sjögren syndrome-associated peripheral neuropathy: a six-case series.

  Hiroyuki Yamashita, Toshiki Eri, Yo Ueda, Takashi Ozaki, Hiroyuki Takahashi, Takahiro Tsuno, Yuko Takahashi, Toshikazu Kano, Akio Mimori

  OBJECTIVES: The clinical and therapeutic aspects of primary Sjögren syndrome (PSS) in patients with peripheral neuropathy were analyzed and the specifics of individual case studies are discussed. METHODS: We retrospectively studied six patients (four women, two men; mean age 64.5 years) presenting with PSS with peripheral neurological involvement over a five-year period (2008-2012). All patients had neurological examinations, including nerve conduction studies, somatosensory evoked potentials, and sural nerve biopsies. Treatment regimens included corticosteroids, intravenous gammaglobulin, or immunosuppressive treatment. RESULTS: Peripheral neuropathy was observed in six (7.9 %) of 76 patients with SS as the underlying disease; three were cases of multiple mononeuropathy, two cases had sensory ataxic neuropathy, one of which was autonomic neuropathy, and one case was diagnosed as painful sensory neuropathy without sensory ataxia. Four of the six patients were diagnosed with SS after the onset of neurological symptoms. Individual peripheral neuropathies had distinct neurological, electrophysiological, and pathological characteristics. The effect of steroids and intravenous gammaglobulin differed depending on the case. CONCLUSIONS: In PSS patients, a precise diagnosis is important, because the therapeutic strategy and response varies depending on the type of neuropathy. In clinical practice, it is important to consider a diagnosis of SS when patients present with peripheral neuropathy.

  Sep. 2013, Modern rheumatology, 23(5) (5), 925 - 33, English, International magazine

  [Refereed]

  Scientific journal


• Chorea in systematic lupus erythematosus; a case report.

  Yo Ueda, Yuko Takahashi, Hiroyuki Yamashita, Tosikazu Kano, Akio Mimori

  We report a 33-year-old female who developed a movement disorder during maintenance therapy for systemic lupus erythematosus (SLE). She was diagnosed with SLE at the age of 25, and experienced an episode of SLE-associated hemophagocytic syndrome at age 27, which was successfully treated with intensive immunosuppressive therapy. In November 2012, during maintenance therapy with prednisolone (PSL) 5 mg/day and tacrolimus 0.5 mg/day, she developed acute-onset involuntary movements that were classified as chorea in combination with athetosis in her right limbs and right homonymous hemianopia, which subsided after about 1 h. Her laboratory tests on admission showed an elevated serum anti-double- stranded DNA antibody, positive serum anti-cardiolipin IgG, and an elevated IgG index in cerebrospinal fluid. Magnetic resonance imaging (MRI) showed no significant abnormality on admission, but an ischemic change in her left pallidum appeared on day 7. She was treated with a combination of high-dose corticosteroid, immunosuppressive agents (rituximab, cyclophosphamide, mycofenolate mofetil), antithrombotic therapy (heparin, cilostazol), and dopamine antagonists. Her symptoms remitted partially. Chorea in SLE is recognized as an anti-phospholipid-antibody-associated disorder. In our case, both immunological and ischemic mechanisms were thought to be involved.

  2013, Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology, 36(6) (6), 467 - 72, English, Domestic magazine

  [Refereed]


• Systemic lupus erythematosus complicated by Crohn's disease: a case report and literature review.

  Hiroyuki Yamashita, Yo Ueda, Hoshimi Kawaguchi, Akitake Suzuki, Yuko Takahashi, Hiroshi Kaneko, Toshikazu Kano, Akio Mimori

  BACKGROUND: Although patients with systemic lupus erythematosus (SLE) may experience various gastrointestinal disorders, SLE and Crohn's disease (CD) rarely coexist. The diseases may have gastrointestinal (GI) manifestations, laboratory results, and radiographic findings that appear similar and consequently differentiating between GI involvement in CD and in SLE may be difficult. We present the case of a patient with SLE and CD who developed continuous GI bleeding and diarrhea that was initially treated as SLE-related colitis to little effect. CASE PRESENTATION: A 55-year-old Japanese woman with systemic lupus erythematosus (SLE) developed continuous gastrointestinal bleeding and diarrhea since the patient was aged 30 years that was initially treated as SLE-related colitis. Although a longitudinal ulcer and aphthous ulcers in the colon were observed every examination, biopsy showed only mild inflammation and revealed neither granuloma nor crypt abscess. The patient underwent surgery for anal fistulas twice at 50 and 54 years of age and her symptoms were atypical of lupus enteritis. Colonoscopy was performed again when the patient was 55 years of age because we suspected she had some type of inflammatory bowel disease (IBD). Cobblestone-like inflammatory polyps and many longitudinal ulcers were detected between the descending colon and the cecum. Macroscopic examination strongly suggested CD. Histopathological examination revealed non-caseating granuloma and no evidence of vasculitis, consistent with CD. Introduction of infliximab dramatically relieved the patient's melena and abdominal symptoms. CONCLUSION: Diagnostic criteria for CD and SLE overlap, making them difficult to diagnose correctly. It is important to consider CD for patients who have SLE with gastrointestinal manifestations. The pathology of lupus enteritis should be clarified through the accumulation of cases of SLE combined with CD.

  Dec. 2012, BMC gastroenterology, 12, 174 - 174, English, International magazine

  [Refereed]

  Scientific journal


• Prognosis of pneumocystis pneumonia complicated in patients with rheumatoid arthritis (RA) and non-RA rheumatic diseases.

  Yuji Yoshida, Yuko Takahashi, Nobuyoshi Minemura, Yo Ueda, Hiroyuki Yamashita, Hiroshi Kaneko, Akio Mimori

  Clinical presentation of pneumocystis pneumonia (PCP) during immunosuppressive therapy for rheumatic diseases was compared between patients with rheumatoid arthritis (RA; n = 7) and those without RA (non-RA; n = 12) based on a chart review. Both RA and non-RA patients with PCP were treated with methotrexate (n = 7) combined with steroids (n = 6) and/or biologics (n = 4). RA-PCP patients were found to have a higher mortality rate than non-RA-PCP patients (3/7 vs. 0/12, respectively; p = 0.036) due to a later exacerbation of interstitial pneumonia and a higher presentation rate of diffuse pulmonary lesions (4/7 vs. 1/12, respectively; p = 0.036) despite lower mean levels of serum beta-D: -glucan (314 ± 214 vs. 1139 ± 1114 pg/ml, respectively; p = 0.02) that suggested a lower burden of Pneumocystis jirovecii. In conclusion, PCP in RA patients with existing pulmonary lesions may trigger subsequent progression to lethal interstitial pneumonia.

  Aug. 2012, Modern rheumatology, 22(4) (4), 509 - 14, English, International magazine

  [Refereed]

  Scientific journal


• [A case of Stevens-Johnson syndrome (SJS) progressive toxic epidermal necrolysis (TEN) onset during hyposensitization therapy for pulmonary tuberculosis complicated with dermatomyositis].

