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野津 寛大大学院医学研究科 医科学専攻教授
研究者基本情報
■ 学位■ 研究ニュース
- 2022年07月13日, 拡大新生児マススクリーニングで「重症型」の脊髄性筋萎縮症患者を発見! ― 新生児期での早期発見による効果的な治療の実施へ ―
- 2022年07月11日, 医師主導治験によって症候性先天性サイトメガロウイルス感染症に対する抗ウイルス薬「バルガンシクロビル」の有用性が示されました
- 2021年12月09日, 小児難治性ネフローゼ症候群に対するリツキシマブ投与後の寛解維持療法の開発
- 2021年11月12日, 2020年の緊急事態宣言が神戸市小児の気管支喘息による受診数に及ぼした影響
- 2021年11月08日, 神戸市における水痘ワクチン定期接種化後の急病センター受診患者数の減少効果に関する調査
- 2021年08月10日, 未診断のギッテルマン症候群が日本人に多い可能性が判明 ― ゲノムデータベースから民族別の有病率を推算 ―
- 2021年03月30日, 治療可能な難病を早期発見する新しい新生児マススクリーニング
- 2020年07月27日, アルポート症候群における遺伝子型と治療有効性の関係に関する検討
- 2020年06月19日, ステロイド感受性ネフローゼ症候群の新たな疾患感受性遺伝子の発見 ―発症機序の解明や新たな治療法開発に期待―
- 2020年06月02日, アルポート症候群に対する核酸医薬を用いた新規治療法開発
- 2020年02月06日, 抗サイトメガロウイルス薬「バルガンシクロビル」の 医師主導治験を開始
- 2018年07月17日, 小児の慢性腎疾患発症のリスクに関わる遺伝子 ―小児ステロイド感受性ネフローゼ症候群の疾患感受性遺伝子のHLAハプロタイプを同定―
■ 研究分野
研究活動情報
■ 受賞- 2023年10月 神戸大学, 神戸大学学長表彰(財務貢献)
- 2022年10月 神戸大学学長表彰(財務貢献)
- 2021年10月 神戸大学学長表彰(財務貢献)
- 2021年06月 Clinical and Experimental Nephrologyベストサイテーション賞
- 2021年04月 Pediatrics International Best Reviewer Award
- 2020年08月 神戸大学, 神戸大学学長表彰(財務貢献)
- 2020年08月 日本腎臓学会, 第63回日本腎臓学会学術総会優秀演題賞, Alport症候群に対するエクソンスキッピング療法の開発
- 2019年04月 日本小児科学会, 2019年日本小児科学会学術研究賞, 遺伝性腎疾患における分子生物学的発症機序の解明および治療法の開発
- 2017年05月 日本腎臓学会, 第1回日本腎臓学会 Clinical Scientist Award, Alport症候群の臨床遺伝学的研究
- 2017年03月 川野小児医学奨学団体, 第17回小児医学川野賞, 小児遺伝性腎疾患における網羅的診断体制の確立および治療法の開発その他の賞
- 2008年05月 日本小児腎臓学会, 第43回小児腎臓病学会学術集会奨励賞, 発端者のCOL4A5遺伝子に体細胞モザイクに変異を有し、軽症の臨床症状を示したAlport症候群の2家系
- 2007年06月 日本小児腎臓病学会, 第42回小児腎臓病学会学術集会奨励賞, 日本人3型Bartter症候群患者5例における遺伝子型および表現型に関する研究
- 2006年06月 日本小児腎臓病学会, 第41回小児腎臓病学会学術集会奨励賞, 尿中落下細胞の解析によりExon Skippingを証明できた1例
- BACKGROUND: Autosomal-dominant tubulointerstitial kidney disease caused by MUC1 (ADTKD-MUC1) is a rare disorder characterized by progressive kidney dysfunction. Pathogenic variants in MUC1 are difficult to detect owing to the variable number tandem repeat region. To address this issue, VNtyper-Kestrel, a bioinformatics pipeline for short-read sequencing data, was recently developed. In this study, the performance of VNtyper-Kestrel for detecting MUC1 variants in clinical settings was evaluated. METHODS: We used VNtyper-Kestrel to retrospectively analyze short-read sequencing data for 209 individuals with suspected ADTKD who were previously evaluated through long-read sequencing. Data from a panel including ~ 180 genes and an ADTKD-specific panel were used. In addition, the pipeline was applied to 976 patients with suspected hereditary kidney diseases other than ADTKD and positive cases were validated using long-read sequencing. Accuracy was assessed by comparisons with the results of long-read sequencing. RESULTS: Using VNtyper-Kestrel, we identified MUC1 variants in 16 of 19 confirmed cases of ADTKD-MUC1. Three initially negative cases were reanalyzed using the ADTKD-specific panel, yielding positive detection results with high confidence. We obtained two low-confidence positive results from 190 cases of suspected ADTKD and 10 low-confidence positive results among 976 non-ADTKD cases; however, all were classified as false positives upon long-read sequencing validation. CONCLUSIONS: VNtyper-Kestrel demonstrated high sensitivity in identifying MUC1 variants when sequencing coverage was adequate, supporting its potential as a rapid and cost-effective screening tool. However, confirmatory long-read sequencing is needed in uncertain cases. Optimizing coverage and refining patient selection criteria could improve the clinical utility of this approach.2025年04月, Clinical and experimental nephrology, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Isotonic fluids are becoming the standard for hydration and maintenance fluid therapy, but there is no consensus on the optional choice among the different types of isotonic solution. METHODS: This study is a single-center, non-randomized controlled trial at Kobe University Hospital, Japan, between April 2021 and March 2023. The study included pediatric patients aged 1-19 years who underwent kidney biopsies. From April 2021 to March 2022, 0.9% sodium chloride (saline) was administered, and from April 2022 to March 2023, balanced crystalloids were used. The primary outcome was the occurrence of hyponatremia (< 137 mEq/L) after a kidney biopsy. Secondary outcomes included other electrolyte balances, blood gas parameters, creatinine-based estimated glomerular filtration rate (Cr-eGFR), and arginine vasopressin concentrations (UMIN Clinical Trial Registry: UMIN 000044330). RESULTS: Of 61 patients enrolled, 2 were excluded, leaving 34 in the saline group and 25 in the balanced crystalloid group. No hyponatremia occurred, and serum sodium concentrations were similar between both groups (138.7 vs. 138.9 mEq/L, P = 0.08). The saline group showed a greater increase in serum chloride (+ 1.7 vs. + 0.2, P < 0.01) and a greater decrease in HCO3- concentrations (- 0.6 vs. + 0.9, P < 0.01). There were minimal changes in pH (- 0.01 vs. - 0.01, P = 0.99) and Cr-eGFR (- 1.5 vs. + 1.1 mL/min/1.73 m2, P = 0.96) in both groups. CONCLUSIONS: During pediatric kidney biopsy, both saline and balanced crystalloids were effective in preventing hyponatremia. Although saline infusion results in higher serum chloride concentrations and lower blood HCO3- concentrations than balanced crystalloids infusion, the clinical significance was minimal.2025年04月, Pediatric nephrology (Berlin, Germany), 40(4) (4), 1033 - 1040, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: More than half of patients with congenital nephrotic syndrome (CNS) or infantile nephrotic syndrome (infantile NS) have a monogenic aetiology. This study aimed to clarify differences in the clinical course, genetic background, and genotype-phenotype correlation between CNS and infantile NS. METHODS: We enrolled patients who were diagnosed with CNS or infantile NS and referred to our hospital for genetic analysis and investigated the clinical characteristics and genetic background of patients with identified causative genes. RESULTS: Among 74 patients enrolled, disease-causing genetic variants were detected in 50 patients. The median age for developing kidney failure in the genetic CNS (n = 33) and genetic infantile NS (n = 17) groups with monogenic variants was 13.2 and 19.0 months, respectively (P = 0.13). The age at developing kidney failure was significantly earlier in CNS patients with genes other than NPHS1 than in CNS patients with NPHS1 variants (1.0 vs. 31.0 months; P < 0.001). In patients with pathogenic variants other than NPHS1, there was a significant difference in the age at developing kidney failure between CNS and infantile NS patients (1.0 vs. 15.0 months; P < 0.001). Of patients with NPHS1 variants, no infants with NS had any truncating variants or developed kidney failure during follow-up. CONCLUSIONS: The onset of CNS or infantile NS affects the kidney prognosis in patients with genetic nephrotic syndrome. Among patients with pathogenic variants in the same gene, patients with infantile NS may have a milder genotype and better prognosis than those with CNS.2025年03月, Pediatric nephrology (Berlin, Germany), 英語, 国際誌研究論文(学術雑誌)
- Nephrotic syndrome is the most common glomerular disease in children, and various hypotheses regarding its etiology have been proposed, primarily focusing on immune-related mechanisms. Nephrotic syndrome can manifest as a monogenic disease caused by deleterious variants in genes such as NPHS1, which encodes nephrin. In steroid-sensitive nephrotic syndrome, HLA class II and immune-related genes have been identified as susceptibility genes. Moreover, NPHS1 is a susceptibility gene for steroid-sensitive nephrotic syndrome in patients from East Asian populations. Anti-nephrin antibodies have been identified as a significant factor in the pathogenesis of nephrotic syndrome. These discoveries have substantially advanced our understanding of nephrotic syndrome. However, the mechanisms underlying the production of anti-nephrin antibodies and their association with genetic backgrounds have remained unclear and warrant further investigation.2025年03月, Clinical and experimental nephrology, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Autosomal dominant tubulointerstitial kidney disease (ADTKD) is characterized by tubular atrophy, interstitial fibrosis, and progressive kidney dysfunction. Its causative genes include UMOD, MUC1, REN, HNF1B, and SEC61A1. ADTKD contributes to unexplained chronic kidney disease (CKD), and many cases remain genetically undiagnosed. This study aimed to elucidate the clinical features of patients genetically diagnosed with ADTKD in Japan. METHODS: We included individuals with suspected congenital anomalies of the kidney and urinary tract, nephronophthisis, polycystic kidney disease, or ADTKD. Genetic analyses using direct sequencing, short-read next-generation sequencing (SRS), and/or long-read next-generation sequencing (LRS) were performed on 1097 families. Patients with ADTKD-HNF1B were excluded due to prior reporting. RESULTS: Variants in UMOD, MUC1, REN, and SEC61A1 were identified in 52 patients from 40 families (18, 16, 5, and 1 family, respectively). The median age at diagnosis was 38.5 years, and the urinary protein-to-creatinine ratio was 0.05 g/gCr. End-stage kidney disease was present at diagnosis in 37% of patients. Genetic testing was performed in 58% due to suspected ADTKD based on pathology or clinical course and in 38% due to unexplained CKD. Kidney biopsies were performed in 55%, with ADTKD confirmed pathologically in 41%. SRS and LRS were used in 55% and 30% of all families, respectively; for ADTKD-MUC1, 75% of families were analyzed using LRS. CONCLUSIONS: Clinical and pathological diagnosis of ADTKD remains challenging, emphasizing the importance of comprehensive genetic testing. Enhanced access to advanced genetic testing such as LRS is essential to improve diagnostic precision and management.2025年02月, Clinical and experimental nephrology, 英語, 国内誌研究論文(学術雑誌)
- Systemic lupus erythematosus (SLE) can present with various symptoms, including rare manifestations such as gangrene. This report describes a 12-year-old girl with SLE who presented with intermittent claudication and gangrene. Although intermittent claudication is rare in paediatric cases, it is essential to consider vascular diseases including those associated with SLE as a potential cause. The patient initially experienced pain, redness, and cold sensations in the right great toe accompanied by intermittent claudication, with symptoms worsening over time. Diagnostic imaging, including contrast-enhanced CT and MRI, revealed occlusion of the right popliteal artery with associated vasculitis and thrombosis. The diagnosis of SLE and antiphospholipid syndrome was confirmed based on clinical criteria. Treatment included prednisone, methylprednisolone pulse therapy, mycophenolate mofetil, hydroxychloroquine, and anticoagulants. The patient showed significant improvement, with resolution of the claudication and effective management of her gangrene through immunosuppressive therapy and careful wound care. This case highlights the importance of considering vascular complications in paediatric SLE and underscores the need for early diagnosis and comprehensive treatment.2025年02月, Modern rheumatology case reports, 英語, 国際誌研究論文(学術雑誌)
- The coronavirus disease 2019 (COVID-19) pandemic has affected people worldwide, and pediatric patients with underlying diseases are at high risk of developing severe COVID-19. However, there are limited reports on the clinical impact of COVID-19, especially in patients with underlying neuromuscular diseases (NMD) and inborn errors of metabolism (IEM). This study aimed to investigate the incidence and clinical presentation of COVID-19 in patients with NMD and IEM. This was a single-center, cross-sectional study of patients with NMD and IEM in Japan for 2 years, from April 1, 2020 to March 31, 2022. Among 255 participants with a median age of 14 (range: 0-50) years, 192 (75%) and 63 (25%) had NMD and IEM, respectively. Among 255 patients, 8 (5 NMD and 3 IEM) were positive for the anti-severe acute respiratory syndrome coronavirus 2 nucleocapsid antibody, and the incidence was considered 3%. All positive patients had mild or asymptomatic COVID-19. None of the patients exhibited moderate or severe symptoms. In conclusion, this study revealed that the incidence of COVID-19 was low, and mild or subclinical infection was common even in patients with NMD and IEM, who may be at a higher risk of severe COVID-19.2025年02月, The Kobe journal of medical sciences, 70(4) (4), E106-E112, 英語, 国内誌研究論文(学術雑誌)
- INTRODUCTION: Alport syndrome (AS) is an inherited kidney disease caused by variants in the COL4A3, COL4A4, or COL4A5 genes, resulting in type IV collagen abnormalities. Although autosomal dominant variants in COL4A3 and COL4A4 are increasingly being diagnosed, X-linked AS (XLAS) caused by COL4A5 variants predominates. Single nucleotide substitutions in introns positioned at first and second from the last nucleotide (called a consensus sequence) of exons always cause aberrant splicing. However, whether intronic variants at the third to fifth positions from the last nucleotide of exons can cause aberrant splicing is unclear. METHODS: We identified 11 intronic variants positioned at the third, fourth, and fifth nucleotides from the exon 3' end in COL4A5 from our AS cohort (January 2006-July 2022). We conducted in vitro splicing assays using minigenes and in silico splicing analysis using commercial splicing prediction software and evaluated mRNA sequences obtained from patients' samples when available. RESULTS: All 11 patients showed aberrant splicing patterns in the minigene splicing assays. In vivo analysis of 6 patients corroborated these findings. The commercial splicing prediction software accurately predicted splicing changes in 10 variants. CONCLUSIONS: This study shows that 11 intronic variants at the third to fifth positions in COL4A5 introns cause aberrant splicing. This finding highlights the importance of evaluating such variants for the diagnosis and prognosis of XLAS. Further investigation is warranted to confirm the pathogenicity of these variants and their effect on the prognosis of the kidney in XLAS.2025年02月, Kidney international reports, 10(2) (2), 516 - 521, 英語, 国際誌研究論文(学術雑誌)
- Springer Science and Business Media LLC, 2024年12月, Clinical and Experimental Nephrology, 29(1) (1), 39 - 56研究論文(学術雑誌)
- Alport syndrome (AS) is a hereditary disease caused by mutations in the COL4A5 gene and leads to chronic kidney disease. Currently, no specific treatment has been developed. However, a recent study using AS-model mice demonstrated that the exon skipping method could partially rescue the symptoms. In this study, we evaluated the effects of the exon skipping method using kidney organoids generated from AS-patient-derived induced pluripotent stem cells (AS-iPSCs). We generated kidney organoids from AS-iPSCs, which exhibited nephron structures. As expected, the C-terminus of COL4A5 was not expressed in AS-organoids. Interestingly, anti-sense oligonucleotides restored the expression of the C-terminus of COL4A5 in vitro. Next, we transplanted AS-organoids into mice and evaluated glomerular basement membrane formation in vivo. We found that AS-organoids formed a lower slit diaphragm ratio compared to control organoids. Finally, we assessed the effects of exon skipping on transplanted organoids but observed minimum effects. These studies suggest that AS-iPSCs can generate kidney organoids lacking the C-terminus of COL4A5, and that exon skipping can induce its expression in vitro.2024年12月, Genes to cells : devoted to molecular & cellular mechanisms, 29(12) (12), 1118 - 1130, 英語, 国際誌研究論文(学術雑誌)
- OBJECTIVE: This study aimed to measure and compare cerebrospinal fluid neuronal injury biomarkers in the acute phase of complex febrile seizure (CFS) and infection-triggered acute encephalopathy (AE). Furthermore, we determined the pathogenesis of AE with biphasic seizures and late reduced diffusion (AESD). METHODS: Pediatric patients with febrile status epilepticus who visited Hyogo Prefectural Kobe Children's Hospital from November 1, 2016, to December 31, 2022, and whose cerebrospinal fluid samples were collected within 24 h of neurological symptom onset were included. Patients were classified as having CFS or infection-triggered AE according to their definitions. Patients with AE were further categorized into AESD or unclassified AE. Cerebrospinal fluid biomarkers (neuron-specific enolase, growth differentiation factor 15 [GDF-15], S100 calcium-binding protein B [S100B], glial fibrillary acidic protein, and tau protein were measured and compared among the groups. RESULTS: Total of 63 patients (45 with CFS and 18 with AE) were included. Among the AE patients, nine were classified as having AESD and nine as having unclassified AE. S100B levels were significantly higher in patients with AESD than in patients with CFS (485 pg/ml vs. 175.3 pg/ml) and were even higher in patients with AESD and neurological sequelae (702.4 pg/ml). GDF-15 levels were significantly elevated in patients with AE compared to patients with CFS (85.8 pg/ml vs. 23.6 pg/ml). CONCLUSIONS: The elevation of S100B suggests that activated astrocytes may be closely associated with the early pathology of AESD. Elevated GDF-15 levels in infection-triggered AE suggest the activation of defense mechanisms caused by stronger neurological injury.2024年11月, Journal of the neurological sciences, 466, 123238 - 123238, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2024年11月, 日本小児科学会雑誌, 128(11) (11), 1478 - 1478, 日本語RAS阻害薬不応の蛋白尿を呈し遺伝学的検査でCUBN異常症と診断した1例
- INTRODUCTION: Buccal midazolam (buc MDL) is the first buccal mucosal delivery formulation applied for status epilepticus in Japan. Herein, we aimed to investigate the effectiveness and adverse events of buc MDL as a pre-hospital treatment for epileptic seizures in real-world clinical practice. METHODS: This study involved a retrospective review based on medical records. We included children who received buc MDL as pre-hospital treatment for epileptic seizures and were subsequently transported to the emergency department between April 2021 and November 2023. RESULTS: This study included 26 patients (136 episodes). The overall efficacy rate, which was defined as seizure cessation within 10 min after buc MDL administration with no recurrence within 30 min, was 43 %. Moreover, 70 % of the episodes did not require additional medications. None of the episodes required bag-mask ventilation or intubation following seizure cessation with buc MDL alone. The efficacy was decreased when buc MDL was administered longer than 15 min from seizure onset. Furthermore, the efficacy did not decrease as long as it was within 0.2-0.5 mg/kg, even if the dose was smaller than the appropriate dose for the specific age. CONCLUSIONS: The response rate was significantly higher in episodes where buc MDL was administered within 15 min. Additionally, there was no concern regarding respiratory depression with buc MDL alone.2024年11月, Brain & development, 46(10) (10), 332 - 338, 英語, 国際誌研究論文(学術雑誌)
- KEY POINTS: Patients with both COL4A3 and COL4A4 variants exhibited poor renal prognosis compared with those with autosomal dominant Alport syndrome. The proportion of patients with digenic Alport syndrome was 1.7% among all patients with Alport syndrome. BACKGROUND: Digenic Alport syndrome could be associated with poor renal prognosis. However, the characteristics of patients with digenic Alport syndrome remain ambiguous. METHODS: We retrospectively investigated the clinical symptoms, pathological findings, genetic variants, and proportions of patients with digenic Alport syndrome. The ages at detection of proteinuria and development of ESKD were compared between patients with digenic Alport syndrome with disease-causing variants in COL4A3 and COL4A4 and those with autosomal dominant Alport syndrome (ADAS) previously analyzed by our group. RESULTS: Eighteen patients from nine families with digenic variants in COL4A3 and COL4A4 and four male and five female patients with digenic variants in COL4A5 and COL4A3 or COL4A4 were enrolled in this study. Next-generation sequencing revealed that the proportion of patients with digenic Alport syndrome was 1.7% among all patients with Alport syndrome. In patients with digenic variants in COL4A3 and COL4A4, the median ages at detection of proteinuria and ESKD were 10.0 and 57.0 years, respectively. Compared with the patients with ADAS, the age at detection of proteinuria tended to be earlier (10.0 versus 20.0 years; P = 0.073) and that at development of ESKD was significantly earlier (57.0 versus 72.0 years; P = 0.045) in patients with digenic Alport syndrome. CONCLUSIONS: Overall, patients with digenic Alport syndrome harboring COL4A3 and COL4A4 variants exhibited poor renal compared with the patients with ADAS. Therefore, timely identification of the two disease-causing variants is critical for the renal prognostic assessment and early treatment of patients with digenic Alport syndrome.2024年10月, Kidney360, 5(10) (10), 1510 - 1517, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND AND HYPOTHESIS: Male patients with X-linked Alport syndrome (XLAS) generally develop end-stage kidney disease in early or middle adulthood and show distinct genotype-phenotype correlations. Female patients, however, show various phenotypes ranging from asymptomatic to severe with no genotype-phenotype correlations. However, the factors affecting the severity of XLAS in female patients are unclear. Since X-chromosome inactivation (XCI) affects the severity of certain female X-linked diseases, we investigated whether genotype and XCI were associated with XLAS severity in female patients in a large Japanese cohort. METHODS: Among 139 female patients with genetically diagnosed XLAS at our institution, we conducted XCI analysis on peripheral blood leukocytes using the human androgen receptor assay method and analyzed two cohorts. In 74 adult female patients, we evaluated the correlation between kidney function (creatinine-estimated glomerular filtration rate [Cr-eGFR] optimized for Japanese individuals) and genotype/XCI using multivariable linear regression analysis, and in 65 pediatric female patients, we evaluated the correlation between kidney function (Cr-eGFR optimized for Japanese individuals) and genotype/XCI using multivariable linear regression analysis. We also investigated the correlation between the development of proteinuria (urine protein-to-creatinine ratio above normal for the patient's age) and genotype/XCI using multivariable Cox proportional hazard analysis. RESULTS: In adult female patients, XCI pattern was significantly associated with Cr-eGFR (regression coefficient estimate = -0.53, P = 0.004), whereas genotype was not (P = 0.892). In pediatric female patients, both genotype and XCI pattern were significant independent risk factors for the development of proteinuria (hazard ratio [HR], 3.702; 95% confidence interval [CI], 1.681-8.150; P = 0.001 and HR, 1.043; 95% CI, 1.061-1.070; P = 0.001, respectively), whereas both genotype and XCI pattern were not associated with Cr-eGFR (P = 0.20, P = 0.67, respectively). CONCLUSION: Genotype and XCI are factors associated with the severity in females with XLAS.2024年08月, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本マススクリーニング学会, 2024年07月, 日本マス・スクリーニング学会誌, 34(2) (2), 209 - 209, 日本語