  Hiroyuki Yamashita, Yo Ueda, Yuko Takahashi, Akio Mimori

  A 58-year-old female with a history of dermatomyositis was receiving large oral doses of steroids. She had pulmonary tuberculosis and developed a fever, systemic exudative erythema, exanthema, and epidermolysis covering 30% of her body surface area while being treated with four agents, including isoniazid (INH) and rifampicin (RFP). Histopathologically, eosinophilic necrosis was observed in all layers of the epidermis and a diagnosis of Stevens-Johnson syndrome (SJS) progressive toxic epidermal necrolysis (TEN) was made. The drugs suspected in the drug-induced lymphocyte stimulation test (DLST) re-testing were INH and RFP, and the DLST was considered to be important during the recovery period as well as in the acute phase. Early treatment with plasma exchange therapy and large quantities of intravenous immunoglobulin (IVIG) was successful. Plasma exchange therapy and IVIG are extremely effective when SJS and TEN occur in a patient already on high-dose steroid therapy. Note that the incidence of SJS and TEN is believed to be higher in patients with collagen disease, such as in our case, as compared to the general population.

  Jul. 2012, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 86(4) (4), 419 - 24, Japanese, Domestic magazine

  [Refereed]

  Scientific journal


• [A case of adult-onset varicella pneumonia and varicella-zoster virus (VZV) meningitis resulting from a reoccurrence of varicella].

  Hiroyuki Yamashita, Yo Ueda, Yuko Takahashi, Mimori Akio

  The patient was a 74-year old male who presented with a skin rash, cough, and impaired consciousness. A diffuse, systemic, dark red rash was observed and he was admitted. Varicella infection was diagnosed based on the varicella-zoster virus (VZV)-IgM levels. The extremely high VZV- IgG levels observed were unlikely to be present in an initial infection and the infection was thought to be a reoccurrence. Diffuse nodular shadows measuring < or = 5 mm in diameter were observed on chest computed tomography (CT);this was consistent with the typical imaging findings of varicella pneumonia. The cerebrospinal fluid (CSF) was positive for CSF VZV-IgM antibody, CSF VZV-PCR, and CSF antibody titer index. A diagnosis of varicella meningitis was made. When both respiratory and neurological symptoms are observed in patients with varicella infection, it is necessary to consider a combined diagnosis of varicella pneumonia and varicella meningitis/encephalitis and perform chest imaging and a CSF examination. Repeated asymptomatic re-infection is considered necessary in order to maintain a lifelong immunity to varicella; however, the opportunities for asymptomatic re-infection are decreasing with the declining birth rate and trend toward small families. As a result, reoccurrences of varicella infection in the elderly are expected to increase with rapidly increasing longevity.

  May 2012, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 86(3) (3), 306 - 9, Japanese, Domestic magazine

  [Refereed]

  Scientific journal


• [A case of rheumatoid arthritis involving disseminated torichosporonosis].

  Yo Ueda, Hiroyuki Yamashita, Yuji Yoshida, Yuko Takahashi, Akio Mimori

  A 75-year-old man who developed disseminated trichosporonosis had a long history of immunosuppressive therapy with weekly methotrexate and low-dose prednisolone for rheumatoid arthritis (RA). He had been administered 30 mg of prednisolone per day for organizing pneumonia, probably due to the RA, for about 3 months before admission for a lumbar compression fracture. He then developed bilateral aspiration pneumonia with pleural effusion, treated successfully with broad-spectrum antibiotics meropenem and ciprofloxacin, and fluid management. He then developed acute, progressive respiratory failure with changes in both lung lobes in chest computed tomography (CT). Meropenem, ciprofloxacin, micafungin, and pulsed steroid administration were ineffective. He died of respiratory failure, after which Trichosporon asahii was first detected in blood and urine culture. Disseminated trichosporonosis was determined based on positive blood culture, elevated serum glucuronoxylomannan antigen and beta-D glucan, and the man's lack of clinical progress. He had numerous risk factors for trichosporonosis, including neutrophilic dysfunction due to prolonged steroid therapy, administration of broad-spectrum antibiotics and micafungin, and central venous catheterization. Disseminated trichosporonosis is a chiefly hematological infection and case reports without hematological disorders are rare, so we report this instructive case.

  Sep. 2011, Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 85(5) (5), 532 - 6, Japanese, Domestic magazine

  [Refereed]


• [Successful bosentan therapy in a case of pulmonary arterial hypertention developed during immunosuppressive therapy for lupus nephritis].

  Yo Ueda, Yuko Takahashi, Hiroyuki Yamashita, Hiroshi Kaneko, Akio Mimori

  We report a 43-year-old female who developed pulmonary arterial hypertension (PAH) during intensive immunosuppressive therapy for systematic lupus erythematosus (SLE). She was diagnosed as SLE at the age of 32 years based on serological and hematological abnormalities, oral ulcers, and facial erythema. She experienced frequent flare-ups of disseminated discoid lupus between the ages of 33 and 36 years and developed immune thrombocytopenia at the age of 39 years. In 2007 when she was 43 years old, she developed lupus nephritis (LN) with elevated serum anti-double stranded DNA antibodies and urine protein of less than 1 g/day. Combination therapy for the LN with 35 mg/day prednisolone and intravenous cyclophosphamide (IVCY) led to renal remission. After the seventh monthly session of IVCY, she developed dyspnea on exertion. PAH was diagnosed based on enlarged main pulmonary arteries on the chest x-ray, right ventricular outflow and a peak tricuspid regurgitant pressure gradient exceeding 45 mmHg on echocardiography, an elevated plasma brain natriuretic peptide (BNP) level of 260 pg/ml, the exclusion of pulmonary thromboembolism, and no lung fibrosis. The PAH was treated successfully with bosentan. At present the tricuspid regurgitation has disappeared, and the plasma BNP level has normalized.

  2011, Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology, 34(2) (2), 99 - 104, English, Domestic magazine

  [Refereed]


• Epstein-Barr virus-induced infectious mononucleosis after two separate episodes of virus-associated hemophagocytic syndrome.

  Tatsuharu Ohno, Yo Ueda, Wataru Kishimoto, Kazue Arimoto-Miyamoto, Tomoharu Takeoka, Masaaki Tsuji

  A 24-year-old man, who had suffered previous two episodes of non- Epstein-Barr virus (EBV)-associated hemophagocytic syndrome (HPS) at the ages of 16 and 18, developed EBV-induced infectious mononucleosis. His antibody pattern to EBV highlighted the initial infection. The disease took a self-limited course without developing into HPS. No reactivation of EBV infection was noted over the following 6 years. The patient may have attained immune competency in adulthood, which was somehow impaired during his adolescence.

  2009, Internal medicine (Tokyo, Japan), 48(13) (13), 1169 - 73, English, Domestic magazine

  [Refereed]

  Scientific journal

• 樹状細胞および骨髄由来抑制細胞(MDSC)に対するJAK阻害薬6種の作用比較

  西坂一馬, 千藤荘, 山田啓貴, 岡野隆一, 西村啓佑, 上田洋, 三枝淳

  2025, 日本臨床免疫学会総会プログラム・抄録集, 53rd


• SLEの患者報告アウトカム Lupus Patient-Reported Outcome tool(LupusPRO)のSLICC/ACR damage indexに対する予測的妥当性 LUNAレジストリ

  能瀬 洋子, 大西 輝, 西村 啓佑, 山本 譲, 山田 啓貴, 千藤 荘, 上田 洋, 佐田 憲映, 一瀬 邦弘, 吉見 竜介, 大野 滋, 矢嶋 宣幸, 梶山 浩, 佐藤 秀三, 下島 恭弘, 藤原 道雄, 木田 節, 宮脇 義亜, 松尾 祐介, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2024, 日本リウマチ学会総会・学術集会プログラム・抄録集, 68回, 561 - 561, Japanese


• JAK阻害薬のcyclingにおける有効性の比較検討-関西多施設ANSWER cohortを用いた解析-

  前田俊恒, 林申也, 中野直樹, 亀長智幸, 岡野隆一, 白杉郁, 神野定男, 山本譲, 上田洋, 山田啓貴, 西村啓佑, 山下真依, 千藤荘, 山本英里子, 山本渉, 村田浩一, 藤井貴之, 秦健一郎, 吉川紋佳, 蛯名耕介, 惠谷悠紀, 吉田直史, 安室秀樹, 原良太, 片山昌紀, 橋本求, 岡野匡志, 壷坂正徳

  2024, 日本リウマチ学会総会・学術集会プログラム・抄録集, 68th


• 当科おける膠原病性間質性肺炎に対するニンテダニブの安全性と有効性の検討

  山岡匠, 安場遥香, 山本航大, 山本英里子, 水川薫, 西坂一馬, 山下真依, 能瀬洋子, 市川晋也, 米田勝彦, 白杉郁, 山田啓貴, 西村啓佑, 千藤荘, 上田洋, 三枝淳

  2024, 日本リウマチ学会総会・学術集会プログラム・抄録集, 68th


• 好酸球性多発血管炎性肉芽腫症(EGPA)による多発単神経炎に対する寛解導入療法中にくも膜下出血(SAH)を発症した一例

  安場遥香, 山田啓貴, 山岡匠, 山本航大, 山本英里子, 西村啓佑, 千藤荘, 上田洋, 三枝淳

  2024, 日本リウマチ学会総会・学術集会プログラム・抄録集, 68th


• 疫学1:RA/関節型JIAの治療 関節リウマチにおける免疫チェックポイント阻害薬(ICI)投与前後のRA治療内容の変化 関西多施設ANSWERコホートを用いた検討

  村上 孝作, 田中 真生, 大西 輝, 鬼澤 秀夫, 村田 浩一, 藤井 貴之, 山本 渉, 武内 徹, 平松 ゆり, 沖田 康孝, 前田 悠一, 安室 秀樹, 上田 洋, 山田 啓貴, 橋本 求, 渡部 龍, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67回, 526 - 526, Japanese


• ミコフェノール酸モフェチル併用が有効であったTAFRO症候群の一例

  長谷川侑美, 片岡渉, 相内志津子, 水川薫, 中川大章, 西坂一馬, 山下真依, 白杉郁, 千藤荘, 山田啓貴, 西村啓佑, 上田洋, 三枝淳

  2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67th


• バリシチニブが奏功したマクロファージ活性化症候群を伴う成人スチル病の1例

  西坂一馬, 片岡渉, 長谷川侑美, 相内志津子, 水川薫, 中川大章, 永本匠, 山田啓貴, 西村啓佑, 千藤荘, 上田洋, 三枝淳

  2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67th


• 寛解導入治療開始後に多発動脈瘤および右胃大網動脈瘤破裂をきたした顕微鏡的多発血管炎の一例

  中川大章, 長谷川侑美, 片岡渉, 相内志津子, 水川薫, 西坂一馬, 千藤荘, 山田啓貴, 西村啓佑, 上田洋, 三枝淳

  2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67th


• 持続型G-CSF製剤による薬剤性大型血管炎の1例

  水川薫, 長谷川侑美, 片岡渉, 相内志津子, 中川大章, 西坂一馬, 山田啓貴, 西村啓佑, 千藤荘, 上田洋, 三枝淳

  2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67th


• Felty症候群による好中球減少に対してステロイド大量療法,メトトレキサート,アバタセプトが奏功した一例

  相内志津子, 長谷川侑美, 片岡渉, 水川薫, 中川大章, 西坂一馬, 山田啓貴, 西村啓佑, 千藤荘, 上田洋, 三枝淳

  2023, 日本リウマチ学会総会・学術集会プログラム・抄録集, 67th


• 腸内細菌が産生するリノール酸代謝物と腸内細菌叢の異常はコラーゲン誘発性関節炎モデルマウスの疾患活動性と関連する

  米田勝彦, 千藤荘, 西村啓佑, 上田洋, 三枝淳, 千藤荘, 西村啓佑, 上田洋, 三枝淳, 千藤荘

  2023, 日本臨床免疫学会総会プログラム・抄録集, 51st


• JAK阻害薬:安全性 関節リウマチ患者における生物学的製剤とJAK阻害剤6666例の継続率と中止理由についての検討 関西多施設ANSWER cohortによる解析

  蛯名 耕介, 前田 悠一, 沖田 康孝, 惠谷 悠紀, 平尾 眞, 山本 渉, 橋本 求, 村田 浩一, 原 良太, 片山 昌紀, 永井 孝治, 平松 ゆり, 孫 瑛洙, 安室 秀樹, 藤井 貴之, 岡野 隆一, 上田 洋, 岡野 匡志, 熊ノ郷 淳, 岡田 誠司

  (一社)日本リウマチ学会, Mar. 2022, 日本リウマチ学会総会・学術集会プログラム・抄録集, 66回, 351 - 351, Japanese


• SLE・抗リン脂質抗体症候群(臨床):バイオマーカー 当院における抗DNA抗体検出法についての検討 Farr法とCLIA法の比較について

  岡野 隆一, 明石 健吾, 山田 啓貴, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 381 - 381, Japanese


• 多発性筋炎・皮膚筋炎:ケースプレゼンテーション 皮膚硬化を呈した抗ミトコンドリア抗体陽性筋炎の1例

  岩倉 伸昴, 山田 啓貴, 市川 晋也, 向原 沙紀, 白杉 郁, 明石 健吾, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 401 - 401, Japanese


• 異所性石灰化病変を合併した全身性エリテマトーデス患者に対してテリパラチドにより異所性石灰化と骨粗鬆症を同時に治療しえた一例

  岡野 隆一, 明石 健吾, 山田 啓貴, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 612 - 612, Japanese


• 中型血管炎による難治性多発消化管潰瘍を呈した顕微鏡的多発血管炎の一例

  白杉 郁, 向原 沙紀, 市川 晋也, 山田 啓貴, 上田 洋, 大西 輝, 三枝 淳

  (一社)日本リウマチ学会, Mar. 2021, 日本リウマチ学会総会・学術集会プログラム・抄録集, 65回, 665 - 665, Japanese


• Combined Inhibition of Autophagy and Glutamine Metabolism Suppresses Cell Growth of RA Synoviocytes and Ameliorates Arthritis in SKG Mice