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 568 - 568, 日本語本邦のネフローゼ患者における抗ネフリン抗体の発現について
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 574 - 574, 日本語原因除去後長期にわたり維持する偽性Gitelman症候群の検討
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 574 - 574, 日本語遺伝学的に診断された常染色体顕性尿細管間質性腎疾患の臨床像
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 576 - 576, 日本語Alport症候群患者の診断における3歳児検尿の役割の検討
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 576 - 576, 日本語Digenic Alport syndromeの重症度に関する検討
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 577 - 577, 日本語腎生検時輸液における生理食塩水とリンゲル液の安全性の比較に関する検討
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 578 - 578, 日本語免疫抑制薬未使用の小児頻回再発型/ステロイド依存性ネフローゼ症候群に対するリツキシマブ医師主導治験
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 579 - 579, 日本語ネフリン/IgGカクテル抗体を用いた小児特発性ネフローゼ症候群腎組織の抗ネフリン抗体検出とその有用性
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 598 - 598, 日本語早産や低出生体重児の潜在的レニン・アンギオテンシン・アルドステロン(RAAS)系亢進の存在に関する検討
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 599 - 599, 日本語OCRL異常症の表現型は,phosphatidylinositol 4,5-bisphosphate 5-phosphatase活性と相関する
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 676 - 676, 日本語検尿異常により発見された蛋白尿症と単一遺伝子異常との関連
- (一社)日本小児腎臓病学会, 2024年05月, 日本小児腎臓病学会雑誌, 37(Suppl.) (Suppl.), 111 - 111, 日本語
- (一社)日本小児神経学会, 2024年05月, 脳と発達, 56(Suppl.) (Suppl.), S206 - S206, 日本語
- (一社)日本小児神経学会, 2024年05月, 脳と発達, 56(Suppl.) (Suppl.), S225 - S225, 日本語
- (一社)日本小児神経学会, 2024年05月, 脳と発達, 56(Suppl.) (Suppl.), S225 - S225, 日本語
- INTRODUCTION/AIMS: Duchenne muscular dystrophy (DMD) presents with skeletal muscle weakness, followed by cardiorespiratory involvement. The need for longitudinal data regarding DMD that could serve as a control for determining treatment efficacy in clinical trials has increased notably. The present study examined the longitudinal data of Japanese DMD patients collectively and assessed individual patients with pathogenic variants eligible for exon-skipping therapy. METHODS: Patients with DMD who visited Kobe University Hospital between March 1991 and March 2019 were enrolled. Data between the patients' first visit until age 20 years were examined. RESULTS: Three hundred thirty-seven patients were included. Serum creatine kinase levels showed extremely high values until the age of 6 years and a rapid decline from ages 7-12 years. Both the median 10-m run/walk velocity and rise-from-floor velocity peaked at the age of 4 years and declined with age. The values for respiratory function declined from the age of 11 years. The median left ventricular ejection fraction was >60% until the age of 12 years and rapidly declined from ages 13-15 years. Examination of the relationship between pathogenic variants eligible for exon-skipping therapy and longitudinal data revealed no characteristic findings. DISCUSSION: We found that creatine kinase levels and motor, respiratory, and cardiac functions each exhibited various changes over time. These findings provide useful information about the longitudinal data of several outcome measures for patients with DMD not receiving corticosteroids. These data may serve as historical controls in comparing the natural history of DMD patients not on regular steroid use in appropriate clinical trials.2024年05月, Muscle & nerve, 69(5) (5), 604 - 612, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Membranoproliferative glomerulonephritis (MPGN) can be divided into immune-complex MPGN (IC-MPGN) and C3 glomerulopathy (C3G), which includes dense deposit disease (DDD) and C3 glomerulonephritis (C3GN). These conditions result from abnormalities in different complement pathways and may lead to different prognoses. However, there are limited studies describing the respective clinical courses. METHODS: In this study, Japanese pediatric patients diagnosed with MPGN based on kidney biopsies conducted between February 2002 and December 2022 were reclassified as having IC-MPGN or C3G (DDD or C3GN). We retrospectively analyzed the clinical characteristics and outcomes of these patients. RESULTS: Out of 25 patients with MPGN, three (12.0%) were diagnosed with DDD, 20 (80.0%) with C3GN, and two (8.0%) with IC-MPGN. There were 13 (65.0%) patients and one (33.3%) patient in remission after treatment for C3GN and DDD, respectively, and no patients with IC-MPGN achieved remission. The median follow-up period was 5.3 (2.5-8.9) years, and none of the patients in either group progressed to an estimated glomerular filtration rate < 15 ml/min/1.73 m2. Patients with C3GN presenting mild to moderate proteinuria (n = 8) received a renin-angiotensin system inhibitor (RAS-I) alone, and these patients exhibited a significant decrease in the urinary protein creatinine ratio and a notable increase in serum C3 levels at the last follow-up. CONCLUSIONS: Most patients with MPGN were diagnosed with C3GN. The remission rate for C3GN was high, and no patients developed kidney failure during the approximately 5-year follow-up. Additionally, patients with C3GN with mild to moderate proteinuria had good outcomes with RAS-I alone, but continued vigilance is necessary to determine long-term prognosis.2024年04月, Pediatric nephrology (Berlin, Germany), 英語, 国際誌研究論文(学術雑誌)
- Springer Science and Business Media LLC, 2024年04月, Clinical and Experimental Nephrology研究論文(学術雑誌)
- We present a case of nephronophthisis 13 that resulted from WDR19 variants. The patient, a nine-year-old Japanese boy, had detection of mild proteinuria during a school urine screening. Urinalysis revealed mild proteinuria without hematuria. Blood tests indicated pancytopenia, mild elevation of liver enzymes, and kidney dysfunction. Ultrasound examination disclosed hepatosplenomegaly. Abdominal computed tomography and bone marrow assessments ruled out malignant tumors. Subsequent kidney and liver biopsies suggested nephronophthisis and congenital hepatic fibrosis. Furthermore, comprehensive genetic analysis through next-generation sequencing revealed compound heterozygous variants in WDR19 (NM_025132.4), including the previously reported c.3533G > A, p.(Arg1178Gln), and c.3703G > A, p.(Glu1235Lys) variants, confirming the diagnosis of nephronophthisis 13. There is potential need for liver and kidney transplantation in patients with nephronophthisis and hepatic fibrosis. Early diagnosis is therefore crucial to mitigate delays in treating complications associated with kidney and hepatic insufficiency and to facilitate preparation of transplantation. To achieve early diagnosis of nephronophthisis, it is imperative to consider it as a differential diagnosis when extrarenal symptoms and kidney dysfunction coexist, particularly when mild proteinuria is observed through opportunistic urinalysis. Genetic testing is important because nephronophthisis manifests as diverse symptoms, necessitating an accurate diagnosis. Next-generation sequencing was shown to be invaluable for the genetic diagnosis of nephronophthisis, given the numerous identified causative genes.2024年04月, CEN case reports, 英語, 国内誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 631 - 631, 日本語膵仮性嚢胞内の仮性動脈瘤破裂を来した重症心身障がい児の1例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 631 - 632, 日本語国産手術支援ロボットhinotoriによるロボット支援下左副腎褐色細胞腫摘出術を行った1例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 625 - 625, 日本語3歳時の就寝時刻が遅いと小学1年生時の勤勉性や思いやりが低下する 尼崎市コホート研究
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 619 - 620, 日本語不全型川崎病に続発した全身型若年性特発性関節炎の1例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 624 - 624, 日本語潰瘍性大腸炎の発症時に免疫性血小板減少症を合併した1例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 625 - 625, 日本語小児SLEに対してアニフロルマブを使用した2例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 630 - 631, 日本語抗TNFα抗体製剤使用中に乾癬様皮疹が出現した2例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 616 - 616, 日本語生後1週以降の頻脈で発症したMMI内服中のバセドウ病母体から出生した新生児バセドウ病の1例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 617 - 617, 日本語卵巣ステロイド細胞腫瘍合併母体から出生した46,XX性分化異常症の児
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 617 - 618, 日本語全身合併症を伴った前眼部形成異常の1例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 631 - 631, 日本語膵仮性嚢胞内の仮性動脈瘤破裂を来した重症心身障がい児の1例
- (公社)日本小児科学会, 2024年04月, 日本小児科学会雑誌, 128(4) (4), 631 - 632, 日本語国産手術支援ロボットhinotoriによるロボット支援下左副腎褐色細胞腫摘出術を行った1例
- Autosomal dominant polycystic kidney disease (ADPKD) is commonly caused by PKD1, and mosaic PKD1 variants result in milder phenotypes. We present the case of a 32 year-old male with chronic active Epstein-Barr virus who underwent bone marrow transplantation with chemoradiotherapy at age 9. Despite a low-frequency mosaic splicing PKD1 variant, he developed severe renal cysts and end-stage renal disease in his 30 s. This case highlights how environmental factors may contribute to the genetic predisposition to ADPKD.2024年03月, Human genome variation, 11(1) (1), 17 - 17, 英語, 国際誌研究論文(学術雑誌)
- Recently, heterozygous loss-of-function NFKB1 variants were identified as the primary cause of common variable immunodeficiency (CVID) in the European population. However, pathogenic NFKB1 variants have never been reported in the Japanese population. We present a 29-year-old Japanese woman with CVID. A novel variant, c.136 C > T, p.(Gln46*), was identified in NFKB1. Her mother and daughter carried the same variant, demonstrating the first Japanese pedigree with an NFKB1 pathogenic variant.2024年03月, Human genome variation, 11(1) (1), 15 - 15, 英語, 国際誌研究論文(学術雑誌)
- PURPOSE: Tubulointerstitial nephritis (TIN) has various etiologies, including IgG4-related disease (IgG4-RD), autoimmune diseases, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), and others. IgG4-positive plasma cell infiltration can occasionally be found in TIN unrelated to IgG4-RD. Therefore, there may be problems with usage of IgG4 immunostaining to differentiate between TIN with and TIN without IgG4-RD. This study aimed to compare the proportion of plasma cells that are positive for each IgG subclass and to clarify the predominant IgG subclass trends and clinical characteristics associated with IgG4-RD and non-IgG4-related interstitial nephritis. METHODS: The study enrolled 44 cases of TIN: 6 of IgG4-RD, 8 of autoimmune disease, 9 of AAV, and 21 of unknown disease group. In addition to clinical characteristics, IgG subclass composition of interstitial plasma cells was evaluated among 4 groups by immunohistochemistry. RESULTS: IgG1 was the predominant IgG subclass in TIN unrelated to IgG4-RD. In the IgG4-RD group, the IgG subclass rate was high in both IgG1 and IgG4. The rate of average IgG4-positive cells was significantly lower in the autoimmune disease group and unknown disease group compared with the IgG4-RD group. CONCLUSION: The present study revealed IgG1-dominant immune profiles of TIN unrelated to IgG4-RD. Further investigation is required to elucidate the clinicopathological differences between IgG1-dominant and IgG4-dominant groups in IgG4-RD.2024年02月, International urology and nephrology, 英語, 国際誌研究論文(学術雑誌)
- Although the causes of neurodevelopmental disorders remain unknown, several environmental risk factors have attracted considerable attention. We conducted a retrospective, longitudinal, population-based cohort study using data from infant health examinations of children born to mothers with pregnancies between April 1, 2014 and March 31, 2016 in Kobe City to identify the perinatal factors associated with neurodevelopmental referrals in 3-year-old children. There were 15,223 and 1283 children in the normal and referral groups, respectively. Neurodevelopmental referrals at the health checkup for 3-year-old children were significantly associated with the lack of social support during pregnancy (adjusted odds ratio [aOR] 1.99, 99% CI 1.14-3.45, p = 0.001), history of psychiatric consultation (aOR 1.56, 99% CI 1.10-2.22, p = 0.001), no social assistance post-delivery (aOR 1.49, 99% CI 1.03-2.16, p = 0.006), Edinburgh Post-natal Depression Scale (EPDS) score ≥ 9 (aOR 1.36, 99% CI 1.01-1.84, p = 0.008), infant gender (male) (aOR 2.51, 99% CI 2.05-3.06, p < 0.001), and cesarean delivery (aOR 1.39, 99% CI 1.11-1.75, p < 0.001). In conclusion, this exploratory study in the general Japanese population identified six perinatal factors associated with neurodevelopmental referrals in 3-year-old children: infant gender (male), cesarean section, maternal history of psychiatric consultation, EPDS score ≥ 9, lack of social support during pregnancy, and no social assistance post-delivery.2024年02月, Scientific reports, 14(1) (1), 3492 - 3492, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2024年02月, 日本小児科学会雑誌, 128(2) (2), 188 - 188, 日本語3歳児の睡眠習慣と小学1年生の学力および非認知能力との関連
- (公社)日本小児科学会, 2024年02月, 日本小児科学会雑誌, 128(2) (2), 205 - 205, 日本語検尿を契機とし持続する蛋白尿を指摘された症例における単一遺伝子異常同定に関する検討
- (公社)日本小児科学会, 2024年02月, 日本小児科学会雑誌, 128(2) (2), 207 - 207, 日本語腎生検時における生理食塩水とリンゲル液の安全性の比較に関する検討
- (公社)日本小児科学会, 2024年02月, 日本小児科学会雑誌, 128(2) (2), 233 - 233, 日本語Minigeneを用いたIn vitro splicing解析によるWT1遺伝子におけるIntron variantの病原性評価
- (公社)日本小児科学会, 2024年02月, 日本小児科学会雑誌, 128(2) (2), 234 - 234, 日本語全エクソーム解析およびmRNA解析により診断に至ったAl-Raqad症候群の1例
- (公社)日本小児科学会, 2024年02月, 日本小児科学会雑誌, 128(2) (2), 236 - 236, 日本語Alport症候群患者の診断における3歳児検尿の役割に関する検討
- (公社)日本小児科学会, 2024年02月, 日本小児科学会雑誌, 128(2) (2), 293 - 293, 日本語当院における小児心停止症例に対する遺伝学的診断(Genetic autopsy)を含めた原因究明システムの構築
- Serum leucine-rich alpha-2 glycoprotein (LRG) has been utilized for adult inflammatory bowel disease (IBD); however, its efficacy in pediatric IBD remains unknown. The aim of this study was to compare the diagnostic accuracy of serum LRG for pediatric IBD with that of current inflammatory markers, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). This retrospective case-control study included pediatric patients, aged <16 years, who underwent colonoscopy and/or esophagogastroduodenoscopy between April 2017 and March 2022. All eligible patients were divided into two groups: patients with IBD, diagnosed with ulcerative colitis and Crohn's disease, and non-IBD controls. The optimal cut-off value of serum LRG for IBD diagnosis was determined from receiver operating characteristic analysis, and diagnostic accuracy of serum LRG was compared to serum ESR and CRP. A total of 53 patients (24 with IBD and 29 non-IBD controls) met the inclusion criteria. The cut-off value of serum LRG for IBD diagnosis was determined to be 19.5 μg/ml. At this cut-off value, serum LRG had a positive predictive value (PPV) of 0.80 and negative predictive value (NPV) of 0.88. In contrast, PPV and NPV were 0.78 and 0.70 for serum ESR and 0.82 and 0.72 for serum CRP, respectively. Serum LRG can be a potential diagnostic marker for pediatric IBD, with higher diagnostic accuracy than that of the conventional serum markers ESR and CRP.2024年01月, The Kobe journal of medical sciences, 69(4) (4), E122-E128, 英語, 国内誌研究論文(学術雑誌)
- Protein induced by vitamin K absence or antagonist-II (PIVKA-II) is avitamin K (VK) deficiency indicator in neonates. However, PIVKA-II detection frequency in neonatal blood at birth and the correlation between PIVKA-II and gestational age are unclear. We retrospectively analyzed infants admitted to our institution between June 1, 2018, and March 31, 2022, whose clinical and PIVKA-II data were available, and classified them into preterm and term infant groups. Overall incidence of PIVKA-II-positive cases (≥ 50 mAU/mL) was 42.8%, including 0.6% apparent VK deficiency (≥ 5000 mAU/mL), 3.1% experimental VK deficiency (1000-4999 mAU/mL), and 10.7% latent VK deficiency (200-999 mAU/mL) cases. Incidence of PIVKA-II-positive cases was significantly higher in the term group than in the preterm group (49.4% vs. 29.7%, p < 0.001). Gestational age correlated with PIVKA-II levels (r2 = 0.117, p < 0.0001). Median serum PIVKA-II levels and incidence of PIVKA-II-positive cases (≥ 50 mAU/mL, 16.4%) were lower at 5 days after birth than at birth, possibly reflecting the postnatal VK prophylaxis impact. Only one infant was diagnosed with VK deficiency bleeding (PIVKA-II levels, at birth: 10,567 mAU/mL; at day 5: 2418 mAU/mL). Thus, serum PIVKA-II levels after birth weakly correlated with gestational age. VK deficiency was more common in term infants than in preterm infants.2024年01月, Scientific reports, 14(1) (1), 921 - 921, 英語, 国際誌研究論文(学術雑誌)
- Becker muscular dystrophy is caused by DMD mutations and is characterized by progressive muscle atrophy. The wide variations observed in muscle atrophy progression in Becker muscular dystrophy are considered multifactorial, including differences in mutations and environmental factors. In this case, two brothers, aged 2 and 3 years, had the identical DMD mutation, confirming their Becker muscular dystrophy diagnosis. They began using handrails when ascending and descending stairs at the age of 16 due to progressive muscular weakness. Over an 18-year follow-up, the older brother consistently had high serum creatine kinase levels, significantly over median levels. Muscle computed tomography finings revealed that the older brother’s gluteus maximus and vastus femoris cross-sectional areas were only half and one-third of the younger brother’s, respectively. The mean computed tomography values of gluteus maximus and vastus femoris were significantly lower in the older brother. Our report suggests that muscle atrophy in Becker muscular dystrophy cannot be solely explained by dystrophin mutation or environmental factors.SAGE Publications, 2024年01月, SAGE Open Medical Case Reports, 12研究論文(学術雑誌)
- (一社)日本腎臓学会, 2024年01月, 日本腎臓学会誌, 66(1) (1), 303 - 309, 日本語【腎臓学この1年の進歩】ネフリンとネフローゼ症候群
- (一社)日本小児腎臓病学会, 2024年, 日本小児腎臓病学会雑誌, 37, 92 - 93, 日本語
- (一社)日本小児神経学会, 2024年01月, 脳と発達, 56(1) (1), 70 - 70, 日本語
- 2024年, Pediatrics international : official journal of the Japan Pediatric Society, 66(1) (1), e15725, 英語, 国際誌
- Newborn screening (NBS) for spinal muscular atrophy (SMA) is necessary, as favorable outcomes can be achieved by treatment with disease-modifying drugs in early infancy. Although SMA-NBS has been initiated in Japan, its clinical results have not been fully reported. We report the findings of the initial 2.5 years of a pilot SMA-NBS of approximately 16,000 infants conducted from February 2021 in Hyogo Prefecture, Japan. Clinical data of 17 infants who tested positive were retrospectively obtained from the NBS follow-up centers participating in this multicenter cohort observational study. Genetic testing revealed 14 false positives, and three infants were diagnosed with SMA. Case 1 had two copies of survival motor neuron (SMN) 2 and showed SMA-related symptoms at diagnosis. Case 2 was asymptomatic, with two copies of SMN2. Asymptomatic case 3 had four copies of SMN2 exon 7, including the SMN1/2 hybrid gene. Cases 1 and 2 were treated within 1 month and case 3 at 8 months. All the patients showed improved motor function scores and did not require respiratory support. The identification of infants with SMA via NBS and early treatment improved their motor and respiratory outcomes. Thus, implementation of SMA-NBS at a nationwide scale should be considered.MDPI AG, 2023年12月, Genes, 14(12) (12), 2211 - 2211研究論文(学術雑誌)
- This study investigated the relationship between sleep habits in early childhood and academic performance and non-cognitive skills in the first grade. We retrospectively analyzed a longitudinal population-based cohort from birth through early childhood, up to elementary school, in Amagasaki City, Japan. The primary outcome was academic performance in the first grade. Other outcomes were self-reported non-cognitive skills. Overall, 4395 children were enrolled. Mean national language scores for children with bedtimes at 18:00-20:00, 21:00, 22:00, and ≥ 23:00 were 71.2 ± 19.7, 69.3 ± 19.4, 68.3 ± 20.1, and 62.5 ± 21.3, respectively. Multiple regression analysis identified bedtime at 3 years as a significant factor associated with academic performance. However, sleep duration was not significantly associated with academic performance. Bedtime at 3 years also affected non-cognitive skills in the first grade. Diligence decreased with a later bedtime (21:00 vs. 18:00-20:00; odds ratio [OR]: 1.98, 95% confidence interval [CI] 1.27-3.09; 22:00 vs. 18:00-20:00; OR: 2.15, 95% CI 1.37-3.38; ≥ 23:00 vs. 18:00-20:00; OR: 2.33, 95% CI 1.29-4.20). Thus, early bedtime at 3 years may be associated with a higher academic performance and better non-cognitive skills in the first grade. Optimum early-childhood sleep habits may positively impact academic future.2023年11月, Scientific reports, 13(1) (1), 20926 - 20926, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Only 80% of children with idiopathic nephrotic syndrome respond well to glucocorticoid therapy. Multidrug-resistant nephrotic syndrome (MRNS) is associated with a poor kidney prognosis. Several retrospective studies have identified rituximab as an effective treatment for MRNS; however, prospective studies are required to assess its efficacy and safety. METHODS: We conducted a multicenter, non-blinded, single-arm trial to investigate the efficacy and safety of rituximab in patients with childhood-onset MRNS who were resistant to cyclosporine and more than three courses of steroid pulse therapy. The enrolled patients received four 375 mg/m2 doses of rituximab in combination with baseline cyclosporine and steroid pulse therapy. The primary endpoint was a > 50% reduction in the urinary protein/creatinine ratio from baseline on day 169. Complete and partial remissions were also evaluated. RESULTS: Six patients with childhood-onset MRNS were enrolled. All patients were negative for pathogenic variants of podocyte-related genes. On day 169, five patients (83.3%) showed a > 50% reduction in the urinary protein/creatinine ratio, two patients showed partial remission, and two patients showed complete remission. No deaths occurred and severe adverse events occurred in two patients (infection in one patient and acute kidney injury in one patient). Three patients needed treatment for moderate-to-severe infection. CONCLUSIONS: The study treatment effectively reduced the urinary protein/creatinine ratio in patients with childhood-onset MRNS. The adverse events in this study were within the expected range; however, attention should be paid to the occurrence of infections.2023年11月, Clinical and experimental nephrology, 英語, 国内誌研究論文(学術雑誌)