  Ikuko Naka, Jun Saegusa, Kenichi Uto, Yuzuru Yamamoto, Yoshihide Ichise, Hirotaka Yamada, Yo Ueda, Takaichi Okano, Soshi Takahashi, Sho Sendo, Akio Morinobu

  Oct. 2020, ARTHRITIS & RHEUMATOLOGY, 72, English

  Summary international conference


• Resolvin D5 Modulates Th17/Treg Cell Differentiation and Suppresses Osteoclastogenesis

  Hirotaka Yamada, Jun Saegusa, Sho Sendo, Yo Ueda, Takaichi Okano, Yoshikazu Fujikawa, Yuzuru Yamamoto, Takumi Nagamoto, Yoshihide Ichise, Ikuko Naka, Kengo Akashi, Akira Onishi, Masakazu Shinohara, Akio Morinobu

  Oct. 2020, ARTHRITIS & RHEUMATOLOGY, 72, English

  Summary international conference


• 異所性石灰化病変を合併した全身性エリテマトーデス患者に対してテリパラチドにより異所性石灰化と骨粗鬆症を同時に治療しえた一例

  岡野 隆一, 三枝 淳, 山本 譲, 明石 健吾, 上田 洋, 大西 輝, 森信 暁雄

  (一社)日本骨粗鬆症学会, Sep. 2020, 日本骨粗鬆症学会雑誌, 6(Suppl.1) (Suppl.1), 268 - 268, Japanese


• 間質性肺炎を有するRA患者におけるDMARDsの安全性に関する系統的レビュー

  大西 輝, 岡野 隆一, 上田 洋, 明石 健吾, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 634 - 634, Japanese


• 悪性腫瘍を有するRA患者におけるDMARDsの安全性に関する系統的レビュー

  大西 輝, 岡野 隆一, 上田 洋, 明石 健吾, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 636 - 636, Japanese


• 高用量ステロイド治療中の膠原病患者におけるニューモシスティス肺炎(PCP)予防薬の効果

  明石 健吾, 神野 定男, 大西 輝, 米田 勝彦, 白杉 郁, 岡野 隆一, 上田 洋, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 697 - 697, Japanese


• ステロイド、DMARDs加療中のRA患者へのワクチン接種の有効性、安全性に関する系統的レビュー

  大西 輝, 岡野 隆一, 上田 洋, 明石 健吾, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Aug. 2020, 日本リウマチ学会総会・学術集会プログラム・抄録集, 64回, 763 - 763, Japanese


• The Comparative Efficacy of Pneumocystis Pneumonia Prophylactic Regimens in Patients with Connective Tissue Diseases Receiving Prolonged High-dose Glucocorticoids

  Kengo Akashi, Sadao Jinno, Akira Onishi, Mai Yamashita, Yoko Nose, Takaichi Okano, Yo Ueda, Sho Sendo, Jun Saegusa, Akio Morinobu

  Oct. 2019, ARTHRITIS & RHEUMATOLOGY, 71, English

  Summary international conference


• ベーチェット病に伴う仙腸関節炎に対して抗TNFα阻害薬で治療中に、食道穿通病変と回盲部潰瘍が出現し、内科的治療で治療しえた腸管型ベーチェット病の1例

  能瀬 洋子, 井上 綾華, 上田 洋, 宮崎 はる香, 大井 充, 岡野 隆一, 千藤 荘, 明石 健吾, 大西 輝, 星 奈美子, 三枝 淳, 児玉 裕三, 森信 暁雄

  (一社)日本臨床免疫学会, Oct. 2019, 日本臨床免疫学会総会プログラム・抄録集, 47回, 112 - 112, Japanese


• THE CLINICAL FEATURES OF ANTI-TIF1GAMMA ANTIBODY POSITIVE DERMATOMYOSITIS

  Yoshikazu Fujikawa, Kengo Akashi, Motoko Katayama, Mai Yamashita, Yoko Nose, Takaichi Okano, Yo Ueda, Sho Sendo, Akira Onishi, Jun Saegusa, Akio Morinobu

  Jun. 2019, ANNALS OF THE RHEUMATIC DISEASES, 78, 1559 - 1559, English

  Summary international conference


• アダリムマブの寛解後休薬についての検討

  千藤 荘, 藤川 良一, 永本 匠, 山本 譲, 一瀬 良英, 山田 啓貴, 仲 郁子, 上田 洋, 岡野 隆一, 明石 健吾, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 623 - 623, Japanese


• 当施設におけるニューモシスティス肺炎に対する治療の実態

  明石 健吾, 神野 定男, 片山 素子, 山下 真依, 能瀬 洋子, 藤川 良一, 永本 匠, 山本 譲, 山田 啓貴, 一瀬 良英, 仲 郁子, 岡野 隆一, 上田 洋, 千藤 荘, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 729 - 729, Japanese


• SLEとの鑑別を要した自己免疫性溶血性貧血と特発性膜性腎症の合併例

  片山 素子, 千藤 荘, 山下 真依, 能瀬 洋子, 岡野 隆一, 上田 洋, 明石 健吾, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 735 - 735, Japanese


• 関節リウマチとSLEを合併した強皮症オーバーラップ症候群の一例

  山下 真依, 岡野 隆一, 能瀬 洋子, 上田 洋, 千藤 荘, 明石 健吾, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 758 - 758, Japanese


• 抗TIF1γ抗体陽性皮膚筋炎症例の臨床的特徴

  藤川 良一, 明石 健吾, 片山 素子, 山下 真依, 能瀬 洋子, 永本 匠, 山本 譲, 山田 啓貴, 一瀬 良英, 仲 郁子, 岡野 隆一, 上田 洋, 千藤 荘, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 767 - 767, Japanese


• ANCA関連血管炎の寛解導入療法中に、リツキシマブに起因する急性血小板減少が疑われた3例

  能瀬 洋子, 上田 洋, 片山 素子, 山下 真依, 岡野 隆一, 千藤 荘, 明石 健吾, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2019, 日本リウマチ学会総会・学術集会プログラム・抄録集, 63回, 784 - 784, Japanese


• 顔面から頸部の表在感覚障害をきたしたIgA血管炎の1例

  千藤 荘, 三枝 淳, 上田 洋, 岡野 隆一, 明石 健吾, 森信 暁雄

  (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 83 - 83, Japanese


• トファシチニブは骨髄由来抑制性細胞(MDSC)の増殖を促しSKGマウスの間質性肺炎を抑制する

  千藤 荘, 三枝 淳, 山田 啓貴, 上田 洋, 森信 暁雄

  (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 85 - 85, Japanese


• 顔面から頸部の表在感覚障害をきたしたIgA血管炎の1例

  千藤 荘, 三枝 淳, 上田 洋, 岡野 隆一, 明石 健吾, 森信 暁雄

  (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 110 - 110, Japanese


• トファシチニブは骨髄由来抑制性細胞(MDSC)の増殖を促しSKGマウスの間質性肺炎を抑制する

  千藤 荘, 三枝 淳, 山田 啓貴, 上田 洋, 森信 暁雄

  (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 124 - 124, Japanese


• サイトメガロウイルス食道炎・胃炎による門脈ガス血症を来した多発血管炎性肉芽腫症

  森 直樹, 千藤 荘, 片山 素子, 寺田 菜々子, 能瀬 洋子, 山下 真依, 岡野 隆一, 上田 洋, 明石 健吾, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本臨床免疫学会, Nov. 2018, 日本臨床免疫学会総会プログラム・抄録集, 46回, 138 - 138, Japanese