- (一社)日本小児栄養消化器肝臓学会, 2023年10月, 日本小児栄養消化器肝臓学会雑誌, 37(Suppl.) (Suppl.), 81 - 81, 日本語
- Abstract Alport syndrome (AS) is a hereditary glomerulonephritis caused by COL4A3, COL4A4 or COL4A5 gene mutations and characterized by abnormalities of glomerular basement membranes (GBMs). Due to a lack of curative treatments, the condition proceeds to end-stage renal disease even in adolescents. Hampering drug discovery is the absence of effective in vitro methods for testing the restoration of normal GBMs. Here, we aimed to develop kidney organoid models from AS patient iPSCs for this purpose. We established iPSC-derived collagen α5(IV)-expressing kidney organoids and confirmed that kidney organoids from COL4A5 mutation-corrected iPSCs restore collagen α5(IV) protein expression. Importantly, our model recapitulates the differences in collagen composition between iPSC-derived kidney organoids from mild and severe AS cases. Furthermore, we demonstrate that a chemical chaperone, 4-phenyl butyric acid, has the potential to correct GBM abnormalities in kidney organoids showing mild AS phenotypes. This iPSC-derived kidney organoid model will contribute to drug discovery for AS.Springer Science and Business Media LLC, 2023年09月, Communications Biology, 6(1) (1)研究論文(学術雑誌)
- (一社)日本てんかん学会, 2023年09月, てんかん研究, 41(2) (2), 326 - 326, 日本語意識障害を呈した小児に対する救急外来簡易脳波の原因疾患別特徴
- (一社)日本腎臓学会, 2023年09月, 日本腎臓学会誌, 65(6-W) (6-W), 783 - 783, 日本語長期緩下剤内服により偽性Gitelman症候群を発症し末期腎不全に至った1例
- (公社)日本整形外科学会, 2023年09月, 日本整形外科学会雑誌, 97(9) (9), 613 - 613, 日本語
- (一社)日本腎臓学会, 2023年09月, 日本腎臓学会誌, 65(6-W) (6-W), 770 - 770, 日本語免疫抑制剤治療を回避しえたLMX1Bのde novo変異によるネフローゼ症候群の一例
- (一社)日本腎臓学会, 2023年09月, 日本腎臓学会誌, 65(6-W) (6-W), 804 - 804, 日本語詳細な遺伝子解析により診断に至った常染色体優性尿細管間質性腎疾患(ADTKD)の1例
- More than half of patients with high-risk neuroblastoma (HR-NB) experience relapse/regrowth due to the activation of chemoresistant minimal residual disease (MRD). MRD in patients with HR-NB can be evaluated by quantitating neuroblastoma-associated mRNAs (NB-mRNAs) in bone marrow (BM) and peripheral blood (PB) samples. Although several sets of NB-mRNAs have been shown to possess a prognostic value for MRD in BM samples (BM-MRD), MRD in PB samples (PB-MRD) is considered to be low and difficult to evaluate. The present report describes an HR-NB case presenting higher PB-MRD than BM-MRD before 1st and 2nd relapse/regrowth. A 3-year-old female presented with an abdominal mass, was diagnosed with HR-NB, and treated according to the nationwide standard protocol for HR-NB. Following systemic induction and consolidation therapy with local therapy, the patient achieved complete remission but experienced a 1st relapse/regrowth 6 months after maintenance therapy. The patient partially responded to salvage chemotherapy and anti-GD2 immunotherapy but had a 2nd relapse/regrowth 14 months after the 1st relapse/regrowth. Consecutive PB-MRD and BM-MRD monitoring revealed that PB-MRD was lower than BM-MRD at diagnosis (100 times) and 1st and 2nd relapse/regrowth (1,000 and 3 times) but became higher than BM-MRD before 1st and 2nd relapse/regrowth. The present case highlights that PB-MRD can become higher than BM-MRD before relapse/regrowth of patients with HR-NB.2023年09月, Oncology letters, 26(3) (3), 369 - 369, 英語, 国際誌
- (公社)日本整形外科学会, 2023年09月, 日本整形外科学会雑誌, 97(9) (9), 613 - 613, 日本語Frontometaphyseal dysplasia type 1の遺伝学的診断と遺伝カウンセリング
- BACKGROUND: Proteinuria remission is the most significant predictive factor for kidney outcome in childhood IgA nephropathy (c-IgAN). Even if proteinuria remission can be obtained, some patients have recurrence of proteinuria in the long-term. METHODS: This is a retrospective analysis of 312 cases of proteinuria remission among 538 consecutive children with biopsy-proven IgAN from 1976 to 2013. To elucidate the incidence and factors related to recurrence of proteinuria in c-IgAN, we compare clinical and pathological findings between patients with and without recurrence of proteinuria. RESULTS: Among 312 patients with remission of proteinuria, 91 (29.2%) had recurrence of proteinuria within the observation period (median 8 years). Using a multivariate Cox regression analysis, significant factors associated with recurrence of proteinuria were onset age (HR 1.13 [95%CI: 1.05-1.22], P = 0.002) and presence of hematuria after proteinuria remission (HR 2.11 [95%CI: 1.30-3.45], P = 0.003). The Kaplan-Meier analysis showed significant differences in CKD G3a-G5-free survival between the patients with no-recurrence of proteinuria, recurrence of proteinuria and non-proteinuria remission (P < 0.0001, log-rank test). Kidney survival was 100% in no-recurrence of proteinuria, 92.2% in recurrence of proteinuria, and 65.6% in non-proteinuria remission at 15 years. Cox analyses adjusted by proteinuria remission showed that recurrence of proteinuria (HR 03.10e9 [95%CI: NA], P = 0.003) was a significant factor associated with progression to CKD G3a-G5 in all patients with c-IgAN. CONCLUSIONS: Approximately 30% of patients with proteinuria remission had recurrence of proteinuria regardless of treatment. Both remission and recurrence of proteinuria are significant prognostic factors for kidney outcome. A higher resolution version of the Graphical abstract is available as Supplementary information.2023年08月, Pediatric nephrology (Berlin, Germany), 英語, 国際誌研究論文(学術雑誌)
- Abstract Focal segmental glomerulosclerosis (FSGS) is a common glomerular injury leading to end-stage renal disease. Monogenic FSGS is primarily ascribed to decreased podocyte integrity. Variants between residues 184 and 245 of INF2, an actin assembly factor, produce the monogenic FSGS phenotype. Meanwhile, variants between residues 57 and 184 cause a dual-faceted disease involving peripheral neurons and podocytes (Charcot–Marie–Tooth CMT/FSGS). To understand the molecular basis for INF2 disorders, we compared structural and cytoskeletal effects of INF2 variants classified into two subgroups: One (G73D, V108D) causes the CMT/FSGS phenotype, and the other (T161N, N202S) produces monogenic FSGS. Molecular dynamics analysis revealed that all INF2 variants show distinct flexibility compared to the wild-type INF2 and could affect stability of an intramolecular interaction between their N- and C-terminal segments. Immunocytochemistry of cells expressing INF2 variants showed fewer actin stress fibers, and disorganization of cytoplasmic microtubule arrays. Notably, CMT/FSGS variants caused more prominent changes in mitochondrial distribution and fragmentation than FSGS variants and these changes correlated with the severity of cytoskeletal disruption. Our results indicate that CMT/FSGS variants are associated with more severe global cellular defects caused by disrupted cytoskeleton-organelle interactions than are FSGS variants. Further study is needed to clarify tissue-specific pathways and/or cellular functions implicated in FSGS and CMT phenotypesSpringer Science and Business Media LLC, 2023年07月, Scientific Reports, 13(1) (1)[査読有り]研究論文(学術雑誌)
- (一社)日本小児神経学会, 2023年07月, 脳と発達, 55(4) (4), 279 - 282, 英語
- (一社)日本小児神経学会, 2023年07月, 脳と発達, 55(4) (4), 279 - 282, 英語
- Elsevier {BV}, 2023年07月, Kidney International Reports, 英語[査読有り]研究論文(学術雑誌)
- BACKGROUND: Patients with severe IgA vasculitis with nephritis (IgAVN) typically receive aggressive therapy as an initial approach. We have consistently performed combination therapy including corticosteroids and immunosuppressants as initial therapy for severe IgAVN over a 20-year-plus period, with only minor changes to the treatment protocol. This study seeks to reveal the efficacy of combination therapy for severe IgAVN. METHODS: We retrospectively studied 50 Japanese children diagnosed between 1996 and 2019 with clinicopathologically severe IgAVN who were defined as ISKDC classification grade IIIb-V and/or serum albumin < 2.5 g/dL. RESULTS: The median age at the onset of IgAVN was 8.0 years (IQR: 6.0-10.0). At biopsy, 44% of patients had nephrotic syndrome and 14% had kidney dysfunction. All patients were treated with combination therapy after biopsy. Abnormal proteinuria resolved after initial therapy in all 50 patients. However, eight patients (16%) had recurrence of proteinuria. Abnormal proteinuria was again resolved in three of these patients with additional treatment. At the last follow-up (median 59.5 months; IQR, 26.2-84.2), the median urine protein-to-creatine ratio was 0.08 g/gCr (IQR, 0.05-0.15), and only one patient had kidney dysfunction. CONCLUSIONS: Combination therapy provided good kidney outcomes for Japanese children with severe IgAVN. Even including recurrent cases, the degree of proteinuria was slight, and kidney function was good at the last follow-up. A higher resolution version of the Graphical abstract is available as Supplementary information.2023年06月, Pediatric nephrology (Berlin, Germany), 英語, 国際誌研究論文(学術雑誌)
- (公社)日本医師会, 2023年06月, 日本医師会雑誌, 152(特別1) (特別1), S146 - S150, 日本語【遺伝を考える】(II章)遺伝学的診断 個別診療分野における遺伝学的診断の進歩 腎・泌尿器領域
- (一社)日本遺伝カウンセリング学会, 2023年06月, 日本遺伝カウンセリング学会誌, 44(2) (2), 139 - 139, 日本語
- (一社)日本遺伝カウンセリング学会, 2023年06月, 日本遺伝カウンセリング学会誌, 44(2) (2), 149 - 149, 日本語
- (一社)日本遺伝カウンセリング学会, 2023年06月, 日本遺伝カウンセリング学会誌, 44(2) (2), 156 - 156, 日本語
- (一社)日本遺伝カウンセリング学会, 2023年06月, 日本遺伝カウンセリング学会誌, 44(2) (2), 163 - 163, 日本語
- (一社)日本遺伝カウンセリング学会, 2023年06月, 日本遺伝カウンセリング学会誌, 44(2) (2), 117 - 117, 日本語
- 大阪小児科学会, 2023年06月, 大阪小児科学会誌, 40(2) (2), 9 - 9, 日本語新生児期に低ナトリウム血症を来した常染色体潜性多発性嚢胞腎の症例
- OBJECTIVE: Hemorrhagic shock and encephalopathy syndrome (HSES) is a serious condition that requires intensive care and is associated with a high mortality rate. However, its pathogenesis remains unclear. In the present study, a genetic analysis was performed to determine the genetic background of patients with clinically suspected Dravet syndrome (DS) who developed HSES. METHODS: Whole exome sequencing was performed, followed by minigene analysis of the intron variant detected by whole exome sequencing to confirm its effect on splicing. RESULTS: Whole exome sequencing revealed a novel 21-bp deletion in intron 3 of SCN1A NM_001165963.4 (NC_000002.11:g.166073675_166073695del). This deletion was not found in the patient's parents and was proven to be de novo. Minigene analysis revealed an aberrant mRNA lacking 40 and 106 bp from the 5' end of exon 4 of SCN1A. Therefore, we diagnosed this case as DS due to the deletion in intron 3 of SCN1A. CONCLUSIONS: We report a case of DS with HSES caused by a 21-bp deletion in the intron of SCN1A that was confirmed by minigene analysis. The present case met Levin's criteria for HSES and the splicing analysis of SCN1A is an important finding. This study has important implications for understanding HSES pathogenesis.2023年06月, Brain & development, 45(6) (6), 317 - 323, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Fabry disease is an X-linked lysosomal storage disorder caused by insufficient α-galactosidase A (GLA) activity resulting from variants in the GLA gene, which leads to glycosphingolipid accumulation and life-threatening, multi-organ complications. Approximately 50 variants have been reported that cause splicing abnormalities in GLA. Most were found within canonical splice sites, which are highly conserved GT and AG splice acceptor and donor dinucleotides, whereas one-third were located outside canonical splice sites, making it difficult to interpret their pathogenicity. In this study, we aimed to investigate the genetic pathogenicity of variants located in non-canonical splice sites within the GLA gene. METHODS: 13 variants, including four deep intronic variants, were selected from the Human Gene Variant Database Professional. We performed an in vitro splicing assay to identify splicing abnormalities in the variants. RESULTS: All candidate non-canonical splice site variants in GLA caused aberrant splicing. Additionally, all but one variant was protein-truncating. The four deep intronic variants generated abnormal transcripts, including a cryptic exon, as well as normal transcripts, with the proportion of each differing in a cell-specific manner. CONCLUSIONS: Validation of splicing effects using an in vitro splicing assay is useful for confirming pathogenicity and determining associations with clinical phenotypes.2023年05月, Clinical and experimental nephrology, 英語, 国内誌研究論文(学術雑誌)
- (公社)日本小児保健協会, 2023年05月, 小児保健研究, 82(講演集) (講演集), 138 - 138, 日本語
- (一社)日本小児神経学会, 2023年05月, 脳と発達, 55(Suppl.) (Suppl.), S284 - S284, 日本語3歳時の就寝時刻または睡眠時間と小学1年生の学力との関連 尼崎市の人口ベースの研究
- (一社)日本小児神経学会, 2023年05月, 脳と発達, 55(Suppl.) (Suppl.), S318 - S318, 日本語
- (公社)日本皮膚科学会, 2023年05月, 日本皮膚科学会雑誌, 133(5) (5), 1355 - 1355, 日本語母乳中に自己抗原反応性IgAが認められたNeonatal linear IgA bullous dermatosisの1例
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 95 - 95, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 96 - 96, 日本語X染色体連鎖型Alport症候群女性における、X染色体不活化パターン・表現型相関
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 96 - 96, 日本語LAMB2関連疾患における臨床的特徴と遺伝型・表現型相関
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 115 - 115, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 121 - 121, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 124 - 124, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 126 - 126, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 131 - 131, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 134 - 134, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 142 - 142, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 166 - 166, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 187 - 187, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 198 - 198, 日本語
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 238 - 238, 日本語COL4A5遺伝子におけるsplicing異常をきたすvariantsの特徴と臨床型との相関に関する研究
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 239 - 239, 日本語本邦における2型Bartter症候群の臨床的特徴とGenotype/Phenotype Correlation
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 260 - 260, 日本語CUBN異常症の遺伝学的特徴と臨床像
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 261 - 261, 日本語Podocalyxin異常に伴う腎炎発症機序の検討
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 261 - 261, 日本語当院で診断したMAFB異常4例と腎症に関する考察
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 262 - 262, 日本語X染色体連鎖型Alport症候群女性における,X染色体不活化・表現型相関
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 323 - 323, 日本語小児C3腎炎の後方視的検討
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 335 - 335, 日本語小児IgA腎症の肉眼的血尿発作に伴う急性腎障害発症に鉄とマクロファージが関与する 多機関共同研究
- (一社)日本小児神経学会, 2023年05月, 脳と発達, 55(Suppl.) (Suppl.), S302 - S302, 日本語
- (一社)日本小児神経学会, 2023年05月, 脳と発達, 55(Suppl.) (Suppl.), S319 - S319, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 94 - 94, 日本語
- (一社)日本小児腎臓病学会, 2023年05月, 日本小児腎臓病学会雑誌, 36(Suppl.) (Suppl.), 94 - 94, 日本語
- While 44-83% of children with steroid-resistant nephrotic syndrome (SRNS) without a proven genetic cause respond to treatment with a calcineurin inhibitor (CNI), current guidelines recommend against the use of immunosuppression in monogenic SRNS. This is despite existing evidence suggesting that remission with CNI treatment is possible and can improve prognosis in some cases of monogenic SRNS. Herein, our retrospective study assessed response frequency, predictors of response and kidney function outcomes among children with monogenic SRNS treated with a CNI for at least three months. Data from 203 cases (age 0-18 years) were collected from 37 pediatric nephrology centers. Variant pathogenicity was reviewed by a geneticist, and 122 patients with a pathogenic and 19 with a possible pathogenic genotype were included in the analysis. After six months of treatment and at last visit, 27.6% and 22.5% of all patients respectively, demonstrated partial or full response. Achievement of at least partial response at six months of treatment conferred a significant reduction in kidney failure risk at last follow-up compared to no response (hazard ratio [95% confidence interval] 0.25, [0.10-0.62]). Moreover, risk of kidney failure was significantly lower when only those with a follow-up longer than two years were considered (hazard ratio 0.35, [0.14-0.91]). Higher serum albumin level at CNI initiation was the only factor related to increased likelihood of significant remission at six months (odds ratio [95% confidence interval] 1.16, [1.08-1.24]). Thus, our findings justify a treatment trial with a CNI also in children with monogenic SRNS.2023年05月, Kidney international, 103(5) (5), 962 - 972, 英語, 国際誌研究論文(学術雑誌)
- [This corrects the article DOI: 10.1016/j.ekir.2021.12.037.].2023年05月, Kidney international reports, 8(5) (5), 1127 - 1129, 英語, 国際誌
- Pediatric steroid-sensitive nephrotic syndrome (pSSNS) is the most common childhood glomerular disease. Previous genome-wide association studies (GWAS) identified a risk locus in the HLA Class II region and three additional independent risk loci. But the genetic architecture of pSSNS, and its genetically driven pathobiology, is largely unknown. Here, we conduct a multi-population GWAS meta-analysis in 38,463 participants (2440 cases). We then conduct conditional analyses and population specific GWAS. We discover twelve significant associations-eight from the multi-population meta-analysis (four novel), two from the multi-population conditional analysis (one novel), and two additional novel loci from the European meta-analysis. Fine-mapping implicates specific amino acid haplotypes in HLA-DQA1 and HLA-DQB1 driving the HLA Class II risk locus. Non-HLA loci colocalize with eQTLs of monocytes and numerous T-cell subsets in independent datasets. Colocalization with kidney eQTLs is lacking but overlap with kidney cell open chromatin suggests an uncharacterized disease mechanism in kidney cells. A polygenic risk score (PRS) associates with earlier disease onset. Altogether, these discoveries expand our knowledge of pSSNS genetic architecture across populations and provide cell-specific insights into its molecular drivers. Evaluating these associations in additional cohorts will refine our understanding of population specificity, heterogeneity, and clinical and molecular associations.2023年04月, Nature communications, 14(1) (1), 2481 - 2481, 英語, 国際誌研究論文(学術雑誌)
- A Japanese boy developed nephrotic syndrome (NS) and had microscopic hematuria at 8 years old. Renal biopsy was performed. Light microscopy study revealed mesangial proliferation and all immunofluorescent stains (including IgA) were negative, so he was diagnosed with non-IgA diffuse mesangial proliferation (DMP). Complete remission was achieved at 13 days after the initiation of oral prednisolone, and hematuria also disappeared 3 days later, but the patient developed frequently relapsing nephrotic syndrome. Cyclosporine A (CyA) was introduced at 10 years old, and there were no relapses between then and when it was discontinued at 12 years old. A second renal biopsy revealed minimal change without CyA nephrotoxicity. However, there was repeated relapse of NS after discontinuation, so CyA was reintroduced 8 months later, and NS remained in remission thereafter. Microscopic hematuria appeared at 13 years old, however, with gross hematuria appearing at the time of infection. A third renal biopsy revealed mesangial proliferation with IgA-dominant deposition, so the patient was diagnosed with IgA nephropathy. Currently (14 years old), CyA treatment has been discontinued and the patient is undergoing lisinopril therapy for IgA nephropathy, but there are still relapses of NS. To the best of our knowledge, there have been no previous reports of a patient with non-IgA DMP at the onset of NS who had later development of IgA nephropathy. The patient showed non-IgA DMP at the onset, suggesting that NS with non-IgA DMP and IgA nephropathy has some common pathophysiology. Treatment for NS, such as PSL and/or CyA treatment, may suppress the clinical manifestation of late IgA nephropathy.2023年04月, CEN case reports, 英語, 国内誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 618 - 618, 日本語サイトメガロウイルス既感染母体から出生し,尿濾紙スクリーニング検査を契機に診断に至った症候性サイトメガロウイルス感染症の1新生児例
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 628 - 628, 日本語当院での脳症関連遺伝子パネルを用いた疾患関連遺伝子の同定の試み
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 626 - 627, 日本語新型コロナワクチン接種後に血尿を伴うネフローゼ症候群を発症した1例
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 633 - 633, 日本語Acetazolamide内服と生活指導で発作予防可能であった低カリウム性周期性四肢麻痺の1例
- (株)診断と治療社, 2023年04月, 小児科診療, 86(春増刊) (春増刊), 737 - 738, 日本語
- 発達腎研究会, 2023年04月, 発達腎研究会誌, 30(1) (1), 15 - 16, 日本語当院で診断したMAFB異常4例のまとめと腎症に関する考察
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 625 - 625, 日本語汎血球減少と斜指を契機に診断したMECOM関連症候群の女児
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 632 - 632, 日本語血性鼻汁をきっかけに診断したLCHの男児
- (一社)日本小児栄養消化器肝臓学会, 2023年04月, 日本小児栄養消化器肝臓学会雑誌, 37(1) (1), 35 - 35, 日本語
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 627 - 627, 日本語COVID-19感染症を契機に急性増悪した全身型重症筋無力症の女児例
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 621 - 621, 日本語アダリムマブを導入した潰瘍性大腸炎の12歳男児例
- (公社)日本小児科学会, 2023年04月, 日本小児科学会雑誌, 127(4) (4), 625 - 626, 日本語一過性の細胞免疫不全所見を認めた超早期発症型炎症性腸疾患の1例
- (一社)日本小児栄養消化器肝臓学会, 2023年04月, 日本小児栄養消化器肝臓学会雑誌, 37(1) (1), 35 - 35, 日本語
- The authors wish to make the following correction to this paper [...].2023年03月, Genes, 14(3) (3), 英語, 国際誌
- We report here a fatal oligohydramnios case, which was suspected due to autosomal recessive polycystic kidney disease at first, but genetic analysis using chorionic tissue and umbilical cord after stillbirth led to the diagnosis of 17q12 deletion syndrome. Subsequent genetic analysis of the parents showed no 17q12 deletion. In this case, if the fetus had autosomal recessive polycystic kidney disease, the recurrence rate in the next pregnancy was suspected to be 25%, but since it was a de novo autosomal dominant disorder, the recurrence rate is extremely low. When a fetal dysmorphic abnormality is detected, a genetic autopsy not only helps to understand the cause but also provides information about the recurrence rate. This information is important for the next pregnancy. A genetic autopsy is useful in cases of fetal deaths or abortions resulting from fetal dysmorphic abnormalities.2023年03月, The journal of obstetrics and gynaecology research, 英語, 国際誌
- 2023年03月, RENAL REPLACEMENT THERAPY, 9(1) (1), 英語研究論文(学術雑誌)
- BACKGROUND AND OBJECTIVES: The evident genotype-phenotype correlation shown by the X-linked Alport syndrome warrants the assessment of the impact of identified gene variants on aberrant splicing. We previously reported that single nucleotide variants (SNVs) in the last nucleotide of exons in COL4A5 cause aberrant splicing. It is known that the nucleotides located 2nd and 3rd to the last nucleotides of exons can also play an essential role in the first step of the splicing process. In this study, we aimed to investigate whether SNVs positioned 2nd or 3rd to the last nucleotide of exons in COL4A5 resulted in aberrant splicing. METHODS: We selected eight candidate variants: six from the Human Gene Variant Database Professional and two from our cohort. We performed an in-vitro splicing assay and reverse transcription-polymerase chain reaction (RT-PCR) for messenger RNA obtained from patients, if available. RESULTS: The candidate variants were initially classified into the following groups: three nonsense, two missense, and three synonymous variants. Splicing assays and RT-PCR for messenger RNA revealed that six of the eight variants caused aberrant splicing. Four variants, initially classified as non-truncating variants, were found to be truncating ones, which usually show relatively more severe phenotypes. CONCLUSION: We revealed that exonic SNVs positioned 2nd or 3rd to the last nucleotide of exons in the COL4A5 were responsible for aberrant splicing. The results of our study suggest that attention should be paid when interpreting the pathogenicity of exonic SNVs near the 5' splice site.2023年03月, Clinical and experimental nephrology, 27(3) (3), 218 - 226, 英語, 国内誌研究論文(学術雑誌)
- Abstract Bartter syndrome type 1 is caused by mutations in the solute carrier family 12 member 1 (SLC12A1), encoding the sodium-potassium-chloride cotransporter-2 (NKCC2). In addition to causing renal salt-losing tubulopathy, SLC12A1 mutations are known to cause nephrocalcinosis due to hypercalciuria, as well as failure to thrive associated with abnormal calcium and phosphorus homeostasis. We report a now 7-year-old Japanese girl with polyuria, hyponatremia, hypokalemia, and metabolic alkalosis, in whom compound heterozygous novel SLC12A1 mutations were identified. Elevated parathyroid hormone (PTH) levels were consistently noted after the age of 1 year in conjunction with gradually declining serum calcium and increasing serum phosphorus levels. To confirm suspected PTH-resistance, Ellsworth Howard tests were performed at the ages of 6 years 8 months and 6 years 10 months in the absence or presence of ibuprofen, respectively. Urinary adenosine 3′,5′-cyclic monophosphate excretion increased on both occasions in response to PTH(1-34) infusion suggesting pseudohypoparathyroidism type II. However, only during treatment with ibuprofen did PTH induce an almost normal phosphaturic response. The nonsteroidal anti-inflammatory drugs thus enhanced growth velocity, alleviated hypercalciuria, and increased PTH-stimulated urinary phosphorus excretion without significantly affecting renal function.The Endocrine Society, 2023年02月, JCEM Case Reports, 1(2) (2), 英語[査読有り]研究論文(学術雑誌)
- 2023年02月, Journal of nephrology, 1 - 4, 英語, 国際誌研究論文(学術雑誌)
- We report a case of vertical transmission of Coxsackievirus (CV)-A6 with severe congenital pneumonia/sepsis. A male infant presented with severe respiratory symptoms at birth and was treated with full cardiopulmonary support, including inhaled nitric oxide. Three days before delivery, his older brother was diagnosed with hand, foot, and mouth disease (HFMD). His mother developed transient fever 1 day before delivery and presented a blister on her thumb 2 days after delivery. A multiplex polymerase chain reaction test on day 2 was positive for human rhinovirus/enterovirus. CV-A6 was later detected in the serum, tracheal aspirate, and stool of the patient sampled on day 6, and in the maternal serum sampled on the day of delivery. He was diagnosed with congenital CV-A6 pneumonia/sepsis caused by vertical transmission, based on VP1 consensus sequences used for typing of the virus that demonstrated a 100% match between the mother and infant. Further, the strain was closely related to the lethal CV-A6-Changchun strains in the phylogenetic analysis of the P2 region, which contributes to the pathogenicity. In conclusion, congenital CV-A6 infection should be considered if a woman exhibits HFMD symptoms during the perinatal period. Detailed virologic examination is useful for understanding its pathogenesis.2023年02月, International journal of environmental research and public health, 20(4) (4), 英語, 国際誌
- (公社)日本小児科学会, 2023年02月, 日本小児科学会雑誌, 127(2) (2), 204 - 204, 日本語AVPR2ヘテロ接合体バリアントを持つ女性における,X染色体不活性化パターンと腎性尿崩症の発症との相関
- (公社)日本小児科学会, 2023年02月, 日本小児科学会雑誌, 127(2) (2), 251 - 251, 日本語COL4A5遺伝子のイントロン+3から+5のバリアントにおける病原性の有無の検討
- (公社)日本小児科学会, 2023年02月, 日本小児科学会雑誌, 127(2) (2), 305 - 305, 日本語非IgA型びまん性メサンギウム増殖発症の頻回再発型ネフローゼ症候群治療経過中にIgA腎症を発症した1例
- (株)総合医学社, 2023年02月, 小児科臨床, 76(1) (1), 61 - 65, 日本語
- We evaluated kidney histology in a 43-year-old woman with autosomal dominant tubulointerstitial kidney disease subtype hepatocyte nuclear factor 1β. Magnetic resonance imaging showed multiple cysts in the renal medullary area, and computed tomography showed hypoplasia of the pancreatic body and tail. A kidney biopsy showed thinning of the cortex, size reduction of glomerular tuft area, proximal tubule clustering, fibrosis around the tubules, loss of peritubular capillaries, and multilayered epithelial cells of cortical collecting ducts; this last finding was consistent with so-called medullary dysplasia specific to congenital disease, in which the renal pelvic epithelial cells enter the collecting duct.2023年02月, Internal medicine (Tokyo, Japan), 62(3) (3), 419 - 422, 英語, 国内誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2023年02月, 日本小児科学会雑誌, 127(2) (2), 190 - 190, 日本語生後2ヵ月以内の症候性先天性サイトメガロウイルス感染症児を対象とした経口バルガンシクロビル治療 医師主導治験の結果
- BACKGROUND: Patients with complex febrile seizures (CFS) often display abnormal laboratory results, unexpectedly prolonged seizures, and/or altered consciousness after admission. However, no standardized values have been established for the clinical and laboratory characteristics of CFS in the acute phase, making the management of CFS challenging. This study aimed to determine the clinical and laboratory characteristics of children with CFS during the acute phase. In particular, the duration of impaired consciousness and the detailed distribution of blood test values were focused. METHODS: We retrospectively reviewed medical records of a consecutive pediatric cohort aged 6-60 months who were diagnosed with CFS and admitted to Kobe Children's Hospital between October 2002 and March 2017. During the study period, 486 seizure episodes with confirmed CFS were initially reviewed, with 317 seizure episodes included in the analysis. Detailed clinical and laboratory characteristics were summarized. RESULTS: Among 317 seizure episodes (296 children with CFS), 302 required two or fewer anticonvulsants to be terminated. In 296 episodes showing convulsive seizures, median seizure duration was 30.5 min. The median time from onset to consciousness recovery was 175 min. Impaired consciousness lasting > 6, 8, and 12 h was observed in 13.9%, 7.6%, and 1.9% patients with CFS, respectively. Additionally, the distribution of aspartate aminotransferase, lactate dehydrogenase, creatinine, and glucose were clarified with 3, 10, 50, 90, and 97 percentile values. CONCLUSION: This study detailed the clinical and laboratory findings of acute-phase CFS using the data of the largest 15-year consecutive cohort of children with CFS. These results provide important information for appropriate acute management of CFS.2023年01月, BMC neurology, 23(1) (1), 28 - 28, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Cytokine levels have been measured in acute encephalopathy (AE) to determine its pathology or as a diagnostic biomarker to distinguish it from febrile seizures (FS); however, the dynamics of cytokine level changes have not yet been fully captured in these two neurological manifestations. Thus, we aimed to explore the time course of serum cytokine level changes within 72 h after onset in AE and FS. METHODS: We retrospectively measured cytokine level in residual serum samples at multiple timepoints in seven children whose final diagnoses were AE or FS. RESULTS: The levels of 13 cytokines appeared to increase immediately after onset and peaked within 12-24 h after onset: interleukin (IL)-1β, IL-4 IL-5, IL-6, IL-8, IL-10, IL-17, eotaxin, fibroblast growth factor, granulocyte colony-stimulating factor, interferon gamma, interferon-inducible protein-10, and macrophage chemoattractant protein-1. There were no dynamic changes in the levels of three cytokines (IL-1 receptor agonist, macrophage inflammatory protein-1α, and platelet-derived growth factor-bb) 72 h after onset. Levels of some cytokines decreased to around control levels within 48 h after onset: IL-1β, IL-4, IL-5, IL-17, fibroblast growth factor, and interferon gamma. The levels of most cytokines appeared to be higher in AE, especially in hemorrhagic shock encephalopathy syndrome, than in FS. CONCLUSIONS: Cytokine levels in both AE and FS change dynamically, such as the levels of several cytokines increased within a few hours after onset and decreased at 12-24 h after onset. Therefore, it will be desirable to make clinical decisions regarding the administration of anti-inflammatory therapy in 24 h after onset in AE.2023年01月, BMC neurology, 23(1) (1), 7 - 7, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2023年, 日本小児腎臓病学会雑誌, 36, 53 - 53, 日本語
- (一社)日本小児腎臓病学会, 2023年, 日本小児腎臓病学会雑誌, 36, 53 - 54, 日本語
- 兵庫県小児科医会, 2023年, 兵庫県小児科医会報, (79) (79), 13 - 17, 日本語
- Our goal was to conduct a scoping review of the literature on the treatment of infection-triggered encephalopathy syndrome/acute encephalopathy in children, focusing on treatment targets and treatment initiation timing. We performed literature searches using PubMed for articles reporting treatments of infection-triggered encephalopathy syndrome/acute encephalopathy. We included articles describing specific treatments for acute encephalopathy with control groups. For the purpose of searching new therapies only experimentally tried in the case series, we also included case series studies without control groups in this review, if the studies contained at least two cases with clear treatment goals. Therapies were classified based on their mechanisms of action into brain protection therapy, immunotherapy, and other therapies. We operationally categorized the timing of treatment initiation as T1 (6-12 h), T2 (12-24 h), T3 (24-48 h), and T4 (>48 h) after the onset of seizures and/or impaired consciousness. Thirty articles were included in this review; no randomized control study was found. Eleven retrospective/historical cohort studies and five case-control studies included control groups with or without specific therapies or outcomes. The targeted conditions and treatment timing varied widely across studies. However, the following three points were suggested to be effective in multiple studies: (1) Careful seizure management and targeted temperature management within 12 h (T1) of onset of febrile seizure/prolonged impaired consciousness without multiple organ failure may reduce the development of acute encephalopathy with biphasic seizures and late reduced diffusion; (2) immunotherapy using corticosteroids, tocilizumab, or plasma exchange within 24 h (T1-T2) of onset of acute necrotizing encephalopathy may reduce sequelae; and (3) anakinra therapy and ketogenic diet demonstrate little evidence of neurologic sequelae reduction, but may reduce seizure frequency and allow for weaning from barbiturates, even when administered weeks (T4) after onset in children with febrile infection-related epilepsy syndrome. Although available studies have no solid evidence in the treatment of infection-triggered encephalopathy syndrome/acute encephalopathy, this scoping review lays the groundwork for future prospective clinical trials.2023年, Frontiers in neuroscience, 17, 1150868 - 1150868, 英語, 国際誌研究論文(学術雑誌)
- We encountered a case with congenital iris coloboma, omphalocele, and developmental delay with a 2.5 Mb deletion on chromosome 4q25 encompassing PITX2, leading to Axenfeld-Rieger syndrome (ARS), NEUROG2, and ANK2. ARS is characterized by the aplasia of the anterior eye, odontogenesis, and abdominal wall aplasia. In our case, iris coloboma and omphalocele were thought to be caused by PITX2 haploinsufficiency. However, these symptoms are nonspecific, and clinical symptoms alone can make it difficult to make a correct diagnosis. In addition, the genes responsible for developmental delay, among others, are not well understood. Developmental delay, in this case, might be caused due to NEUROG2 haploinsufficiency. In spite of the partial deletion of ANK2, the causative gene of long QT syndrome type 4, the electrocardiogram was normal. Genetic testing can lead to a correct diagnosis, and it may be effective in detecting complications.2023年, Case reports in genetics, 2023, 4592114 - 4592114, 英語, 国際誌
- BACKGROUND: Prospective research of children receiving heterogeneous vaccines has shown that immunization is not associated with pediatric idiopathic nephrotic syndrome (NS) relapses. However, prospective data concentrating only on influenza (flu) virus vaccines are not available. METHODS: This multicenter prospective study was conducted in children with NS who received inactivated flu vaccines from June 2017 to July 2018. The day of flu vaccination was defined as day 0, and the period between prevaccination and postvaccination days was defined as - X to + Y (period from day - 180 to 0 as the precontrolled period). The primary outcome was the NS relapse rate from day 0 to + 30 as a direct association with vaccination compared with those in the precontrolled period. Exacerbation was defined as children experiencing more NS relapses after vaccination compared with those in the precontrolled period, or children starting any new immunosuppressants due to NS relapse after vaccination. RESULTS: Sixty-three children were included. Relapse rates were not significantly different between the precontrolled period and 0 to + 30 periods (0.38 vs. 0.19 times/person-year, p = 0.95). Although the exacerbation rate during the 0 to + 180 period in children without NS relapse in the precontrolled period was very low (4/54 [7.4 %]), children with at least one NS relapse in the precontrolled period showed a remarkable increase in the rate (4/9 [44.4%]; p = 0.01). CONCLUSIONS: Flu vaccination did not significantly precipitate the direct relapse of NS in children. However, it might increase the disease activity in children with at least one NS relapse within a half year before vaccination. A higher resolution version of the Graphical abstract is available as Supplementary information.2022年11月, Pediatric nephrology (Berlin, Germany), 38(7) (7), 1 - 10, 英語, 国際誌研究論文(学術雑誌)
- Spinal muscular atrophy (SMA) is a common devastating neuromuscular disorder, usually involving homozygous deletion of the SMN1 gene. Newly developed drugs can improve the motor functions of infants with SMA when treated in the early stage. To ensure early diagnosis, newborn screening for SMA (SMA-NBS) via PCR-based genetic testing with dried blood spots (DBSs) has been spreading throughout Japan. In Hyogo Prefecture, we performed a pilot study of SMA-NBS to assess newborn infants who underwent routine newborn metabolic screening between February 2021 and August 2022. Hyogo Prefecture has ~40,000 live births per year and the estimated incidence of SMA is 1 in 20,000-25,000 based on genetic testing of symptomatic patients with SMA. Here, we screened 8336 newborns and 12 screen-positive cases were detected by real-time PCR assay. Multiplex ligation-dependent probe amplification assay excluded ten false positives and identified two patients. These false positives might be related to the use of heparinized and/or diluted blood in the DBS sample. Both patients carried two copies of SMN2, one was asymptomatic and the other was symptomatic at the time of diagnosis. SMA-NBS enables us to prevent delayed diagnosis of SMA, even if it does not always allow treatment in the pre-symptomatic stage.2022年11月, Genes, 13(11) (11), 英語, 国際誌研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2022年11月, 日本小児腎臓病学会雑誌, 35(2) (2), 167 - 167, 日本語
- (一社)日本小児腎臓病学会, 2022年11月, 日本小児腎臓病学会雑誌, 35(2) (2), 159 - 159, 日本語
- (一社)日本小児腎臓病学会, 2022年11月, 日本小児腎臓病学会雑誌, 35(2) (2), 170 - 170, 日本語
- Rotavirus (RV) is the leading cause of acute gastroenteritis (AGE), particularly in infants. In 2006, the high efficacy of oral RV vaccines (RVVs, RotarixTM and RotaTeqTM) was demonstrated. Voluntary RVV started in Japan in 2011, and in October 2020 were launched as universal oral RVVs in Japan. However, the impact of changes from voluntary to universal RVVs has not been studied in a primary emergency medical center in Japan. We investigated changes in the number of pediatric patients with AGE after introducing universal RVVs in our center. A clinical database of consecutive patients aged <16 who presented to Kobe Children's Primary Emergency Medical Center between 1 April 2016 and 30 June 2022 was reviewed. After implementing universal RVVs, fewer children presented with RV-associated AGE (the reduction of proportion of the patients in 2022 was -61.7% (all ages), -57.9% (<1 years), -67.8% (1-<3 years), and -61.4% (3-<5 years) compared to 2019). A similar decrease in those of age who were not covered by the universal RVV was observed. There was a significant decline in the number of patients with AGE during the RV season who presented to the emergency department after implementing universal RVVs.2022年10月, Vaccines, 10(11) (11), 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Free bilirubin (Bf) is a better marker than total serum bilirubin (TSB) for predicting bilirubin encephalopathy (BE). To date, two UGT1A1 genetic variants (rs4148323 and rs3064744) have been associated with neonatal hyperbilirubinemia; however, the direct association between UGT1A1 variants and Bf levels in newborns has not been elucidated. METHODS: We retrospectively analyzed the clinical data of 484 infants, including the genotype data of two UGT1A1 genetic variants. We divided the infants into a high Bf group (Bf ≥ 1.0 µg/dL, n = 77) and a non-high Bf group (Bf < 1.0 µg/dL, n = 407), based on the peak Bf values. Logistic regression analysis was performed to calculate the odds ratios (ORs) for each variant allele compared to wild-type alleles. RESULTS: The frequencies of the A allele in rs4148323 and (TA)7 allele in rs3064744 in the high Bf group (29% and 4%, respectively) were significantly different from those in the non-high Bf group (16% and 12%, respectively). In logistic regression analysis, for rs4148323, the A allele was significantly associated with an increased risk of hyper-free bilirubinemia over the G allele (adjusted OR: 1.80, 95% confidence interval [CI]: 1.19-2.72, p < 0.01). However, for rs3064744, the (TA)7 allele was significantly associated with a decreased risk of hyper-free bilirubinemia over the (TA)6 allele (adjusted OR: 0.42, 95% CI: 0.18-0.95, p = 0.04). CONCLUSIONS: This study is the first to show that the A allele in rs4148323 is a risk factor and that the (TA)7 allele in rs3064744 is a protective factor for developing hyper-free bilirubinemia in Japanese newborns.2022年10月, International journal of environmental research and public health, 19(20) (20), 英語, 国際誌研究論文(学術雑誌)
- (一社)日本腎臓学会, 2022年10月, 日本腎臓学会誌, 64(6-W) (6-W), 714 - 714, 日本語活性型Rac1蛋白の定量解析により診断した新規ARHGAP24遺伝子変異による小児巣状分節性糸球体硬化症の1例
- (一社)日本腎臓学会, 2022年10月, 日本腎臓学会誌, 64(6-W) (6-W), 731 - 731, 日本語濃厚な家族歴があり,両側多発腎嚢胞・肝膵嚢胞を有するAlport症候群の一例
- (株)総合医学社, 2022年10月, 小児科臨床, 75(5) (5), 773 - 793, 日本語
- (一社)日本先天代謝異常学会, 2022年10月, 日本先天代謝異常学会雑誌, 38, 193 - 193, 日本語死亡時のアシルカルニチン分析結果を契機に確定診断したグルタル酸血症2型の一例
- More than half of high-risk neuroblastoma (NB) patients have experienced relapse due to the activation of chemoresistant minimal residual disease (MRD) even though they are treated by high-dose chemotherapy with autologous peripheral blood stem cell (PBSC) transplantation. Although MRD in high-risk NB patients can be evaluated by quantitative PCR with several sets of neuroblastoma-associated mRNAs (NB-mRNAs), the prognostic significance of MRD in PBSC grafts (PBSC-MRD) is unclear. In the present study, we collected 20 PBSC grafts from 20 high-risk NB patients and evaluated PBSC-MRD detected by droplet digital PCR (ddPCR) with 7NB-mRNAs (CRMP1, DBH, DDC, GAP43, ISL1, PHOX2B, and TH mRNA). PBSC-MRD in 11 relapsed patients was significantly higher than that in 9 non-relapsed patients. Patients with a higher PBSC-MRD had a lower 3-year event-free survival (P = 0.0148). The present study suggests that PBSC-MRD detected by ddPCR with 7NB-mRNAs has a prognostic impact on high-risk NB patients.2022年10月, Heliyon, 8(10) (10), e10978, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Urinary screening for 3-year-olds cannot adequately detect congenital anomalies of the kidney and urinary tract (CAKUT). METHODS: Urinary screening for 3-year-olds was investigated over 30 years. Dipsticks for proteinuria, hematuria, glycosuria, leukocyturia, and nitrite at first screening, and dipsticks, urinary sediments, and renal ultrasonography at second screening were performed. Screening results were evaluated. RESULTS: The positive rates of proteinuria, hematuria, leukocyturia, and nitrite relative to 218,831 children at the first screening were 1.0%, 4.6%, 2.3%, and 0.88%, respectively. Thirty-seven glomerular disease, 122 CAKUT, and 5 urological disease cases were found. We detected 6 stage 3-4 chronic kidney disease (CKD) and 3 end-stage kidney disease cases, including 3 CAKUT, comprising 2 bilateral renal hypoplasia and 1 vesicoureteral reflux (VUR), and 6 glomerular diseases, comprising 4 focal segmental glomerulosclerosis and 2 Alport syndrome. The positive rates relative to 218,831 children and CKD detection rates for each tentative diagnosis of mild hematuria, severe hematuria, proteinuria and hematuria, proteinuria, and suspected urinary tract infection were 1.4% and 0.67%, 0.11% and 3.7%, 0.01% and 28.6%, 0.02% and 45.0%, and 0.08% and 9.7%, respectively. Among 14 VUR cases with significant bacteriuria, 13 were found by leukocyturia, 12 had grade ≥ IV VUR, and 10 had severe renal scars. CONCLUSIONS: Nine stage 3-5 CKD cases comprising 3 CAKUT and 6 glomerular disease were found by urinary screening of 3-year-olds among 218,831 children. The combination of urine dipsticks including leukocyturia at the first screening and ultrasonography at the second screening appeared useful.2022年09月, Clinical and experimental nephrology, 英語, 国内誌研究論文(学術雑誌)