• 感染症 RA患者の疾患活動性に対するtrimethoprim-sulfamethoxazoleの効果 ANSWER縦断的コホート研究(Infection The effects of trimethoprim-sulfamethoxazole on disease activity in patients with RA: ANSWER longitudinal cohort study)

  Onishi Akira, Akashi Kengo, Hashimoto Motomu, Yamamoto Wataru, Murata Koichi, Katayama Masaki, Amuro Hideki, Son Yonsu, Yoshida Shuzo, Nagai Koji, Hara Ryota, Ebina Kosuke, Hirano Toru, Yamamoto Yuzuru, Yamada Hirotaka, Ichise Yoshihide, Naka Ikuko, Okano Takaichi, Takahashi Soshi, Ueda Yo, Sendo Sho, Saegusa Jun, Morinobu Akio

  (一社)日本リウマチ学会, Mar. 2018, 日本リウマチ学会総会・学術集会プログラム・抄録集, 62回, 415 - 415, English

  [Refereed]


• 関節リウマチの治療評価と予測1 血清メタボローム解析による関節リウマチ患者の生物学的製剤治療反応性の予測バイオマーカーの同定

  高橋 宗史, 三枝 淳, 大木 洋子, 白井 太一朗, 藤川 良一, 永本 匠, 山本 譲, 山田 啓貴, 一瀬 良英, 仲 郁子, 岡野 隆一, 明石 健吾, 上田 洋, 千藤 荘, 大西 輝, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2018, 日本リウマチ学会総会・学術集会プログラム・抄録集, 62回, 517 - 517, Japanese


• 血管炎5:大型血管炎症例集積研究 高安動脈炎における当院での治療成績とトシリズマブの有効性についての検討

  藤川 良一, 千藤 荘, 大木 洋子, 白井 太一朗, 永本 匠, 山本 譲, 山田 啓貴, 一瀬 良英, 仲 郁子, 岡野 隆一, 高橋 宗史, 上田 洋, 明石 健吾, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2018, 日本リウマチ学会総会・学術集会プログラム・抄録集, 62回, 525 - 525, Japanese


• 炎症性筋疾患に合併する間質性肺疾患における血清マーカーの推移

  明石 健吾, 大木 洋子, 白井 太一朗, 藤川 良一, 永本 匠, 山本 譲, 山田 啓貴, 一瀬 良英, 仲 郁子, 岡野 隆一, 高橋 宗史, 上田 洋, 千藤 荘, 大西 輝, 三枝 淳, 森信 暁雄

  (一社)日本臨床免疫学会, Aug. 2017, 日本臨床免疫学会会誌, 40(4) (4), 308 - 308, Japanese


• GLUTAMINE METABOLISM PLAYS A KEY ROLE IN THE CELL GROWTH OF FIBROBLAST-LIKE SYNOVIOCYTES IN RHEUMATOID ARTHRITIS

  S. Takahashi, J. Saegusa, H. Yamada, Y. Ichise, I. Naka, T. Okano, K. Akashi, S. Sendo, Y. Ueda, A. Onishi, A. Morinobu

  Jun. 2017, ANNALS OF THE RHEUMATIC DISEASES, 76, 487 - 488, English

  Summary international conference


• A LONGITUDINAL STUDY OF THE EFFECTS OF DISEASE ACTIVITY ON RENAL FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS UTILIZING LINEAR MIXED EFFECT MODELS - ANSWER COHORT STUDY

  A. Onishi, K. Akashi, M. Hashimoto, M. Furu, W. Yamamoto, M. Katayama, R. Hara, T. Fujimura, S. Yoshida, K. Nagai, T. Hirano, K. Ebina, Y. Son, H. Amuro, H. Yamada, Y. Ichise, D. Waki, I. Naka, K. Tsuda, T. Okano, S. Takahashi, S. Sendo, Y. Ueda, Y. Kogata, J. Saegusa, A. Morinobu

  Jun. 2017, ANNALS OF THE RHEUMATIC DISEASES, 76, 115 - 115, English

  Summary international conference


• THE EFFICACY OF 2-YEARS DENOSUMAB TREATMENT FOR GLUCOCORTICOID-INDUCED OSTEOPOROSIS (GIOP)

  K. Akashi, K. Nishimura, G. Kageyama, S. Ichikawa, T. Shirai, Y. Yamamoto, Y. Ichise, H. Yamada, I. Naka, D. Waki, T. Okano, S. Takahashi, Y. Ueda, S. Sendo, A. Onishi, J. Saegusa, A. Morinobu

  Jun. 2017, ANNALS OF THE RHEUMATIC DISEASES, 76, 699 - 699, English

  Summary international conference


• 骨粗鬆症と骨代謝/変形性関節症・軟骨 ステロイド骨粗鬆症(GIO)に対するデノスマブの有効性 2年間の使用成績

  明石 健吾, 西村 啓佑, 蔭山 豪一, 市川 晋也, 白井 太一朗, 山本 譲, 一瀬 良英, 山田 啓貴, 仲 郁子, 津田 耕作, 脇 大輔, 岡野 隆一, 高橋 宗史, 上田 洋, 千藤 荘, 大西 輝, 古形 芳則, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2017, 日本リウマチ学会総会・学術集会プログラム・抄録集, 61回, 545 - 545, Japanese


• 解糖系代謝阻害剤3-ブロモピルビン酸はマウス関節炎を抑制する

  岡野 隆一, 三枝 淳, 西村 啓介, 明石 健吾, 西田 美和, 高橋 宗史, 千藤 荘, 上田 洋, 大西 輝, 古形 芳則, 森信 暁雄

  (一社)日本臨床免疫学会, Aug. 2016, 日本臨床免疫学会会誌, 39(4) (4), 376 - 376, Japanese


• SKGマウス肺病変の進展に伴って増加するCD11b+Gr1 dimcellはGM-CSFによって誘導される

  千藤 荘, 一瀬 良英, 山田 啓貴, 津田 耕作, 仲 郁子, 岡野 隆一, 高橋 宗史, 西村 啓佑, 上田 洋, 明石 健吾, 大西 輝, 古形 芳則, 三枝 淳, 森信 暁雄

  (一社)日本臨床免疫学会, Aug. 2016, 日本臨床免疫学会会誌, 39(4) (4), 410 - 410, Japanese


• 3-BROMOPYRUVATE AMELIORATES AUTOIMMUNE ARTHRITIS BY EXERTING A DUAL EFFECT ON BOTH TH17 AND TREG CELL DIFFERENTIATION AND DENDRITIC CELL ACTIVATION

  T. Okano, J. Saegusa, K. Nishimura, S. Takahashi, S. Sendo, Y. Ueda, A. Onishi, A. Morinobu

  Jun. 2016, ANNALS OF THE RHEUMATIC DISEASES, 75, 113 - 113, English

  Summary international conference


• SOME OF THE PAINFUL RA PATIENTS UNDERRATE GLOBAL HEALTH VAS AT HOSPITALS

  G. Kageyama, A. Onishi, Y. Ueda, Y. Kamei, H. Yamada, Y. Ichise, D. Waki, I. Naka, K. Tsuda, T. Okano, S. Takahashi, M. Nishida, K. Akashi, K. Nishimura, S. Sendo, Y. Kogata, J. Saegusa, A. Morinobu

  Jun. 2016, ANNALS OF THE RHEUMATIC DISEASES, 75, 963 - 963, English

  Summary international conference


• SUBJECTIVE WELL-BEING OF JAPANESE RA PATIENTS WHO REACH TREATMENT TARGET IS HIGHER THAN THE JAPANESE AVERAGE

  G. Kageyama, A. Onishi, Y. Ueda, Y. Kamei, H. Yamada, Y. Ichise, D. Waki, I. Naka, K. Tsuda, T. Okano, S. Takahashi, M. Nishida, K. Akashi, K. Nishimura, S. Sendo, Y. Kogata, J. Saegusa, A. Morinobu

  Jun. 2016, ANNALS OF THE RHEUMATIC DISEASES, 75, 413 - 414, English

  Summary international conference


• KNOCKOUT OF ENDOTHELIN TYPE B RECEPTOR SIGNALING ATTENUATES BLEOMYCIN-INDUCED SKIN SCLEROSIS IN MICE

  K. Akashi, J. Saegusa, S. Sendo, K. Nishimura, K. Tsuda, I. Naka, T. Okano, S. Takahashi, M. Nishida, Y. Ueda, A. Morinobu

  Jun. 2016, ANNALS OF THE RHEUMATIC DISEASES, 75, 170 - 170, English

  Summary international conference


• リウマチ性疾患の基礎研究 SKGマウス肺病変の進展に伴って増加するCD11b+Gr1dim cellはGM-CSFによって誘導される

  千藤 荘, 仲 郁子, 津田 耕作, 岡野 隆一, 西田 美和, 明石 健吾, 高橋 宗史, 上田 洋, 西村 啓佑, 大西 輝, 古形 芳則, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 344 - 344, Japanese


• ベーチェット病 特殊型ベーチェット病に対するTNF阻害剤の有効性

  西村 啓佑, 津田 耕作, 仲 郁子, 岡野 隆一, 明石 健吾, 高橋 宗史, 西田 美和, 上田 洋, 千藤 荘, 大西 輝, 古形 芳則, 蔭山 豪一, 三枝 淳, 河野 誠司, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 361 - 361, Japanese


• 関節リウマチの治療評価と予測 疼痛評価VASが高い患者の健康状態全般評価VASは過小申告されていることがある(ROCKoコホート研究から)

  蔭山 豪一, 大西 輝, 上田 洋, 仲 郁子, 津田 耕作, 岡野 隆一, 高橋 宗史, 西田 美和, 明石 健吾, 西村 啓佑, 千藤 荘, 古形 芳則, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 447 - 447, Japanese


• 関節リウマチの治療 QOL 治療目標に到達した関節リウマチ患者の主観的幸福度は、一般的な日本人より高い(ROCKoコホート研究から)

  蔭山 豪一, 大西 輝, 上田 洋, 仲 郁子, 津田 耕作, 岡野 隆一, 高橋 宗史, 西田 美和, 明石 健吾, 西村 啓佑, 千藤 荘, 古形 芳則, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 456 - 456, Japanese


• リウマチ性疾患の疫学 関節リウマチ患者における社会経済的要因が疾患活動性、日常生活動作に与える影響の検討(ROCKoコホート研究から)

  大西 輝, 蔭山 豪一, 上田 洋, 津田 耕作, 仲 郁子, 岡野 隆一, 明石 健吾, 西村 啓佑, 高橋 宗史, 西田 美和, 千藤 荘, 古形 芳則, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2016, 日本リウマチ学会総会・学術集会プログラム・抄録集, 60回, 468 - 468, Japanese


• その他の膠原病 脊椎関節炎51例の臨床的検討

  千葉 荘, 亀井 優衣子, 脇 大輔, 仲 郁子, 津田 耕作, 岡野 隆一, 明石 健吾, 西田 美和, 西村 啓佑, 高橋 宗史, 上田 洋, 大西 輝, 古形 芳則, 蔭山 豪一, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2015, 日本リウマチ学会総会・学術集会プログラム・抄録集, 59回, 369 - 369, Japanese


• 原発性シェーグレン患者における睡眠障害の検討

  津田 耕作, 蔭山 豪一, 亀井 優衣子, 仲 郁子, 岡野 隆一, 高橋 宗史, 西田 美和, 明石 健吾, 西村 啓佑, 千藤 荘, 上田 洋, 大西 輝, 古形 芳則, 三枝 淳, 森信 暁雄

  (一社)日本リウマチ学会, Mar. 2015, 日本リウマチ学会総会・学術集会プログラム・抄録集, 59回, 657 - 657, Japanese


• 当院における炎症性筋疾患(IIM)88例の治療経験

  明石 健吾, 亀井 優衣子, 脇 大輔, 仲 郁子, 津田 耕作, 岡野 隆一, 西田 美和, 西村 啓佑, 高橋 宗史, 上田 洋, 千藤 荘, 杉山 大典, 古形 芳則, 蔭山 豪一, 三枝 淳, 熊谷 俊一, 森信 暁雄

  (一社)日本臨床免疫学会, Aug. 2014, 日本臨床免疫学会会誌, 37(4) (4), 375 - 375, Japanese


• 当院におけるIgG4関連疾患25例の再燃リスクについての検討

  千藤 荘, 亀井 優衣子, 脇 大輔, 仲 郁子, 津田 耕作, 岡野 隆一, 明石 健吾, 西田 美和, 西村 啓佑, 高橋 宗史, 上田 洋, 大西 輝, 古形 芳則, 蔭山 豪一, 三枝 淳, 森信 暁雄

  (一社)日本臨床免疫学会, Aug. 2014, 日本臨床免疫学会会誌, 37(4) (4), 379 - 379, Japanese


• 自己免疫性肝炎増悪との鑑別が困難だった肺病変を伴わない粟粒結核の1例

  山下 裕之, 上田 洋, 高橋 裕子, 三森 明夫

  症例は48歳女で、4歳時に全身性エリテマトーデス(SLE)を発症し、ループス腎炎を合併したがPredonisolone(PSL)の維持療法で寛解していた。45歳時に肝機能悪化を来たし、肝生検は拒否されたが、検査所見より自己免疫性肝炎(AIH)合併と考え、PSL増量で肝機能は正常化した。しかし発熱、ALP上昇が出現し、SLEの疾患活動性は否定的で、胸部・腹部画像検査では特に異常を認めなかった。AIHおよび自己免疫性胆管炎の悪化を疑い、まずウルソデオキシコール酸、ベザフィブラートを投与し、次いでPSL増量、ステロイドパルスを施行したが改善しなかった。第66病日に同意を得て肝生検を施行し、抗酸菌の存在と肝小葉内のリンパ球・好中球浸潤を伴う類上皮肉芽腫を、さらに骨髄生検で組織球の集簇を疑う肉芽腫を認め、粟粒結核が疑われた。抗結核治療を開始し、偽膜性腸炎合併などもあったが、最終的に肝機能改善が得られ、第138病日に退院した。