- Gitelman syndrome (GS) is a rare, autosomal recessive, salt-losing tubulopathy caused by loss of function in the SLC12A3 gene (NM_000339.2), which encodes the natrium chloride cotransporter. The detection of homozygous or compound heterozygous SLC12A3 variants is expected in GS, but 18%-40% of patients with clinical GS carry only one mutant allele. Previous reports identified some pathogenic deep intronic variants in SLC12A3. Here, we report the screening of SLC12A3 deep intronic variants in 13 patients with suspected GS carrying one mutated SLC12A3 allele. Variant screening used the HaloPlex Target Enrichment System Kit capturing whole introns and the promotor region of SLC12A3, followed by SureCall variant analysis. Rare intronic variants (<1% frequency) were identified, and pathogenicity evaluated by the minigene system. Deep intronic variant screening detected seven rare SLC12A3 variants from six patients. Only one variant showed pathogenicity in the minigene system (c.602-16G>A, intron 4) through activation of a cryptic acceptor site. No variants were detected in the promotor region. Deep intronic screening identified only one pathogenic variant in patients with suspected GS carrying monoallelic SLC12A3 variants. Our results suggest that deep intronic variants partially explain the cause of monoallelic variants in patients with GS.2022年09月, American journal of medical genetics. Part A, 188(9) (9), 2576 - 2583, 英語, 国際誌研究論文(学術雑誌)
- (1) Background: Pseudohypoaldosteronism type 1 (PHA-1) is a disorder caused by renal tubular resistance to aldosterone and is characterized by problems with sodium regulation. PHA-1 is typically divided into primary PHA-1, which is caused by genetic mutation, and secondary PHA-1, which is associated with urinary tract abnormality. However, data on the clinical features of PHA-1 among newborn infants are limited. (2) Methods: We conducted a nationwide prospective surveillance study of neonatal PHA in Japan from 1 April 2019 to 31 March 2022 as part of a rare disease surveillance project of the Japan Society for Neonatal Health and Development. (3) Results: Fifteen cases (male:female = 7:8), including four primary, four secondary, and seven non-classified cases, were reported during the study period. The median gestational age and birthweight were 34 weeks (28-41) and 1852 g (516-4610), respectively. At the onset, the median serum Na and K levels were 132 mEq/L (117-137) and 6.3 mEq/L (4.7-8.3), respectively. The median plasma renin activity was 45 ng/mL/h (3.1-310, n = 9), active renin concentration was 1017 pg/mL (123-2909, n = 6), and serum aldosterone concentration was 5310 pg/mL (3250-43,700). (4) Conclusions: Neonatal PHA-1 was more common among preterm infants with no male predominance. It developed immediately after birth in cases without genetic or renal complications.2022年08月, Journal of clinical medicine, 11(17) (17), 英語, 国際誌研究論文(学術雑誌)
- Background: Approximately 30% of children with steroid-resistant nephrotic syndrome (SRNS) have causative monogenic variants. SRNS represents glomerular disease resulting from various etiologies, which lead to similar patterns of glomerular damage. Patients with SRNS mainly exhibit focal segmental glomerulosclerosis (FSGS). There is limited information regarding associations between histologic variants of FSGS (diagnosed using on the Columbia classification) and monogenic variant detection rates or clinical characteristics. Here, we report FSGS characteristics in a large population of affected patients. Methods: This retrospective study included 119 patients with FSGS, diagnosed using the Columbia classification; all had been referred to our hospital for genetic testing from 2016 to 2021. We conducted comprehensive gene screening of all patients using a targeted next-generation sequencing panel that included 62 podocyte-related genes. Data regarding patients' clinical characteristics and pathologic findings were obtained from referring clinicians. We analyzed the associations of histologic variants with clinical characteristics, kidney survival, and gene variant detection rates. Results: The distribution of histologic variants according to the Columbia classification was 45% (n=53) FSGS not otherwise specified, 21% (n=25) cellular, 15% (n=18) perihilar, 13% (n=16) collapsing, and 6% (n=7) tip. The median age at end stage kidney disease onset was 37 years; there were no differences in onset age among variants. We detected monogenic disease-causing variants involving 12 of the screened podocyte-related genes in 34% (40 of 119) of patients. The most common genes were WT1 (23%), INF2 (20%), TRPC6 (20%), and ACTN4 (10%). The perihilar and tip variants had the strongest and weakest associations with detection of monogenic variants (83% and 0%, respectively; P<0.001). Conclusions: We revealed the distributions of histologic variants of genetic FSGS and nongenetic FSGS in a large patient population. Detailed data concerning gene variants and pathologic findings are important for understanding the etiology of FSGS.2022年08月, Kidney360, 3(8) (8), 1384 - 1393, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本てんかん学会, 2022年08月, てんかん研究, 40(2) (2), 410 - 410, 日本語てんかん重積状態・急性脳症における疾患原因遺伝子の同定の試み
- 日本小児腎不全学会, 2022年08月, 日本小児腎不全学会雑誌, 42, 97 - 100, 日本語
- (一社)日本マススクリーニング学会, 2022年08月, 日本マス・スクリーニング学会誌, 32(2) (2), 233 - 233, 日本語
- (一社)日本筋学会, 2022年08月, 日本筋学会学術集会プログラム・抄録集, 8回, 120 - 120, 日本語福山型筋ジストロフィーのエラストグラフィーを用いた骨格筋画像評価
- 日本小児腎不全学会, 2022年08月, 日本小児腎不全学会雑誌, 42, 97 - 100, 日本語早期の遺伝学的検査が治療方針選択に有用であったステロイド抵抗性ネフローゼ症候群の1例
- BACKGROUND: Oligomeganephronia (OMN) is a rare congenital anomaly involving the kidney and urinary tract, characterized by decreased number and compensatory hypertrophy of the nephron. It is caused by abnormal kidney development during the embryonic period, especially in patients with low birth weight; however, the actual etiology and clinical features remain unknown. We aim to reveal the clinical and pathological characteristics, treatment, and outcome. METHODS: Ten patients diagnosed with OMN between 2013 and 2020 were retrospectively investigated. The data were presented as the median ± interquartile range, and statistical significance was set at p < 0.05. RESULTS: The age at diagnosis was 14.1 years, the male-to-female ratio was 6:4, and only four cases were born with low birth weight. The estimated glomerular filtration rate (eGFR) was 62.2 mL/min/1.73 m2. The glomerulus diameter of OMN patients was significantly larger (217 vs. 154 µm, p < 0.001) in OMN patients, and the number of glomeruli of OMN patients was lower (0.89 vs. 2.05/mm2, p < 0.001) than the control group. Eight of the ten cases were identified by urinary screening. Nine patients were treated with renin-angiotensin system (RAS) inhibitors, following which proteinuria successfully decreased or disappeared. Their median eGFR was also stable, 53.3 mL/min/1.73 m2. CONCLUSIONS: As few symptoms can lead to OMN discovery, most patients were found during urine screening at school. Kidney dysfunction was observed in all patients at the time of kidney biopsy. Proteinuria has been significantly reduced and the decline rate of eGFR might be improved by RAS inhibitors. "A higher resolution version of the Graphical abstract is available as Supplementary information".2022年07月, Pediatric nephrology (Berlin, Germany), 38(3) (3), 757 - 762, 英語, 国際誌研究論文(学術雑誌)
- Our aims were to determine the clinical impact of oral valganciclovir (VGCV) in infants aged ≤2 months with congenital cytomegalovirus (CMV) disease and evaluate the efficacy of VGCV when initiated beyond the neonatal period. The multicenter, single-arm, open-label clinical trial was conducted in Japan. Twenty-five infants aged ≤2 months with congenital CMV disease involving the central nervous system were enrolled and treated with VGCV for 6 months. The primary endpoint was the change in the whole blood CMV load before and after treatment. The secondary endpoint was the change in the auditory brainstem response (ABR) before and after treatment. Changes in ABR were assessed between the younger and older age groups (≤ and >30 days at treatment initiation). Of the 25 patients, one was excluded owing to epilepsy before VGCV administration. The median change in the CMV DNA level in whole blood was -246.0 IU/mL. The best ear and total ear assessments based on ABR were categorized as (improved + unchanged) after treatment for 100% and 93.8%, respectively. No differences in hearing efficacy were observed between the younger and older age groups. Oral VGCV is a potential therapeutic option for treating infants aged ≤2 months with congenital CMV disease.2022年06月, Journal of clinical medicine, 11(13) (13), 英語, 国際誌研究論文(学術雑誌)
- (有)科学評論社, 2022年06月, 腎臓内科, 15(6) (6), 633 - 643, 日本語【ポドサイトパチー】ポドサイト疾患の遺伝学的要因 遺伝性ポドサイト疾患とそのリスク因子
- BACKGROUND: Patients with immunoglobulin A nephropathy who present with focal mesangial proliferation (focal IgAN) can have a relatively good prognosis, and renin-angiotensin system inhibitor (RAS-i) is commonly used as the initial treatment. However, there are some complicated focal IgAN cases with resistance to RAS-i treatment or nephrotic-range proteinuria. Thus, combination therapy including corticosteroids is often used. This study aimed to evaluate the efficacy of combination therapy for complicated focal IgAN cases by comparing to diffuse mesangial proliferation (diffuse IgAN). METHODS: We conducted a multicenter retrospective study on 88 children who received 2-year combination therapy. The participants were classified based on pathological severity: focal IgAN (n = 26) and diffuse IgAN (n = 62). RESULTS: In total, 26 patients with focal IgAN and 52 with diffuse IgAN achieved proteinuria disappearance within 2 years (100 vs. 83.9%, P = 0.03). Moreover, the time to proteinuria disappearance was significantly shorter in the focal IgAN group than in the diffuse IgAN group (2.9 vs. 4.2 months, P < 0.01) and all patients with focal IgAN achieved proteinuria disappearance within 8 months. At the last observation (8.6 vs. 10.4 years, P = 0.13), only patients with diffuse IgAN (n = 12) had greater than stage 2 chronic kidney disease. In terms of irreversible adverse events, one patient exhibited cataracts. CONCLUSION: Combination therapy was significantly effective in patients with complicated focal IgAN. Moreover, the long-term prognosis was good, and the duration of combination therapy for complicated focal IgAN can be decreased to reduce adverse events.2022年06月, Clinical and experimental nephrology, 26(6) (6), 561 - 570, 英語, 国内誌研究論文(学術雑誌)
- Although preterm infant mortality is low, the proportion of patients with treatment-requiring retinopathy of prematurity (TR-ROP) is high in Japan. Various multicenter studies have reported the risk factors for TR-ROP; however, no large-scale studies have been conducted in Japan. We retrospectively analyzed 13,645 infants born at < 28 weeks' gestation (January 1, 2009-December 31, 2018), and registered in the Neonatal Research Network of Japan database. TR-ROP was defined as ROP requiring retinal laser photocoagulation and/or intravitreal anti-vasoendothelial growth factor drugs. Multivariable logistic regression analysis was performed to identify factors associated with TR-ROP development. The median gestational age of enrolled infants was 26 weeks (interquartile range [IQR], 24-27 weeks), median birth weight was 760 g (IQR, 620-918 g). Proportion of patients with TR-ROP was 30.3%. TR-ROP was significantly associated with birth at < 26 weeks' gestational age (adjusted odds ratio [aOR] 1.54), blood transfusion (aOR 1.49), invasive ventilation ≥ 28 days (aOR 1.41), sepsis (aOR 1.29), birth weight < 750 g (aOR 1.28), intraventricular hemorrhage (aOR 1.33), delayed achievement of full enteral feeding > 14 days (aOR 1.28), and continuous positive airway pressure (CPAP) therapy ≥ 28 days (aOR 0.79). Supplemental oxygen ≥ 28 days was not associated with TR-ROP development. Lower gestational age at birth and birth weight, blood transfusion, prolonged invasive ventilation, sepsis, intraventricular hemorrhage, and delayed achievement of full enteral feeding were risk factors for TR-ROP, whereas CPAP use was protective against TR-ROP.2022年05月, Scientific reports, 12(1) (1), 7799 - 7799, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本小児保健協会, 2022年05月, 小児保健研究, 81(講演集) (講演集), 152 - 152, 日本語
- (一社)日本小児神経学会, 2022年05月, 脳と発達, 54(Suppl.) (Suppl.), S251 - S251, 日本語
- (一社)日本小児神経学会, 2022年05月, 脳と発達, 54(Suppl.) (Suppl.), S252 - S252, 日本語
- (一社)日本小児神経学会, 2022年05月, 脳と発達, 54(Suppl.) (Suppl.), S317 - S317, 日本語
- 日本小児体液研究会, 2022年05月, 日本小児体液研究会誌, 14, 43 - 46, 日本語
- (一社)日本腎臓学会, 2022年05月, 日本腎臓学会誌, 64(3) (3), 180 - 180, 日本語遺伝子診断の臨床応用 Alport症候群
- (一社)日本腎臓学会, 2022年05月, 日本腎臓学会誌, 64(3) (3), 219 - 219, 日本語OCRL遺伝子splicing異常による疾患発症メカニズムの検討
- (一社)日本腎臓学会, 2022年05月, 日本腎臓学会誌, 64(3) (3), 231 - 231, 日本語当院小児科の腎疾患患者の新型コロナウイルスワクチン接種状況
- (一社)日本腎臓学会, 2022年05月, 日本腎臓学会誌, 64(3) (3), 231 - 231, 日本語COL4A5遺伝子エクソン内3'末端から2・3番目の一塩基置換は高率にスプライシング異常を来す
- (一社)日本腎臓学会, 2022年05月, 日本腎臓学会誌, 64(3) (3), 231 - 231, 日本語Alport症候群モデルマウスにおけるエクソンスキッピング療法の信頼性保証試験成績報告
- (一社)日本腎臓学会, 2022年05月, 日本腎臓学会誌, 64(3) (3), 242 - 242, 日本語ステロイド感受性ネフローゼ症候群初発時にはSwitched memory B細胞の増加を認める
- (一社)日本小児神経学会, 2022年05月, 脳と発達, 54(Suppl.) (Suppl.), S210 - S210, 日本語
- (有)科学評論社, 2022年05月, 腎臓内科, 15(5) (5), 530 - 535, 日本語【腎臓とミトコンドリア】他の疾患と思われていたがミトコンドリア病であった症例
- (一社)日本腎臓学会, 2022年05月, 日本腎臓学会誌, 64(3) (3), 269 - 269, 日本語重度小児IgA腎症に対するプレドニゾロン、ミゾリビン、リシノプリルを用いた多剤併用療法の有効性
- A 34-year-old man visited our Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, because of dry mouth and weight loss. His plasma glucose level was 32.8 mmol/L and serum levels of ketone bodies were increased, but with metabolic alkalemia. He was also suffering from renal tubular hypomagnesemia and hypokalemia. Abdominal computed tomography showed bilateral renal cysts. These findings were suggestive of maturity-onset diabetes of the young type 5. Genetic testing showed heterozygous hepatocyte nuclear factor 1 beta gene deletion. In the present case, it seemed reasonable to view hepatocyte nuclear factor 1 beta gene deletion as the common cause of maturity-onset diabetes of the young type 5-associated diabetic ketoacidosis and tubular malfunction-induced hypokalemic alkalosis. This case exemplifies the importance of hepatocyte nuclear factor 1 beta gene abnormality as a potential cause of diabetic ketoacidosis with alkalemia.2022年05月, Journal of diabetes investigation, 13(5) (5), 923 - 926, 英語, 国内誌
- BACKGROUND: Cases with asymptomatic proteinuria (ASP) not manifesting nephrotic syndrome often pathologically show focal segmental glomerulosclerosis (FSGS). However, characteristics of those cases had not been intensively studied so far. METHODS: We retrospectively reviewed clinical, pathological, and genetic characteristics of 37 children (median age, 9.3 years) who underwent renal biopsy for persistent isolated proteinuria (urine protein-to-creatinine ratio: UP/C, > 0.2 g/g) between 2003 and 2019. Targeted next-generation sequencing (NGS) was utilized for all patients with FSGS, excluding those with secondary FSGS. RESULTS: At biopsy, all patients with FSGS (N = 14) had UP/C ≥ 0.5 g/g and the median UP/C was significantly higher in those with FSGS than those with minor glomerular abnormalities (MGA) (N = 23) (1.49 vs. 0.53 g/g, P < 0.001). Causative variants were found in seven patients with FSGS (TRPC6, WT1, ACTN4, and INF2 in 3, 2, 1, and 1 patient, respectively): all gene variants were in genes manifesting autosomal dominant inheritance mode. The proportion of the perihilar variant was significantly higher in the genetic FSGS patients than in the non-genetic FSGS patients (4/7 vs. 0/7, P < 0.05). Kaplan-Meier analysis showed that the renal survival rate after ASP diagnosis was significantly lower in the genetic FSGS patients than in the non-genetic FSGS and the MGA patients (P < 0.001). CONCLUSIONS: UP/C was a simple and useful predictive parameter for the diagnosis of FSGS. APS without nephrotic syndrome at onset may be associated with autosomal dominant causes of FSGS, especially in those with the perihilar variant.2022年05月, Clinical and experimental nephrology, 26(5) (5), 453 - 459, 英語, 国内誌研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 168 - 168, 日本語
- (株)東京医学社, 2022年04月, 腎と透析, 92(4) (4), 690 - 697, 日本語
- 発達腎研究会, 2022年04月, 発達腎研究会誌, 29(1) (1), 19 - 20, 日本語IV型コラーゲンの三量体構造におけるプロリンの働き
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 65 - 65, 日本語
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 109 - 109, 日本語
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 110 - 110, 日本語
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 118 - 118, 日本語
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 154 - 154, 日本語
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 184 - 184, 日本語
- (一社)日本小児腎臓病学会, 2022年04月, 日本小児腎臓病学会雑誌, 35(1Suppl.) (1Suppl.), 105 - 105, 日本語
- Introduction: Autosomal dominant tubulointerstitial kidney disease (ADTKD)-MUC1 is predominantly caused by frameshift mutations owing to a single-base insertion into the variable number tandem repeat (VNTR) region in MUC1. Because of the complexity of the variant hotspot, identification using short-read sequencers (SRSs) is challenging. Although recent studies have revealed the usefulness of long-read sequencers (LRSs), the prevalence of MUC1 variants in patients with clinically suspected ADTKD remains unknown. We aimed to clarify this prevalence and the genetic characteristics and clinical manifestations of ADTKD-MUC1 in a Japanese population using an SRS and an LRS. Methods: From January 2015 to December 2019, genetic analysis was performed using an SRS in 48 patients with clinically suspected ADTKD. Additional analyses were conducted using an LRS in patients with negative SRS results. Results: Short-read sequencing results revealed MUC1 variants in 1 patient harboring a cytosine insertion in the second repeat unit of the VNTR region; however, deeper VNTR regions could not be read by the SRS. Therefore, we conducted long-read sequencing analysis of 39 cases and detected MUC1 VNTR variants in 8 patients (in total, 9 patients from unrelated families). With the inclusion of family-affected patients (n = 31), the median age at the development of end-stage kidney disease (ESKD) was 45 years (95% CI: 40-40 years). Conclusion: In Japan, the detection rate of MUC1 variants in patients with clinically suspected ADTKD was 18.8%. More than 20% of patients with negative SRS results had MUC1 variants detected by an LRS.2022年04月, Kidney international reports, 7(4) (4), 857 - 866, 英語, 国際誌研究論文(学術雑誌)
- Background: Alport syndrome is an inherited disorder characterized by progressive renal disease, variable sensorineural hearing loss, and ocular abnormalities. Although many pathogenic variants in COL4A3 and COL4A4 have been identified in patients with autosomal Alport syndrome, synonymous mutations in these genes have rarely been identified. Methods: We conducted in silico splicing analysis using Human Splicing Finder (HSF) and Alamut to predict splicing domain strength and disruption of the sites. Furthermore, we performed in vitro splicing assays using minigene constructs and mRNA analysis of patient samples to determine the pathogenicity of four synonymous variants detected in four patients with suspected autosomal dominant Alport syndrome (COL4A3 [c.693G>A (p.Val231=)] and COL4A4 [c.1353C>T (p.Gly451=), c.735G>A (p.Pro245=), and c.870G>A (p.Lys290=)]). Results: Both in vivo and in vitro splicing assays showed exon skipping in two out of the four synonymous variants identified (c.735G>A and c.870G>A in COL4A4). Prediction analysis of wild-type and mutated COL4A4 sequences using HSF and Alamut suggested these two variants may lead to the loss of binding sites for several splicing factors, e.g., in acceptor sites and exonic splicing enhancers. The other two variants did not induce aberrant splicing. Conclusions: This study highlights the pitfalls of classifying the functional consequences of variants by a simple approach. Certain synonymous variants, although they do not alter the amino acid sequence of the encoded protein, can dramatically affect pre-mRNA splicing, as shown in two of our patients. Our findings indicate that transcript analysis should be carried out to evaluate synonymous variants detected in patients with autosomal dominant Alport syndrome.2022年03月, Kidney360, 3(3) (3), 497 - 505, 英語, 国際誌研究論文(学術雑誌)
- Vital signs are important for patient assessment, but little is known about interpreting those of children in prehospital settings. We conducted an observational study to investigate the association between prehospital vital signs of children and their clinical outcomes in hospitals. We plotted the data of patients with critical outcomes on published reference ranges, such as those of healthy children to evaluate the clinical relevance. Of the 18,493 children screened, 4477 transported to tertiary hospitals were included in the analysis. The outcomes 12 h after being transported to a tertiary hospital were as follows: deceased, 41; hospitalization with critical deterioration events, 65; hospitalization without critical deterioration events, 1086; returned home, 3090; and unknown, 195. The reference ranges of the heart rates (sensitivity: 57.7%, specificity: 67.5%) and respiratory rates (sensitivity: 54.5%, specificity: 67.7%) of healthy children worked best to detect the critical outcomes. Therefore, the reference ranges of healthy children were concluded to be suitable in prehospital settings; however, excessive reliance on vital signs carried potential risks due to their limited sensitivities and specificities. Future studies are warranted to investigate indicators with higher sensitivities and specificities.2022年03月, Scientific reports, 12(1) (1), 5199 - 5199, 英語, 国際誌研究論文(学術雑誌)
- Behavioral Therapy for Children with Avoidant/Restrictive Food Intake Disorder Dependent on Tube or Oral Enteral Nutrient Formula: A Feasibility Study.In children with eating disorders, nutritional status and growth may depend on enteral nutrient formula. Ultimately, its goal is to introduce or reintroduce oral feeding. Japanese research on the treatment of tube or oral formula-dependent children is scarce. This study determined the feasibility of behavioral therapy for children with avoidant/restrictive food intake disorder and dependency on the tube or oral enteral nutrient formula in Japan. Medical records of children diagnosed with this disorder, dependent on the tube or oral enteral nutrient formula and who had received behavioral therapy intervention to withdraw from the formula were retrospectively investigated. We collected their characteristics at first visit and the caloric percentage from oral food intake six months after starting the treatment. In total, four patients (age range: 2-5 years) participated in this study. The feeding routes employed before the intervention were a nasogastric tube for one patient, a gastrostomy bottom for the other patient, and oral formula for the remaining patients (i.e., two children). At the sixth month of the behavioral treatment, none of the patients needed the formula, and the caloric percentage of required nutrition from oral food intake was 100%. Our data demonstrate that this behavioral therapy is feasible for children with avoidant/restrictive food intake disorder dependent on the tube or oral formula in Japan.2022年03月, The Kobe journal of medical sciences, 67(4) (4), E155-E160, 英語, 国内誌研究論文(学術雑誌)
- A woman in her 50s with a three-decade history of biopsy-proven focal segmental glomerulosclerosis and a family history of end-stage kidney disease presented with worsening proteinuria and declining kidney function after three decades of immunosuppressive therapy. While a repeat kidney biopsy did not reveal findings diagnostic of Alport syndrome, genetic testing demonstrated a heterozygous mutation in COL4A5, which confirmed the diagnosis of X-linked Alport syndrome. The heterozygous in-frame deletion mutation may explain her intact hearing and relatively mild symptoms. Genetic testing enables diagnosis of Alport syndrome of various phenotypes, some of which cannot be diagnosed conventionally with clinical course and kidney biopsy. Genetic disorders including collagen IV nephropathy should be considered as a differential diagnosis in patients with focal segmental glomerulosclerosis, especially when a patient has early-onset proteinuria, a family history of kidney disease, syndromic features or proteinuria refractory to glucocorticoid treatment.2022年03月, BMJ case reports, 15(3) (3), 英語, 国際誌研究論文(学術雑誌)
- Fabry disease (FD) manifests decreased α-galactosidase A (α-Gal A) activity and multiorgan damage. There are some undiagnosed cases of the condition among patients on dialysis. The prevalence of FD may also vary with the region. Among 227 male patients undergoing maintenance hemodialysis in Awaji Island, a remote island in Japan, 201 (88.5%) were included in this study. Patients with α-Gal A activity <5.0 pmol/h/disk proceeded to secondary screening. Patients with positive secondary screening underwent further genetic analysis. The number of patients with a family history of cardiac, cerebrovascular, and kidney diseases was 31 (15.4%), 23 (11.4%), and 31 (15.4%) patients, respectively. Although three patients (1.5%) had low α-Gal A activity, none of them was positive in the secondary screening. We could not identify any male hemodialysis patient with FD in Awaji Island, even though some patients had a family history of kidney and cardiovascular diseases.2022年03月, Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Febrile status epilepticus is the most common form of status epilepticus in children. No previous reports compare the effectiveness of treatment strategies using fosphenytoin (fPHT) or phenobarbital (PB) and those using anesthetics as second-line anti-seizure medication for benzodiazepine-resistant convulsive status epilepticus (CSE). We aimed to examine the outcomes of various treatment strategies for febrile convulsive status epilepticus (FCSE) in a real-world setting while comparing the effects of different treatment protocols and their presence or absence. METHODS: This was a single-center historical cohort study that was divided into three periods. Patients who presented with febrile convulsive status epilepticus for ≥60 min even after the administration of at least one anticonvulsant were included. During period I (October 2002-December 2006), treatment was performed at the discretion of the attending physician, without a protocol. During period II (January 2007-February 2013), barbiturate coma therapy (BCT) was indicated for FCSE resistant to benzodiazepines. During period III (March 2013-April 2016), BCT was indicated for FCSE resistant to fPHT or PB. RESULTS: The rate of electroencephalogram monitoring was lower in period I than period II+III (11.5% vs. 85.7%, p<0.01). Midazolam was administered by continuous infusion more often in period I than period II+III (84.6% vs. 25.0%, p<0.01), whereas fPHT was administered less often in period I than period II+III (0% vs. 27.4%, p<0.01). The rate of poor outcome, which was determined using the Pediatric Cerebral Performance Category scale, was higher in period I than period II+III (23.1% vs. 7.1%, p=0.03). The rate of poor outcome did not differ between periods II and III (4.2% vs. 11.1%, p=0.40). CONCLUSIONS: While the presence of a treatment protocol for FCSE in children may improve outcomes, a treatment protocol using fPHT or PB may not be associated with better outcomes.2022年03月, BMC neurology, 22(1) (1), 77 - 77, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2022年03月, 日本小児科学会雑誌, 126(3) (3), 557 - 557, 日本語小児科医の意識調査 大事にする価値観は?兵庫県で次に取り組むべき課題は?
- (一社)日本遺伝カウンセリング学会, 2022年03月, 日本遺伝カウンセリング学会誌, 42(4) (4), 449 - 455, 日本語
- (公社)日本小児科学会, 2022年03月, 日本小児科学会雑誌, 126(3) (3), 547 - 547, 日本語兵庫県における治療可能となった難病に対する拡大新生児マススクリーニングの取り組み
- (公社)日本小児科学会, 2022年03月, 日本小児科学会雑誌, 126(3) (3), 545 - 546, 日本語肉眼的血尿をきたした膜性増殖性糸球体腎炎(MPGN)(C3腎症)の1例
- (公社)日本小児科学会, 2022年03月, 日本小児科学会雑誌, 126(3) (3), 547 - 547, 日本語5歳児検尿を契機に発見されたSchimke症候群の1例
- (一社)日本病理学会, 2022年03月, 日本病理学会会誌, 111(1) (1), 338 - 338, 日本語尿細管間質性腎炎55例の免疫組織化学染色を用いたIgG subclass検討
- (一社)日本遺伝カウンセリング学会, 2022年03月, 日本遺伝カウンセリング学会誌, 42(4) (4), 449 - 455, 日本語生殖細胞系列の網羅的遺伝子解析によって副腎白質ジストロフィーの原因遺伝子であるABCD1のバリアントが二次的に見つかったKleefstra症候群の1例 開示の判断に関与する要素に対する考察
- Fanconi syndrome is a functional disorder of the proximal tubule, characterized by pan-aminoaciduria, glucosuria, hypophosphatemia, and metabolic acidosis. With the advancements in gene analysis technologies, several causative genes are identified for Fanconi syndrome. Several mitochondrial diseases cause Fanconi syndrome and various systemic symptoms; however, it is rare that the main clinical symptoms in such disorders are Fanconi syndrome without systematic active diseases like encephalomyopathy or cardiomyopathy. In this study, we analyzed two families exhibiting Fanconi syndrome, developmental disability and mildly elevated liver enzyme levels. Whole-exome sequencing (WES) detected compound heterozygous known and novel BCS1L mutations, which affect the assembly of mitochondrial respiratory chain complex III, in both cases. The pathogenicity of these mutations has been established in several mitochondria-related functional analyses in this study. Mitochondrial diseases with isolated renal symptoms are uncommon; however, this study indicates that mitochondrial respiratory chain complex III deficiency due to BCS1L mutations cause Fanconi syndrome with developmental disability as the primary indications.2022年03月, Journal of human genetics, 67(3) (3), 143 - 148, 英語, 国際誌研究論文(学術雑誌)
- OBJECTIVE: Biomarkers predicting poor outcomes of status-epilepticus-associated-with-fever (SEF) at an early stage may contribute to treatment guidance. However, none have been reported thus far. We investigated the dynamics of serum growth and differentiation factor (GDF)-15 after seizure onset in patients with SEF and determined whether GDF-15 can predict poor outcomes, particularly in the first 6 h after seizure onset. METHODS: We enrolled 37 pediatric patients with SEF and eight patients with simple febrile seizures (SFS) and collected their blood samples within 24 h of seizure onset and eight febrile control patients between March 1, 2017 and September 30, 2020. All patients were aged ≤15 years. RESULTS: In the SEF group, the median post-seizure serum GDF-15 values were 1,065 (<6h), 2,720 (6-12 h), and 2,411 (12-24 h) pg/mL. The median serum GDF-15 in the first 6 h was measured in patients with SEF without a significant past medical history (n = 21) and was found to be statistically significantly higher (1,587 pg/mL) than in the febrile control (551 pg/mL) and SFS (411 pg/mL) groups. The median serum GDF-15 was statistically significantly higher in patients with SEF with sequelae (n = 5) and patients with acute encephalopathy with biphasic seizures/reduced diffusion/hemorrhagic shock and encephalopathy syndrome (n = 6) than in patients with SEF without sequelae (n = 16) (15,898 vs 756 pg/mL) and patients with prolonged FS (n = 15) (9,448 vs 796 pg/mL). CONCLUSIONS: This study demonstrates the dynamics of serum GDF-15 in patients with SEF and indicates the potential of GDF-15 as an early predictor of poor outcomes.2022年03月, Brain & development, 44(3) (3), 210 - 220, 英語, 国際誌研究論文(学術雑誌)
- Introduction: The clinicopathologic characteristics of nephropathy associated with mitochondrial disease (MD) remain unknown. We retrospectively analyzed a cohort of patients with proteinuria, decreased glomerular filtration rate, or Fanconi syndrome who had a genetic mutation confirmed as the cause of MD, defined as mitochondrial nephropathy. Methods: This nationwide survey included 757 nephrology sections throughout Japan, and consequently, data on 81 cases of mitochondrial nephropathy were collected. Results: The most common renal manifestation observed during the disease course was proteinuria. Hearing loss was the most common comorbidity; a renal-limited phenotype was observed only in mitochondrial DNA (mtDNA) point mutation and COQ8B mutation cases. We found a median time delay of 6.0 years from onset of renal manifestations to diagnosis. Focal segmental glomerular sclerosis (FSGS) was the most common pathologic diagnosis. We then focused on 63 cases with the m.3243A>G mutation. The rate of cases with diabetes was significantly higher among adult-onset cases than among childhood-onset cases. Pathologic diagnoses were more variable in adult-onset cases, including diabetic nephropathy, nephrosclerosis, tubulointerstitial nephropathy, and minor glomerular abnormalities. During the median observation period of 11.0 years from the first onset of renal manifestations in patients with m.3243A>G, renal replacement therapy (RRT) was initiated in 50.8% of patients. Death occurred in 25.4% of the patients during the median observation period of 12.0 years. The median estimated glomerular filtration rate (eGFR) decline was 5.4 ml/min per 1.73 m2/yr in the cases, especially 8.3 ml/min per 1.73 m2/yr in FSGS cases, with m.3243A>G. Conclusion: Here, we described the clinicopathologic features and prognosis of mitochondrial nephropathy using large-scale data.2022年03月, Kidney international reports, 7(3) (3), 580 - 590, 英語, 国際誌研究論文(学術雑誌)
- Nephronophthisis is an autosomal-recessive kidney disease that is caused by abnormalities in primary cilia. Nephronophthisis-related ciliopathies (NPHP-RCs) are a common cause of end-stage kidney disease (ESKD) in children and adolescents. NPHP-RCs are often accompanied by extrarenal manifestations, including intellectual disability, retinitis pigmentosa, or polydactyly. Although more than 100 causative genes have been identified, its diagnosis is difficult because the clinical features of each mutation often overlap. From September 2010 to August 2021, we performed genetic analysis, including next-generation sequencing (NGS), in 574 probands with kidney dysfunction and retrospectively studied cases genetically diagnosed with NPHP-RCs. RESULTS: We detected mutations related to NPHP-RCs in 93 patients from 83 families. Members of 60 families were diagnosed using NGS, and the mutations and the corresponding number of families are as follows: NPHP1 (24), NPHP3 (10), OFD1 (7), WDR35 (5), SDCCAG8 (4), BBS10 (3), TMEM67 (3), WDR19 (3), BBS1 (2), BBS2 (2), IFT122 (2), IFT140 (2), IQCB1 (2), MKKS (2), SCLT1 (2), TTC21B (2), ALMS1 (1), ANKS6 (1), BBS4 (1), BBS12 (1), CC2D2A (1), DYNC2H1 (1), IFT172 (1), and MAPKBP1 (1). A total of 39 cases (41.9%) progressed to ESKD at the time of genetic analysis, whereas 58 cases (62.3%) showed extrarenal manifestations, the most common being developmental delay, intellectual disability, and autism spectrum disorder in 44 patients. Comprehensive genetic analysis using NGS is useful for diagnosing patients with NPHP-RCs.2022年02月, Journal of human genetics, 67(7) (7), 427 - 440, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 251 - 251, 日本語長期の塩酸イソプロテレノール持続静注により管理した先天性洞不全症候群を合併した超早産児の一例
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 369 - 369, 日本語幼児期の生活習慣と小学1年生の学力との関連 3歳時点での就寝時刻が遅いと学力が低下する
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 230 - 230, 日本語Alport症候群に対するアンチセンス核酸およびスプライシング調節蛋白による治療法の開発
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 253 - 253, 日本語OCRL異常におけるgenotype-phenotype correlationに関する検討
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 255 - 255, 日本語中等度紫斑病性腎炎へのレニン・アンジオテンシン系阻害薬治療に関する検討
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 375 - 375, 日本語遺伝子解析が早期診断の一助となった中枢性尿崩症の1家系
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 308 - 308, 日本語一次急病施設における異物・毒物誤飲診療の現状と課題
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 238 - 238, 英語ミトコンドリアDNA修復遺伝子であるDNA Ligase IIIは新規ミトコンドリア病の原因遺伝子である(Mutations in LIG3 cause mitochondrial neurogastrointestinal encephalomyopathy by mtDNA depletion)
- 2022年02月, CEN case reports, 11(1) (1), 159 - 160, 英語, 国内誌
- BACKGROUND: Autosomal recessive polycystic kidney disease (ARPKD) is caused by mutations in the PKHD1 gene. The clinical spectrum is often more variable than previously considered. We aimed to analyze the clinical features of genetically diagnosed ARPKD in the Japanese population. METHODS: We conducted a genetic analysis of patients with clinically diagnosed or suspected ARPKD in Japan. Moreover, we performed a minigene assay to elucidate the mechanisms that could affect phenotypes. RESULTS: PKHD1 pathogenic variants were identified in 32 patients (0-46 years). Approximately one-third of the patients showed prenatal anomalies, and five patients died within one year after birth. Other manifestations were detected as follows: chronic kidney disease stages 1-2 in 15/26 (57.7%), Caroli disease in 9/32 (28.1%), hepatic fibrosis in 7/32 (21.9%), systemic hypertension in 13/27 (48.1%), and congenital hypothyroidism in 3 patients. There have been reported that truncating mutations in both alleles led to severe phenotypes with perinatal demise. However, one patient without a missense mutation survived the neonatal period. In the minigene assay, c.2713C > T (p.Gln905Ter) and c.6808 + 1G > A expressed a transcript that skipped exon 25 (123 bp) and exon 41 (126 bp), resulting in an in-frame mutation, which might have contributed to the milder phenotype. Missense mutations in cases of neonatal demise did not show splicing abnormalities. CONCLUSION: Clinical manifestations ranged from cases of neonatal demise to those diagnosed in adulthood. The minigene assay results indicate the importance of functional analysis, and call into question the fundamental belief that at least one non-truncating mutation is necessary for perinatal survival.2022年02月, Clinical and experimental nephrology, 26(2) (2), 140 - 153, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: The management of congenital nephrotic syndrome of the Finnish type (CNF) is challenging. It is difficult to withdraw intravenous albumin infusions, resulting in long-term hospitalization. In addition, fatal hypotension after bilateral nephrectomy has been reported. In our center, we have performed unilateral nephrectomy during early infancy. METHODS: Infants diagnosed with CNF between 2011 and 2020 in our institution were enrolled. We examined the clinical course before and after unilateral nephrectomy and evaluated the effectiveness of this strategy. RESULTS: Seven patients (all showing NPHS1 mutations) were enrolled. All required daily intravenous albumin infusion via central venous catheter (CVC). Unilateral nephrectomy was performed at a median of 76 days of age (59-208 days). Surgical complications did not occur in any of patients. The mean albumin dose was decreased after unilateral nephrectomy (2.0 vs 0.4 g/kg/day; p = 0.02). Intravenous albumin infusion could be withdrawn at a median of 17 days, the CVC removed at a median of 21 days, and they discharged at a median of 82 days after unilateral nephrectomy. Although bacterial infections were noted seven times before unilateral nephrectomy, only one episode occurred after surgery. Four patients initiated peritoneal dialysis at two to three years of age and all of them underwent kidney transplantation thereafter. CONCLUSIONS: Unilateral nephrectomy during early infancy may be an effective treatment allowing for withdrawal from albumin infusion, prevention of complications, withdrawal from CVCs and shortening hospital stay for patients with CNF.2022年02月, Clinical and experimental nephrology, 26(2) (2), 162 - 169, 英語, 国内誌研究論文(学術雑誌)
- Fabry disease (FD), which is a lysosomal storage disease resulting from a deficiency of α-galactosidase A, leads to the accumulation of globotriaosylceramide in various tissues and multiorgan impairment. Early diagnosis is important to improve long-term prognosis. Early clinical manifestations of FD include neuropathic pain, vascular skin lesions, and sweating abnormalities. Hypohidorosis is one of the clinical findings in the early stage of FD. However, there have been no studies on prospective screening of FD in patients with definitive diagnosis of hypohidrosis. We examined α-galactosidase A activity in white blood cells in 17 (one female and 16 male) patients with generalized hypohidorosis. Among 17 patients, one male patient (approximately 5.8%) had significantly reduced α-galactosidase A activity. He presented with a history of hypohidrosis with heat intolerance and neuropathic tingling pain in a warm environment from 6 years ago. He had a few angiokeratoma on the trunk and extremities. Ultrastructural examination of skin biopsy from the angiokeratoma revealed lamellar inclusions in endothelial cells. Kidney biopsy revealed swollen podocytes and Gb3 deposition in the glomerulus, and urinalysis revealed mulberry bodies. He was finally diagnosed with FD and started on enzyme replacement therapy with agalsidase alpha in the early stage. In addition, his family screening led to find the patients of four additional FD. Screening for FD in patients with hypohidrosis may lead to efficient early detection of FD.2022年02月, The Journal of dermatology, 49(2) (2), 308 - 312, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Rituximab is the standard therapy for childhood-onset complicated frequently relapsing or steroid-dependent nephrotic syndrome (FRNS/SDNS). However, most patients redevelop FRNS/SDNS after peripheral B cell recovery. METHODS: We conducted a multicenter, randomized, double-blind, placebo-controlled trial to examine whether mycophenolate mofetil (MMF) administration after rituximab can prevent treatment failure (FRNS, SDNS, steroid resistance, or use of immunosuppressive agents or rituximab). In total, 39 patients (per group) were treated with rituximab, followed by either MMF or placebo until day 505 (treatment period). The primary outcome was time to treatment failure (TTF) throughout the treatment and follow-up periods (until day 505 for the last enrolled patient). RESULTS: TTFs were clinically but not statistically significantly longer among patients given MMF after rituximab than among patients receiving rituximab monotherapy (median, 784.0 versus 472.5 days, hazard ratio [HR], 0.59; 95% confidence interval [95% CI], 0.34 to 1.05, log-rank test: P=0.07). Because most patients in the MMF group presented with treatment failure after MMF discontinuation, we performed a post-hoc analysis limited to the treatment period and found that MMF after rituximab prolonged the TTF and decreased the risk of treatment failure by 80% (HR, 0.20; 95% CI, 0.08 to 0.50). Moreover, MMF after rituximab reduced the relapse rate and daily steroid dose during the treatment period by 74% and 57%, respectively. The frequency and severity of adverse events were similar in both groups. CONCLUSIONS: Administration of MMF after rituximab may sufficiently prevent the development of treatment failure and is well tolerated, although the relapse-preventing effect disappears after MMF discontinuation.2022年02月, Journal of the American Society of Nephrology : JASN, 33(2) (2), 401 - 419, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Although Lowe syndrome and Dent disease-2 are caused by Oculocerebrorenal syndrome of Lowe (OCRL) mutations, their clinical severities differ substantially and their molecular mechanisms remain unclear. Truncating mutations in OCRL exons 1-7 lead to Dent disease-2, whereas those in exons 8-24 lead to Lowe syndrome. Herein we identified the mechanism underlying the action of novel OCRL protein isoforms. METHODS: Messenger RNA samples extracted from cultured urine-derived cells from a healthy control and a Dent disease-2 patient were examined to detect the 5' end of the OCRL isoform. For protein expression and functional analysis, vectors containing the full-length OCRL transcripts, the isoform transcripts and transcripts with truncating mutations detected in Lowe syndrome and Dent disease-2 patients were transfected into HeLa cells. RESULTS: We successfully cloned the novel isoform transcripts from OCRL exons 6-24, including the translation-initiation codons present in exon 8. In vitro protein-expression analysis detected proteins of two different sizes (105 and 80 kDa) translated from full-length OCRL, whereas only one protein (80 kDa) was found from the isoform and Dent disease-2 variants. No protein expression was observed for the Lowe syndrome variants. The isoform enzyme activity was equivalent to that of full-length OCRL; the Dent disease-2 variants retained >50% enzyme activity, whereas the Lowe syndrome variants retained <20% activity. CONCLUSIONS: We elucidated the molecular mechanism underlying the two different phenotypes in OCRL-related diseases; the functional OCRL isoform translated starting at exon 8 was associated with this mechanism.2022年01月, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 37(2) (2), 262 - 270, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Cases of Henoch-Schönlein purpura nephritis (HSPN) with moderate severity were demonstrated to achieve good prognosis after treatment with renin-angiotensin system (RAS) inhibitors. However, some patients required additional treatment for recurrence after remission. This study aimed to clarify the effect of RAS inhibitors in HSPN cases with moderate severity, including the proportion of cases with recurrence and their response to additional treatment. METHODS: Among 126 patients diagnosed with HSPN between 1996 and 2019, 71 patients with clinicopathologically diagnosed HSPN of moderate severity, defined as ISKDC grade II-IIIa and serum albumin ≥ 2.5 g/dL, were investigated. RESULTS: Proteinuria became negative after RAS inhibitor treatment alone in all 71 cases. However, 16 (22.5%) had recurrence. Eleven recurrent cases achieved negative proteinuria again following additional treatment. At the last follow-up (median 46.5 months; IQR, 23.2-98.2), 5 patients had persistent mild proteinuria; no patients had estimated glomerular filtration rate < 90 mL/min/1.73 m2. The pathological findings in all recurrent cases were ISKDC grade IIIa. The 16 recurrent cases had significantly higher proportions of glomeruli with global/segmental sclerosis (25.0 vs. 0%, P < 0.001) and tubular atrophy/interstitial fibrosis (37.5 vs. 12.7%, P =0.0 24) than 55 cases without recurrence. CONCLUSIONS: Japanese childhood HSPN cases with moderate severity had good outcomes without need for corticosteroids or immunosuppressants, when prescribed RAS inhibitor treatment. Even in recurrent cases, abnormal proteinuria was transient, and prognosis was excellent. A higher resolution version of the Graphical abstract is available as Supplementary information.2022年01月, Pediatric nephrology (Berlin, Germany), 37(8) (8), 1845 - 1853, 英語, 国際誌研究論文(学術雑誌)