  (一社)日本感染症学会, Jul. 2014, 感染症学雑誌, 88(4) (4), 459 - 462, Japanese


• Nocardia elegansによる閉塞性肺炎、脳膿瘍を呈したSLEの1例

  上田 洋, 山元 佳, 渡辺 恒二, 山下 裕之, 大曲 貴夫, 三森 明夫

  症例は69歳男性で、関節痛、両側下腿の痺れを主訴に受診し、血管炎を伴うSLEと診断された。プレドニゾロン(PSL)で治療開始し、改善を認め、PSL漸減となった。発熱、頭痛、嘔吐などの症状が出現し、髄液検査で細胞数上昇、糖低下、墨汁染色で酵母様真菌を認め、血液および髄液のCryptococcus抗原陽性よりCryptococcus髄膜炎と診断された。アムホテリシンBリボソーム製剤(L-AMB)、フルシトシン(5-FU)併用療法を4週間、フルコナゾール(FLCZ)を8週間、以降FLCZで治療を継続した。胸部CTで右下葉病変は改善したが、右中葉肺門部に2cm大の浸潤影を認めCryptococcus肺炎増悪が疑われFLCZを増量した。退院後、間欠的な発熱を認め、右中葉閉塞性肺炎が疑われた。アモキシシリン、クラブラン酸内服を行ったが改善なく入院となった。胸部X線で無気肺増大、閉塞性肺炎を認めた。メロペネム(MEPM)投与を開始し炎症反応も改善傾向を認めた。MRIで右小脳半球に径7mm大の造影効果を伴う病変を認め、肺炎、脳膿瘍を呈する播種性Nocardia症と診断した。初期治療はMEPMに加え、アミカシンを追加し、ST合剤を増量した。治療1ヵ月で病変は著明な縮小を認め、DNA解析でNocardia elegansが同定された。E-test法でST合剤、クラリスロマイシン、イミペネム/シラスタチン、リネゾリドに感受性、AMPC/CVAとミノサイクリンに耐性を認め別途施行した簡易ディスク法でゲンタマイシンに感受性、シプロフロキサシンに耐性を認めた。

  (一社)日本感染症学会, May 2014, 感染症学雑誌, 88(3) (3), 282 - 287, Japanese


• 血管炎 当科におけるANCA関連血管炎に伴う肺胞出血合併例の集計

  河野 正憲, 山下 裕之, 上田 洋, 高橋 裕子, 金子 礼志, 狩野 俊和, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2014, 日本リウマチ学会総会・学術集会プログラム・抄録集, 58回, 411 - 411, Japanese


• 再発性多発軟骨炎の早期診断及び疾患活動性評価におけるFDG-PET/CTの有用性

  山下 裕之, 上田 洋, 依藤 秀樹, 河野 正憲, 窪田 和雄, 高橋 裕子, 金子 礼志, 狩野 俊和, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2014, 日本リウマチ学会総会・学術集会プログラム・抄録集, 58回, 671 - 671, Japanese


• 全身性エリテマトーデスに伴った舞踏様運動の一例

  上田 洋, 高橋 裕子, 山下 裕之, 狩野 俊和, 三森 明夫

  (一社)日本臨床免疫学会, Dec. 2013, 日本臨床免疫学会会誌, 36(6) (6), 467 - 472, Japanese


• 肺動脈周囲の軟部組織の炎症で発症し、急速進行性の経過を呈し、悪性リンパ腫など他疾患との鑑別を要した縦隔炎の1例

  山下 裕之, 上田 洋, 高橋 裕子, 三森 明夫

  51歳男。魚骨によると思われる食道穿孔が原因で急性縦隔炎を発症し、保存的加療により軽快した。画像検査では当初、左肺動脈周囲に軟部組織陰影の拡大を認めたが、単純CTのみしか撮影していなかったため縦隔の炎症所見が目立たず、縦隔炎と診断するのが困難であった。また、軟部組織陰影の拡大は縦隔から左肺門部にかけて肺動脈を取り囲むように認められ、血球減少や肝脾腫を伴っていたことから、急速に増大する縦隔リンパ腫との鑑別を要した。

  (一社)日本感染症学会, Nov. 2013, 感染症学雑誌, 87(6) (6), 746 - 751, Japanese


• RA特殊病態 傍腫瘍性リウマチ様筋骨格系症状を呈した10症例の特徴

  山下 裕之, 上田 洋, 尾崎 貴士, 土屋 遥香, 高橋 裕子, 金子 礼志, 狩野 俊和, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2013, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 57回・22回, 381 - 381, Japanese


• SLEに伴う横断性脊髄炎 重症例およびMMF有効例

  上田 洋, 山下 裕之, 坂内 穎, 高橋 裕子, 狩野 俊和, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2013, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 57回・22回, 515 - 515, Japanese


• 難治性成人発症Still病(AOSD)にtocilizumab(TCZ)が奏功した8例

  坂内 穎, 山下 裕之, 金子 駿太, 森山 純江, 高橋 裕子, 土屋 遥香, 上田 洋, 金子 礼志, 狩野 俊和, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2013, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 57回・22回, 650 - 650, Japanese


• 肝への好酸球浸潤を伴う好酸球性肉芽腫性多発血管炎(Churg-Strauss症候群)の1例

  篠田 恵, 高橋 広行, 上田 洋, 三井 理華, 高橋 裕子, 山下 裕之, 金子 礼志, 狩野 俊和, 三森 明夫

  日本内科学会-関東地方会, Feb. 2013, 日本内科学会関東地方会, 594回, 47 - 47, Japanese


• 皮膚筋炎に合併した肺結核に対する減感作療法中にStevens-Johnson症候群進展型中毒性表皮壊死症(TEN)を発症した1例

  山下 裕之, 上田 洋, 高橋 裕子, 三森 明夫

  症例は58歳女性で、間質性肺炎でステロイド内服を開始したが、四肢筋力低下などより皮膚筋炎と診断され、更に肺結核が判明した。肝障害のためisoniazid(INH)・rifampicin(RFP)・ethambutol(EB)を2/3量で開始し、第11病日よりfull doseに増量したところ皮疹が出現した。薬剤性皮疹を疑って投与を中止し、皮疹軽快後にINH・RFPの減感作療法を開始したが、増量中に顔面浮腫・紅斑・体幹部皮疹が出現した。INH中止後も皮疹は癒合・拡大し、呼吸困難感、口腔内粘膜疹も出現してRFPも中止した。streptomycin(SM)・EB・LVFXに変更したが、表皮剥離も出現し、皮膚生検でStevens-Johnson症候群(SJS)と診断された。プラズマフェレーシスを3日間施行した後、大量免疫グロブリン静注を5日間行い、表皮剥離拡大より最終的にSJS移行型中毒性表皮壊死症と診断された。皮膚症状は4週間の経過で改善し、DLSTではINH、RFP、SMが陽性であった。EBとLVFXを計24ヵ月継続し、肺結核病変の縮小が得られた。