- Idiopathic nephrotic syndrome is the most common childhood glomerular disease. Most forms of this syndrome respond to corticosteroids at standard doses and are, therefore, defined as steroid-sensitive nephrotic syndrome (SSNS). Immunological mechanisms and subsequent podocyte disorders play a pivotal role in SSNS and have been studied for years; however, the precise pathogenesis remains unclear. With recent advances in genetic techniques, an exhaustive hypothesis-free approach called a genome-wide association study (GWAS) has been conducted in various populations. GWASs in pediatric SSNS peaked in the human leukocyte antigen class II region in various populations. Additionally, an association of immune-related CALHM6/FAM26F, PARM1, BTNL2, and TNFSF15 genes, as well as NPHS1, which encodes nephrin expressed in podocytes, has been identified as a locus that achieves genome-wide significance in pediatric SSNS. However, the specific mechanism of SSNS development requires elucidation. This review describes an updated view of SSNS pathogenesis from immunological and genetic aspects, including interactions with infections or allergies, production of circulating factors, and an autoantibody hypothesis.2022年01月, Pediatric nephrology (Berlin, Germany), 英語, 国際誌研究論文(学術雑誌)
- 2022年01月, Pediatrics international : official journal of the Japan Pediatric Society, 64(1) (1), e15350, 英語, 国際誌研究論文(学術雑誌)
- INTRODUCTION: Previous studies reported a dramatic decline in the incidence of varicella and varicella-related deaths after implementing universal varicella vaccination (VarV). Although previous studies reported the effectiveness and economic impact of VarV, they were unknown in the emergency department (ED) setting. METHODS: To determine the effectiveness and economic impact of VarV in the ED, Kobe, Japan, we retrospectively reviewed the clinical database of consecutive patients younger than 16 years presenting to our primary ED from 2011 to 2019. RESULTS: Of the 265,191 children presenting to our ED, 3,092 patients were clinically diagnosed with varicella. The number of patients with varicella was approximately 500 annually, before introducing the universal two-dose VarV for children aged 1 to <3 years in October 2014, in the Japanese national immunization program, and decreased to approximately 200 in 2019. The number of patients with varicella younger than 1 year (ineligible for the vaccination) also decreased. Regarding the economic impact, the medical cost in our ED reduced after the introduction of VarV was JPY 4.1 million (US$ 40,049) annually. From the central data, approximately 95% of children were vaccinated after October 2014; however, a relatively large percentage of infected unvaccinated children (59.0%) presented to ED in this study. After the implementation of the universal VarV, infection was mainly observed in older children (i.e., the unvaccinated generation). CONCLUSIONS: Our data showed the effectiveness and economic impact of VarV in the ED setting. Additionally, our data suggested that the public vaccination program should include older unvaccinated children and other unvaccinated individuals.2022年01月, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 28(1) (1), 35 - 40, 英語, 国際誌研究論文(学術雑誌)
- INTRODUCTION: COL4A5 is a causative gene of X-linked Alport syndrome (XLAS). Male patients with XLAS with nonsense variants have the most severe phenotypes of early onset end-stage kidney disease (ESKD); those with splicing variants have middle phenotypes and those with missense variants have the mildest phenotypes. Therefore, genotyping for male patients with XLAS can be used to predict kidney prognosis. Single-base substitutions at the last nucleotide position in each exon are known to affect splicing patterns and could be splicing variants. Nevertheless, in XLAS, these variants are generally considered to be missense variants, without conducting a transcript analysis, which underestimates some patients as having mild phenotypes. This study aimed to investigate whether single-base substitutions at the last nucleotide position of COL4A5 exons cause aberrant splicing. METHODS: In total, 20 variants were found in the Human Gene Mutation Database (n = 14) and our cohort (n = 6). We performed functional splicing assays using a hybrid minigene analysis and in vivo transcript analyses of patients' samples when available. Then, we investigated genotype-phenotype correlations for patients with splicing variants detected in this study by comparing data from our previous studies. RESULTS: Among the 20 variants, 17 (85%) caused aberrant splicing. Male patients with splicing variants had more severe phenotypes when compared with those with missense variants. Findings from the in vivo analyses for 3 variants were identical to those from the minigene assay. CONCLUSION: Our study revealed that most single-base substitutions at the last nucleotide position of COL4A5 exons result in splicing variants, rather than missense variants, thereby leading to more severe phenotypes.2022年01月, Kidney international reports, 7(1) (1), 108 - 116, 英語, 国際誌研究論文(学術雑誌)
- X-linked Alport syndrome (XLAS) is caused by pathogenic variants in COL4A5 and is characterized by progressive kidney disease, hearing loss, and ocular abnormalities. Recent advances in genetic analysis and further understanding of genotype-phenotype correlations in affected male patients raises the importance of detecting splicing variants in COL4A5. Aberrant splicing of COL4A5 is caused not only by canonical splice site variants but also non-canonical splice site variants such as deep intronic changes or even substitutions in exons. Patients with splicing variants account for ~15% of all cases in XLAS. In addition, it has been shown that there is a significant difference in kidney survival depending on the aberrant splicing patterns of transcripts- in particular in-frame or out-of-frame nucleotide changes in transcripts. Therefore, cDNA analysis of patient mRNA is necessary to determine the impact of splice site variants and to confirm a diagnosis of XLAS and to predict the kidney prognosis. However, it is usually difficult to amplify COL4A5 transcripts extracted from peripheral blood leukocytes. For these cases, in vitro minigene assays or RNA sequence extracted from urine derived cells can confirm aberrant splicing patterns. Moreover, controlling aberrant splicing by nucleic acids or small molecular compounds in genetic diseases are attracting attention as a potential therapeutic strategy. Here, we review the frequency of splicing variants in COL4A5, the latest diagnostic strategies, and the prospects for new therapeutic approaches.2022年, Frontiers in medicine, 9, 841391 - 841391, 英語, 国際誌研究論文(学術雑誌)
- Background: Pathogenic variants in single genes encoding podocyte-associated proteins have been implicated in about 30% of steroid-resistant nephrotic syndrome (SRNS) patients in children. However, LAMA5 gene biallelic variants have been identified in only seven patients so far, and most are missense variants of unknown significance. Furthermore, no functional analysis had been conducted for all but one of these variants. Here, we report three patients with LAMA5 gene biallelic truncating variants manifesting infantile nephrotic syndrome, and one patient with SRNS with biallelic LAMA5 missense variants. Methods: We conducted comprehensive gene screening of Japanese patients with severe proteinuria. With the use of targeted next-generation sequencing, 62 podocyte-related genes were screened in 407 unrelated patients with proteinuria. For the newly discovered LAMA5 variants, we conducted in vitro heterotrimer formation assays. Results: Biallelic truncating variants in the LAMA5 gene (NM_005560) were detected in three patients from two families. All patients presented with proteinuria within 6 months of age. Patients 1 and 2 were siblings possessing a nonsense variant (c.9232C>T, p.[Arg3078*]) and a splice site variant (c.1282 + 1G>A) that led to exon 9 skipping and a frameshift. Patient 3 had a remarkable irregular contour of the glomerular basement membrane. She was subsequently found to have a nonsense variant (c.8185C>T, p.[Arg2720*]) and the same splice site variant in patients 1 and 2. By in vitro heterotrimer formation assays, both truncating variants produced smaller laminin α5 proteins that nevertheless formed trimers with laminin β1 and γ1 chains. Patient 4 showed SRNS at the age of 8 years, and carried compound heterozygous missense variants (c.1493C>T, p.[Ala498Val] and c.8399G>A, p.[Arg2800His]). Conclusions: Our patients showed clear evidence of biallelic LAMA5 truncating variants causing infantile nephrotic syndrome. We also discerned the clinical and pathologic characteristics observed in LAMA5-related nephropathy. LAMA5 variant screening should be performed in patients with congenital/infantile nephrotic syndrome.2021年12月, Kidney360, 2(12) (12), 1968 - 1978, 英語, 国際誌研究論文(学術雑誌)
- For symptomatic congenital cytomegalovirus infections (CCMVI), the usefulness of changes in viral load during valganciclovir (VGCV) treatment for the prediction of hearing dysfunction (HD) is unclear. To determine the utility of viral load change in the whole blood or urine for the prediction of HD, we performed a retrospective study to compare viral load changes during VGCV treatment between CCMVI infants with (n = 12) or without (n = 8) HD at six months of corrected age, whose blood and urine viral loads were measured continuously for eight weeks from April 2009 to December 2019. There was no significant difference in the changes in both the blood and urine viral loads after the initiation of VGCV treatment between CCMVI infants between the groups. Moreover, this negative result was maintained in the analysis for each six weeks or six months treatment period. In conclusion, the change in viral load during antiviral therapy is not useful for the prediction of HD at six months of corrected age in symptomatic CCMVI.2021年12月, Journal of clinical medicine, 10(24) (24), 英語, 国際誌研究論文(学術雑誌)
- Neonatal sepsis is characterized by systemic bacterial invasion followed by a massive inflammatory response. At present, no therapeutic strategy has been found that significantly reduces the mortality of neonatal sepsis. We aimed to investigate the protective role of an initial low-dose septic challenge for the prevention of subsequent lethal sepsis in a mouse model. A stock cecal slurry (CS) solution was prepared from adult ceca. The LD83 (1.5 mg CS/g) was used for all animals. An initial challenge of normal saline (NS) or 0.5 mg CS/g (non-lethal dose) was administered at four days of age, then 1.5 mg CS/g was administered intraperitoneally at seven days of age (72 h post-initial challenge), and survival was monitored. Initial exposure to NS (n = 10) resulted in 90% mortality following exposure to the LD83 CS dose in contrast to an initial exposure to CS (n = 16), which significantly decreased mortality to 6% (p < 0.0001), reduced blood bacterial counts, attenuated inflammatory responses, and suppressed lipid mediators. Initial exposure to a non-lethal CS dose prior to exposure to a lethal CS dose significantly reduces sepsis mortality, a protective effect that might be mediated by modulating abnormal systemic inflammatory responses.2021年12月, Journal of clinical medicine, 10(24) (24), 英語, 国際誌研究論文(学術雑誌)
- 2021年12月, Clinical and experimental nephrology, 25(12) (12), 1277 - 1285, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: An unprovoked seizure is a seizure or a cluster of seizures occurring within 24 h in a patient older than 1 month of age without precipitating factors. Recent studies have reported that extrinsic factors, such as meteorological conditions and air pollutants, may be important in seizure occurrence. Thus, this study aimed to examine the association between the number of visits to the emergency department (ED) by children for nighttime unprovoked seizures and exposure to multi-faceted factors, such as meteorological conditions and air pollution. METHODS: We conducted a clinical observational analysis and reviewed consecutive patients younger than 16 years of age who visited the primary ED center in Kobe City, Japan, during nighttime (7:30 p.m.-7:00 a.m.) between January 1, 2011 and December 31, 2015. We investigated the effects of meteorological factors and air pollutants on the number of patients with unprovoked seizures using multivariate analysis of Poisson regression estimates. RESULTS: In total, 151,119 children visited the ED, out of which 97 patients presented with unprovoked seizures. The mean age of the patients was 4.7 years (range, 1 month to 15.3 years), and 54.6% of them were boys. The total number of patients with unprovoked seizures showed no significant changes with the seasons; however, there were dominant peaks during the fall and fewer visits during the summer. The multivariate analysis of Poisson regression estimates revealed a significant positive relationship between the number of patients presenting with unprovoked seizures and precipitation (+1 patient/87 mm; p = 0.03) and methane (+1 patient/0.14 ppm; p = 0.03) levels and a negative relationship between the number of patients presenting with unprovoked seizures and nitrogen dioxide level (-1 patient/0.02 ppm; p = 0.04). CONCLUSIONS: The present study is the first to evaluate the association between the number of children who presented to the ED with nighttime unprovoked seizures and environmental factors after controlling for confounding factors.2021年12月, Epilepsy & behavior : E&B, 125, 108434 - 108434, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Alport syndrome (AS), which is a rare hereditary disease caused by mutations of genes including COL4A3, COL4A4 and COL4A5, has a wide spectrum of phenotypes. Most disease-causing variants of AS are located in the exons or the conservative splicing sites of these genes, while little is known about the intronic disease-causing variants. METHODS: A Chinese AS family was recruited in this study. All the clinical data of AS patient were collected from medical records. After pedigree analysis, the pathogenic variants were studied by the whole exome sequencing (WES). Minigene assay and in vivo RT-PCR analysis were performed to validate the functions of the variants. RESULTS: Renal biopsy showed a typical histopathology changes of AS. WES revealed compound heterozygous substitution, NM_033380 c.991-14(IVS17) A > G, in the intron 17 of the COL4A5 gene, which were confirmed by Sanger sequencing. Moreover, the variant was co-segregated with the phenotype in this family. Minigene assay in cultured cell lines showed that a splicing error was induced by this intronic variant, which further confirmed by in vivo RT-PCR analysis. CONCLUSION: A novel intronic disease-causing variant in COL4A5 gene was identified by WES, which was the molecular pathogenic basis of AS.2021年11月, BMC nephrology, 22(1) (1), 380 - 380, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2021年11月, 日本小児腎臓病学会雑誌, 34(2) (2), 177 - 177, 日本語
- (一社)日本小児腎臓病学会, 2021年11月, 日本小児腎臓病学会雑誌, 34(2) (2), 204 - 205, 日本語
- (一社)日本小児腎臓病学会, 2021年11月, 日本小児腎臓病学会雑誌, 34(2) (2), 188 - 189, 日本語
- (一社)日本小児腎臓病学会, 2021年11月, 日本小児腎臓病学会雑誌, 34(2) (2), 204 - 205, 日本語
- (一社)日本小児腎臓病学会, 2021年11月, 日本小児腎臓病学会雑誌, 34(2) (2), 188 - 189, 日本語
- 2021年11月, Pediatric nephrology (Berlin, Germany), 36(11) (11), 3805 - 3806, 英語, 国際誌
- The coronavirus disease (COVID-19) pandemic altered environmental factors. We studied the impact of these changes on asthma exacerbation (AE) by comparing the AE-related environmental factors between COVID-19 (2020) and pre-COVID-19 (2011-2019) eras. Between 2011 and 2020, 278,465 children (<16 years old) visited our emergency department, and 7476 were diagnosed with AE. The number of patients showed spring and fall peaks in 2011-2019. Multivariate analyses showed significant positive relationships of the number of AE patients with the average temperature among all patients and 0-5-year-olds and with sulfur dioxide (SO2) levels in 2011-2019 among 0-5-year-olds. Although the spring peak in the number of patients was not observed in 2020 after declaration of a state of emergency, the fall peak was again observed after the state of emergency was lifted. No changes in average temperature were detected, but SO2 was significantly reduced following declaration of the state of emergency in 2020. Therefore, SO2 reduction might have contributed to the disappearance of the peak of AE. However, a fall peak was observed again in 2020, although SO2 levels continued to be low. These data suggest that person to person interaction seems to be associated with AE, presumably due to unknown viral infections.2021年10月, International journal of environmental research and public health, 18(21) (21), 英語, 国際誌研究論文(学術雑誌)
- Severe small-for-gestational-age (sSGA) infants exhibit increased mortality and morbidity. Oxidative stress is suggested to be involved in intrauterine growth restriction. This retrospective study aimed to evaluate the oxidative stress level at birth in an sSGA population. Sera of 28 sSGA (sSGA group) and 31 non-sSGA (control group) infants, born at our hospital between March 2017 and March 2020, were evaluated. Oxidative stress (derivative of reactive oxidative metabolites: d-ROM level), biological antioxidant potential (BAP) level, and the ratio of d-ROM/BAP level (oxidative stress index: OSI) were measured. The sSGA group had a significantly lower birth weight (BW), BW z-score, head circumference, and height than the control group (all p < 0.05). No significant difference was noted in the BAP level; sSGA infants exhibited a significantly higher d-ROM level than control infants. sSGA infants showed a significantly increased OSI compared with control infants, and the BW z-score was inversely correlated with d-ROM levels and OSI in sSGA infants (R2 = 0.300; p < 0.01 and R2 = 0.319; p = 0.02, respectively) but not in controls. In conclusion, sSGA infants, including preterm infants, exhibited higher oxidative stress at birth. The severity of fetal growth restriction was significantly correlated with oxidative stress levels at birth in sSGA infants.2021年10月, International journal of environmental research and public health, 18(20) (20), 英語, 国際誌研究論文(学術雑誌)
- (一社)日本小児感染症学会, 2021年10月, 日本小児感染症学会総会・学術集会プログラム・抄録集, 53回, 122 - 122, 日本語症候性先天性サイトメガロウイルス感染症を対象とした抗ウイルス薬治療の医師主導治験の進捗
- Transient antenatal Bartter syndrome due to melanoma-associated antigen D2 gene mutation is a newly reported type of Bartter syndrome. Its characteristics include an X-linked inheritance pattern, early-onset hydramnios, and spontaneous disappearance of symptoms after childbirth. To date, there have been no reports of prenatally diagnosed cases. We herein present the case of a preterm male born to a mother with early-onset hydramnios and a family history of X-linked idiopathic hydramnios. We suspected melanoma-associated antigen D2 gene mutation and performed direct sequencing. As a result, we were able to prenatally establish a diagnosis of transient Bartter syndrome due to a melanoma-associated antigen D2 gene mutation.2021年10月, European journal of medical genetics, 64(10) (10), 104308 - 104308, 英語, 国際誌研究論文(学術雑誌)
- INTRODUCTION: Frasier syndrome (FS) is a rare inherited kidney disease caused by intron 9 splicing variants of WT1. For wild-type WT1, 2 active splice donor sites in intron 9 cause a mixture of 2 essential transcripts (with or without lysine-threonine-serine [+/KTS or -KTS]), and imbalance of the +KTS/-KTS ratio results in the development of FS. To date, 6 causative intron 9 variants have been identified; however, detailed transcript analysis has not yet been conducted and the genotype-phenotype correlation also remains to be elucidated. METHODS: We conducted an in vitro minigene splicing assay for 6 reported causative variants and in vivo RNA sequencing to determine the +KTS/-KTS ratio using patients' samples. We also performed a systematic review of reported FS cases with a description of the renal phenotype. RESULTS: The in vitro assay revealed that although all mutant alleles produced -KTS transcripts only, the wild-type allele produced both +KTS and -KTS transcripts at a 1:1 ratio. In vivo RNA sequencing showed that patients' samples with all heterozygous variants produced similar ratios of +KTS to -KTS (1:3.2-1:3.5) and wild-type kidney showed almost a 1:1 ratio (1:0.85). A systematic review of 126 cases clarified that the median age of developing ESKD was 16 years in all FS patients, and there were no statistically significant differences between the genotypes or sex chromosome karyotypes in terms of the renal survival period. CONCLUSION: Our study suggested no differences in splicing pattern or renal survival period among reported intron 9 variants causative of FS.2021年10月, Kidney international reports, 6(10) (10), 2585 - 2593, 英語, 国際誌研究論文(学術雑誌)