  (一社)日本感染症学会, Jul. 2012, 感染症学雑誌, 86(4) (4), 419 - 424, Japanese


• 成人に発症した水痘再感染による水痘肺炎及び水痘 帯状疱疹ウイルス髄膜炎の1例

  山下 裕之, 上田 洋, 高橋 裕子, 三森 明夫

  74歳男。63歳時に関節リウマチを発症した。徐々に関節症状が悪化し、メトトレキサート(MTX)及びプレドニゾロンにて症状安定していた。全身散在性に暗赤色の皮疹出現し、数日の間に増悪傾向にあり頭皮・顔面にも出現、さらに上口蓋にも潰瘍病変が出現した。その頃より受け答えが悪くなり、ボーっとしていることが多くなった。ほぼ同時期に咳嗽が増え始めた。MTXの副作用疑われ中止するも改善せず、炎症反応も高値で、精査加療目的にて入院となった。臨床症状も含めて一元的に水痘感染とそれに伴う水痘肺炎及び水痘-帯状疱疹ウイルス髄膜炎と診断した。入院第1病日よりアシクロビルを3週間投与した。第10病日には受け答えも明瞭になり、第20病日には髄液細胞数は減少し、発疹もほぼ痂皮化した。第22病日の胸部X線正面像及びCT像も著しく改善した。アシクロビルにて胸部異常陰影が改善したことからも水痘肺炎の経過に矛盾しないと考えられた。

  (一社)日本感染症学会, May 2012, 感染症学雑誌, 86(3) (3), 306 - 309, Japanese


• リウマチ性疾患の画像(2) 不明熱の診断におけるFDG-PET/CTの有用性 当科における集計

  上田 洋, 山下 裕之, 窪田 和雄, 高橋 裕子, 狩野 俊和, 金子 礼志, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2012, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 56回・21回, 293 - 293, Japanese


• 感染症と自己免疫疾患(1) 免疫抑制治療中に発症したサイトメガロウイルス感染による上部消化管病変の検討

  尾崎 貴士, 上田 洋, 高橋 広行, 高橋 裕子, 山下 裕之, 金子 礼志, 狩野 俊和, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2012, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 56回・21回, 333 - 333, Japanese


• 多関節炎発症後、早期に汎血球減少を来した1例

  川口 星美, 上田 洋, 高橋 裕子, 山下 裕之, 金子 礼志, 狩野 俊和, 三森 明夫

  日本内科学会-関東地方会, Feb. 2012, 日本内科学会関東地方会, 585回, 46 - 46, Japanese


• 播種性トリコスポロン症を発症した関節リウマチの1例

  上田 洋, 山下 裕之, 吉田 祐志, 高橋 裕子, 三森 明夫

  75歳男。12年前に関節リウマチ(RA)を発症し、以来メソトレキセートとプレドニゾロンで加療され、1年前から当院への入院を繰り返していた。3ヵ月前、RAに伴う器質化肺炎の診断で入院加療を行い、肺炎は改善した。今回、強い腰痛を主訴に再度入院となった。腰椎MRIでL4,5に圧迫骨折を認めた。また喀痰の増加と肺雑音を認め、気管支炎の可能性を考慮してスルバクタム・アンピシリンの投与を開始した。第6病日に呼吸状態が悪化し、胸部CTで各葉背側の浸潤影と両側胸水を認めた。誤嚥性肺炎および低アルブミン血症による胸水と考え、絶食、中心静脈管理のうえ抗菌薬投与とアルブミン製剤+フロセミド投与による体液管理を行い、症状の改善が得られた。第19病日に再び呼吸状態が悪化し、胸部CTで両肺上葉優位、非区域性のスリガラス陰影、浸潤影などを呈する多彩な肺炎像を認めた。血清クリプトコックス抗原が8倍と陽性を示したことからクリプトコックス肺炎の可能性を考え、フルコナゾールを投与した。薬剤性肺炎や、RAに伴う間質性肺炎などの可能性も考え、抗菌薬の変更、ステロイドパルス療法も試みたが、いずれも効果なく、第23病日に死亡した。その後、死亡前日に検体採取していた血液・尿培養が陽性化し、Trichosporon asahiiが検出された。

  (一社)日本感染症学会, Sep. 2011, 感染症学雑誌, 85(5) (5), 532 - 536, Japanese


• トシリズマブ HBV既往感染のリウマチ患者に対するトシリズマブの使用経験

  増井 良則, 國松 淳和, 吉川 玲欧, 森山 純江, 上田 洋, 吉田 祐志, 高橋 裕子, 山下 裕之, 三森 明夫, 金子 礼志

  (一社)日本リウマチ学会, Jun. 2011, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 55回・20回, 326 - 326, Japanese


• 免疫抑制治療中に出現したサイトメガロウイルス抗原血症陽性例の検討

  上田 洋, 高橋 裕子, 山下 裕之, 金子 礼志, 三森 明夫

  (一社)日本リウマチ学会, Jun. 2011, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 55回・20回, 608 - 608, Japanese


• ループス腎炎に対する免疫抑制治療中に発症し、ボセンタンが有効であった全身性エリテマトーデスに伴う肺動脈性高血圧症の一例

  上田 洋, 高橋 裕子, 山下 裕之, 金子 礼志, 三森 明夫

  (一社)日本臨床免疫学会, Apr. 2011, 日本臨床免疫学会会誌, 34(2) (2), 99 - 104, Japanese


• 診断力をみがく イメージトレーニング 関節リウマチ治療中に肺野多発結節影を呈した1例/尿路感染症と診断し抗菌治療中に関節炎の増悪を認めた1例/後頸部の激痛を主訴に受診した1例

  上田 洋, 三森 明夫

  (株)南江堂, Oct. 2010, 内科, 106(4) (4), 731 - 735, Japanese


• 肺病変 MTX治療中の関節リウマチに抗TNF-α抗体療法を追加後、間質性肺炎を生じた3例

  上田 洋, 高橋 裕子, 山下 裕之, 小林 昌史, 吉田 祐志, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2010, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 54回・19回, 571 - 571, Japanese


• ウイルス肝炎罹患例におけるリウマチ治療

  金子 礼志, 國松 淳和, 森山 純江, 吉川 玲欧, 増井 良則, 上田 洋, 高橋 裕子, 三森 明夫

  (一社)日本リウマチ学会, Mar. 2010, 日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集, 54回・19回, 684 - 684, Japanese

• 抗IgG重鎖/HLA-DR複合体抗体の関節リウマチにおける臨床的有用性の確立

  上田 洋

  日本学術振興会, 科学研究費助成事業, 若手研究, 神戸大学, 01 Apr. 2024 - 31 Mar. 2027