- OBJECTIVES: Accidental foreign body ingestion (FBI) and toxic agent ingestion (TAI) are commonly encountered among children in primary emergency settings. Early detection and appropriate medical intervention are crucial to improve outcomes. Although many reports from tertiary institutions have shown improvements in therapy, data are still lacking from primary emergency facilities. METHODS: We performed a retrospective analysis based on medical records of FBI/TAI over 4 years at the Kobe Children's Primary Emergency Medical Center. We collected patient information, including age, sex, time between FBI/TAI occurrence and centre visit, provision of first aid, symptoms, type of FBI/TAI, examinations, treatments, and outcomes. RESULTS: A total of 580 children were enrolled. The median age was 1.3 years, and patients under 2 years old accounted for 70% of total cases. Cigarettes (17.5%) were the most common ingested foreign body, followed by medicines (15.3%), detergents (8.1%), in TAI, plastics (14.1%), metal (13.4%), batteries (9.0%) in FBI, and others (22.6%). A total of 42 patients were transferred to advanced hospitals; among these, 22 patients were hospitalised but the foreign body was removed in only 3 (0.9%) patients. Transferred patients were significantly older (P<0.05) in FBI and had a higher rate of any of symptoms (P<0.05) in FBI/TAI. CONCLUSIONS: This large-scale retrospective study of accidental FBI/TAI conducted at a primary emergency facility clarified current management, including treatment at a primary facility. Very few cases of FBI/TAI were treated, even when they were transferred to an advanced treatment hospital. Unified protocols should be established, to improve the management of FBI/TAI.2021年09月, Minerva pediatrics, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本腎臓学会, 2021年09月, 日本腎臓学会誌, 63(6-E) (6-E), 658 - 658, 日本語腎臓研究の最前線 GWASを用いた腎疾患感受性遺伝子同定
- (一社)日本腎臓学会, 2021年09月, 日本腎臓学会誌, 63(6-W) (6-W), 830 - 830, 日本語COL4A5遺伝子のエクソン3'末端に位置する一塩基置換はミスセンス変異ではなくスプライシング変異である
- (一社)日本腎臓学会, 2021年09月, 日本腎臓学会誌, 63(6-W) (6-W), 833 - 833, 日本語早期の遺伝学的検査が治療方針の選択に有用であった小児ステロイド抵抗性ネフローゼの1例
- (一社)日本先天代謝異常学会, 2021年09月, 日本先天代謝異常学会雑誌, 37, 131 - 131, 日本語極低出生体重児におけるビオチンおよびビオチン関連代謝産物の推移
- (一社)日本腎臓学会, 2021年09月, 日本腎臓学会誌, 63(6-E) (6-E), 675 - 675, 日本語腎生検にてmedullary dysplasiaが示唆されたADTKD-HNF1βの一例
- (一社)日本腎臓学会, 2021年09月, 日本腎臓学会誌, 63(6-E) (6-E), 723 - 723, 日本語COL4A4遺伝子変異による常染色体優性アルポート症候群の1例
- (一社)日本先天代謝異常学会, 2021年09月, 日本先天代謝異常学会雑誌, 37, 131 - 131, 日本語極低出生体重児におけるビオチンおよびビオチン関連代謝産物の推移
- BACKGROUND: In typical cases of Bartter syndrome (BS), assessing response to diuretics (furosemide and thiazide), hereinafter referred to as diuretic loading test, may be used to diagnose the type by detecting which part of the kidney tubule is not functioning correctly. However, the diuretic loading test may not always agree with the results of genetic analyses. CASE PRESENTATION: A 5-year-old boy was admitted due to lower extremity weakness and abnormal gait. He had a recurrent episode of muscle weakness and laboratory results showed severe hypokalemia. The direct genomic sequencing of the case revealed a new mutation in the SLC12A1 gene, which is associated with type I Bartter syndrome. Because there was the difference between the phenotype and genotype, we conducted a diuretic loading test to confirm the diagnosis. However, the results showed a clear increase in urine excretion of Na and Cl. These results were not consistent with typical type I BS, but consistent with the patient's phenotype. CONCLUSION: The diuretic loading test has limited utility for diagnosis especially in atypical cases. On the other hand, this test, which allows assessment of channel function, is useful for better understanding of the genotype-phenotype correlation.2021年08月, BMC nephrology, 22(1) (1), 295 - 295, 英語, 国際誌研究論文(学術雑誌)
- Gitelman syndrome is an autosomal recessive inherited salt-losing tubulopathy. It has a prevalence of around 1 in 40,000 people, and heterozygous carriers are estimated at approximately 1%, although the exact prevalence is unknown. We estimated the predicted prevalence of Gitelman syndrome based on multiple genome databases, HGVD and jMorp for the Japanese population and gnomAD for other ethnicities, and included all 274 pathogenic missense or nonsense variants registered in HGMD Professional. The frequencies of all these alleles were summed to calculate the total variant allele frequency in SLC12A3. The carrier frequency and the disease prevalence were assumed to be twice and the square of the total allele frequency, respectively, according to the Hardy-Weinberg principle. In the Japanese population, the total carrier frequencies were 0.0948 (9.5%) and 0.0868 (8.7%) and the calculated prevalence was 0.00225 (2.3 in 1000 people) and 0.00188 (1.9 in 1000 people) in HGVD and jMorp, respectively. Other ethnicities showed a prevalence varying from 0.000012 to 0.00083. These findings indicate that the prevalence of Gitelman syndrome in the Japanese population is higher than expected and that some other ethnicities also have a higher prevalence than has previously been considered.2021年08月, Scientific reports, 11(1) (1), 16099 - 16099, 英語, 国際誌研究論文(学術雑誌)
- Bilateral Renal Hypoplasia with High β2-Microglobulinuria in the Neonatal Period.Urinary β2 microglobulin (β2-MG) is a low-molecular-weight protein that is filtered by the glomerular basement membrane and absorbed by the proximal tubule epithelial cells. In perinatal management, urinary β2-MG levels are used to assess intrauterine inflammation in newborns, since urinary excretion increases during inflammation. Furthermore, β2-MG levels in fetal blood and urine are also used for predicting fetal renal function because β2-MG is not transferred to the placenta. Herein, we reported a patient with persistent high urinary β2-MG levels since neonatal period, who was later diagnosed with bilateral renal hypoplasia. If a newborn presents persistent hyper β2-microglobulinuria even without hematuria or proteinuria, congenital renal malformations should be considered.2021年08月, The Kobe journal of medical sciences, 67(1) (1), E34-E37, 英語, 国内誌研究論文(学術雑誌)
- ABSTRACT: Steroid pulse therapy is widely used to treat virus-associated acute encephalopathy, especially the cytokine storm type; however, its effectiveness remains unknown. We sought to investigate the effectiveness of early steroid pulse therapy for suspected acute encephalopathy in the presence of elevated aspartate aminotransferase (AST) levels.We enrolled children admitted to Hyogo Children's Hospital between 2003 and 2017 with convulsions or impaired consciousness accompanied by fever (temperature >38°C). The inclusion criteria were: refractory status epilepticus or prolonged neurological abnormality or hemiplegia at 6 hours from onset, and AST elevation >90 IU/L within 6 hours of onset. We excluded patients with a neurological history. We compared the prognosis between the groups with or without steroid pulse therapy within 24 hours. A good prognosis was defined as a Pediatric Cerebral Performance Category Scale (PCPC) score of 1-2 at the last evaluation, within 30 months of onset. Moreover, we analyzed the relationship between prognosis and time from onset to steroid pulse therapy.Fifteen patients with acute encephalopathy and 5 patients with febrile seizures were included in this study. Thirteen patients received steroid pulse therapy within 24 hours. There was no between-group difference in the proportion with a good prognosis. There was no significant correlation between PCPC and timing of steroid pulse therapy (rs = 0.253, P = .405). Even after excluding 2 patients with brainstem lesions, no significant correlation between PCPC and steroid pulse therapy timing (rs = 0.583, P = .060) was noted. However, the prognosis tended to be better in patients who received steroid pulse therapy earlier.Steroid pulse therapy within 24 hours did not improve the prognosis in children with suspected acute encephalopathy associated with elevated AST. Still, even earlier administration of treatment could prevent the possible neurological sequelae of this condition.2021年07月, Medicine, 100(30) (30), e26660, 英語, 国際誌研究論文(学術雑誌)
- Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder that causes degeneration of anterior horn cells in the human spinal cord and subsequent loss of motor neurons. The severe form of SMA is among the genetic diseases with the highest infant mortality. Although SMA has been considered incurable, newly developed drugs-nusinersen and onasemnogene abeparvovec-improve the life prognoses and motor functions of affected infants. To maximize the efficacy of these drugs, treatments should be started at the pre-symptomatic stage of SMA. Thus, newborn screening for SMA is now strongly recommended. Herein, we provide some data based on our experience of SMA diagnosis by genetic testing in Japan. A total of 515 patients suspected of having SMA or another lower motor neuron disease were tested. Among these patients, 228 were diagnosed as having SMA with survival motor neuron 1 (SMN1) deletion. We analyzed the distribution of clinical subtypes and ages at genetic testing in the SMN1-deleted patients, and estimated the SMA incidence based on data from Osaka and Hyogo prefectures, Japan. Our data showed that confirmed diagnosis by genetic testing was notably delayed, and the estimated incidence was 1 in 30,000-40,000 live births, which seemed notably lower than in other countries. These findings suggest that many diagnosis-delayed or undiagnosed cases may be present in Japan. To prevent this, newborn screening programs for SMA (SMA-NBS) need to be implemented in all Japanese prefectures. In this article, we also introduce our pilot study for SMA-NBS in Osaka Prefecture.2021年07月, International journal of neonatal screening, 7(3) (3), 英語, 国際誌研究論文(学術雑誌)
- The incidence of syphilis infection among pregnant women is persistently high in Japan and in several developed countries. Here, we report the utility of intravenous benzylpenicillin in 13 infants born to mothers with syphilis infection. Because the recommended treatment (intramuscular benzathine benzylpenicillin) is not available in Japan, we intravenously administered benzylpenicillin for 10 days, which is used for treatment in high-risk cases. The administration of benzylpenicillin in low-risk infants resulted in an extended duration of parent-to-infant separation and increased the infants' exposure to invasive procedures. Thus, establishing evidence of the adequacy of no-treatment follow-up in low-risk groups and introducing intramuscular injections of benzathine benzylpenicillin may improve the management of infants suspected with congenital syphilis in Japan.2021年07月, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 27(11) (11), 1662 - 1664, 英語, 国際誌研究論文(学術雑誌)
- 日本小児腎不全学会, 2021年07月, 日本小児腎不全学会雑誌, 41, 119 - 123, 日本語学校検診で発見されたdense deposit diseaseの1例
- BACKGROUND: Pathological findings in Alport syndrome frequently show mesangial proliferation and sometimes incidental IgA deposition, in addition to unique glomerular basement membrane (GBM) changes including thin basement membrane and/or lamellation. However, similar GBM abnormalities are also often observed in IgA nephropathy. Both diseases are also known to show hematuria, proteinuria, and sometimes macrohematuria when associated with viral infection. Therefore, it can be difficult to make a differential diagnosis, even based on clinical and pathological findings. Some recent articles demonstrated that galactose-deficient IgA1 (Gd-IgA1)-specific monoclonal antibody (KM55) could potentially enable incidental IgA deposition to be distinguished from IgA nephropathy. METHODS: We performed comprehensive gene screening and glomerular Gd-IgA1 and type IV collagen α5 chain immunostaining for five cases with both IgA deposition and GBM changes to confirm that Gd-IgA1 can help to distinguish these two diseases. RESULTS: Four of the cases were genetically diagnosed with Alport syndrome (Cases 1-4) and one was IgA nephropathy with massive GBM changes, which had a negative gene test result (Case 5). In Cases 1-4, glomerular Gd-IgA1 deposition was not detected, although there was positivity for IgA in the mesangial area. In Case 5, glomerular Gd-IgA1 deposition was observed. CONCLUSION: Gd-IgA1 expression analysis could clearly differentiate these two disorders. This approach can be applied to identify these two diseases showing identical clinical and pathological findings.2021年07月, Clinical and experimental nephrology, 25(7) (7), 779 - 787, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Fabry disease is an X-linked inherited lysosomal storage disorder caused by mutations in the gene encoding α-galactosidase A. Males are usually severely affected, while females have a wide range of disease severity. This variability has been assumed to be derived from organ-dependent skewed X-chromosome inactivation (XCI) patterns in each female patient. Previous studies examined this correlation using the classical methylation-dependent method; however, conflicting results were obtained. This study was established to ascertain the existence of skewed XCI in nine females with heterozygous pathogenic variants in the GLA gene and its relationship to the phenotypes. METHODS: We present five female patients from one family and four individual female patients with Fabry disease. In all cases, heterozygous pathogenic variants in the GLA gene were detected. The X-chromosome inactivation patterns in peripheral blood leukocytes and cells of urine sediment were determined by both classical methylation-dependent HUMARA assay and ultra-deep RNA sequencing. Fabry Stabilization Index was used to determine the clinical severity. RESULTS: Skewed XCI resulting in predominant inactivation of the normal allele was observed only in one individual case with low ⍺-galactosidase A activity. In the remaining cases, no skewing was observed, even in the case with the highest total severity score (99.2%). CONCLUSION: We conclude that skewed XCI could not explain the severity of female Fabry disease and is not the main factor in the onset of various clinical symptoms in females with Fabry disease.2021年06月, Clinical and experimental nephrology, 25(11) (11), 1224 - 1230, 英語, 国内誌研究論文(学術雑誌)
- 日本小児泌尿器科学会, 2021年06月, 日本小児泌尿器科学会雑誌, 30(2) (2), 202 - 202, 日本語
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 396 - 396, 日本語小児から成人へのシームレスなネフローゼ診療 単一遺伝子異常と小児および成人におけるネフローゼ症候群
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 435 - 435, 日本語ゲノムデータベースに基づく民族によるGitelman症候群の推定有病率の検討
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 456 - 456, 日本語COL4A5遺伝子collagenous domain内のnon-Glyミスセンス変異によるX染色体連鎖型Alport症候群発症メカニズムの解明
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 444 - 444, 日本語Oxford分類による小児IgA腎症(IgAN)、紫斑病性腎炎(IgAVN)の臨床病理学的検討
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 456 - 456, 日本語CLCN5遺伝子を含むX染色体微細欠失により発症したDent disease-1女性の2例
- (一社)日本遺伝カウンセリング学会, 2021年06月, 日本遺伝カウンセリング学会誌, 42(2) (2), 102 - 102, 日本語
- BACKGROUND: Although hypotension is a life-threatening complication of nephrectomy in children, risk factors for its development remain unknown. We evaluated the incidence, clinical course, and associated risk factors of pediatric post-nephrectomy hypotension in an observational study. METHODS: This retrospective observational study included the clinical data of children who underwent nephrectomy in our center between 2002 and 2020. Patients undergoing nephrectomy at kidney transplantation and those who developed hypotension before nephrectomy were excluded. RESULTS: The study included 55 nephrectomies in 51 patients, including 42 unilateral, 4 two-stage bilateral, and 5 simultaneous bilateral nephrectomies. The diagnoses were isolated Wilms tumor, neuroblastoma, congenital nephrotic syndrome, Denys-Drash syndrome, WAGR (Wilms tumor, aniridia, genitourinary malformations, and mental retardation) syndrome, and autosomal recessive polycystic kidney disease in 24, 10, 9, 6, 1, and 1 patient, respectively. Post-nephrectomy hypotension developed in 11 (20%) patients. Two patients (3.6%) had persistent hypotension; both had their kidneys resected, and one patient (1.8%) died. Male sex, kidney disease, resection of both kidneys, low estimated glomerular filtration rate, increased left ventricular posterior wall thickness in diastole, hypertension before nephrectomy, antihypertensive use, hyperreninemia, and hyperaldosteronism were significantly associated with post-nephrectomy hypotension. Multivariate logistic regression analysis revealed that hypertension before nephrectomy was the only significant risk factor for post-nephrectomy hypotension (P = 0.04). CONCLUSIONS: Hypertension before nephrectomy is a significant risk factor for pediatric post-nephrectomy hypotension. Life-threatening hypotension, which might occur after bilateral nephrectomy in infants, should be considered, especially in children with higher risks.2021年05月, Pediatric nephrology (Berlin, Germany), 36(11) (11), 3699 - 3709, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 92 - 92, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 92 - 92, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 98 - 98, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 126 - 126, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 111 - 111, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 112 - 112, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 113 - 113, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 148 - 148, 日本語
- INTRODUCTION: WT1 missense mutation in exon 8 or 9 causes infantile nephrotic syndrome with early progression to end-stage kidney disease (ESKD), Wilms tumor, and 46,XY female. However, some patients with missense mutations in exon 8 or 9 progress to ESKD in their teens or later. Therefore, we conducted a systematic review and functional analysis of WT1 transcriptional activity. METHODS: We conducted a systematic review of 174 cases with WT1 exon 8 or 9 missense variants from our cohort (n=13) and previous reports (n=161). Of these cases, mild and severe genotypes were selected for further in vitro functional analysis using luciferase assay. RESULTS: The median age of developing ESKD was 1.17 years. A comparative study was conducted among three WT1 genotype classes: mutations of the DNA-binding site (DBS group), mutations outside the DNA-binding site but at sites important for zinc finger structure formation by 2 cysteines and 2 histidines (C2H2 group), and mutations leading to other amino acid changes (Others group). The DBS group showed the severest phenotype and the C2H2 group was intermediate, whereas the Others group showed the mildest phenotype (developing ESKD at 0.90, 2.00, and 3.92 years, respectively, with significant differences). In vitro functional analysis showed dominant-negative effects for all variants; in addition, the DBS and C2H2 mutations were associated with significantly lower WT1 transcriptional activity than the other mutations. CONCLUSION: Not only the DNA-binding site but also C2H2 zinc finger structure sites are important for maintaining WT1 transcriptional activity, and their mutation causes severe clinical symptoms.Elsevier BV, 2021年05月, Kidney International Reports, 6(8) (8), 2114 - 2121, 英語, 国際誌研究論文(学術雑誌)
- We present a female patient with a dual genetic diagnosis of autosomal dominant tubulointerstitial kidney disease and KBG syndrome. The proband was an 18-year-old woman presenting with intellectual disability, renal insufficiency, and hyperuricemia. Abdominal ultrasonography did not reveal any abnormalities. The patient's father had been diagnosed with chronic kidney disease and hyperuricemia in his twenties; however, he had no intellectual disability. Her mother and two younger siblings were not affected. Next generation sequencing (NGS) identified mutations in UMOD (c.796T > C) of the proband and her father, and in ANKRD11 (c.1903_1907del) of the proband. Renal insufficiency and intellectual disability were attributed to mutations in UMOD and ANRKD11, respectively. When making genetic diagnoses, the presence of multiple mutations in an individual should be considered, particularly when not all symptoms could be attributed to a single disease. The number of patients with dual genetic diagnosis is expected to increase as NGS becomes more readily available; thus, making it necessary to undertake a careful and robust assessment of the clinical symptoms and the related genotypes, to ensure an accurate diagnosis.2021年05月, CEN case reports, 10(2) (2), 184 - 188, 英語, 国内誌研究論文(学術雑誌)
- OBJECTIVE: The clinical prediction rule (CPR) for acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) was developed with an area under the receiver operating characteristic curve (AUC) of 0.95 - 0.96. Our objective was to verify the AESD CPR in a new cohort and compare the utilities of three CPRs of acute encephalopathy: the Tada, Yokochi, and Nagase criteria. METHODS: We reviewed the clinical data and medical charts of 580 consecutive patients (aged < 18 years) with febrile convulsive status epilepticus lasting for ≥ 30 min in 2002 - 2017 and measured the performance of the CPRs in predicting AESD and sequelae. RESULTS: The CPRs predicted AESD with an AUC of 0.84 - 0.88. The Tada criteria predicted AESD with a positive predictive value (PPV) of 0.25 and a negative predictive value (NPV) of 0.99. The Yokochi criteria predicted AESD with a PPV and NPV of 0.20 and 0.95, respectively, after 12 h. The Nagase criteria predicted AESD with a PPV and NPV of 0.14 and 1.00, respectively, after 6 h. The PPVs of the Tada, Yokochi, and Nagase criteria for sequelae were 0.28, 0.28, and 0.17, respectively; the corresponding NPVs were 0.97, 0.95, and 0.98, respectively. CONCLUSIONS: The effectiveness of the AESD CPR in a new cohort was lower than that in the derivation study. CPRs are not sufficient as diagnostic tests, but they are useful as screening tests. The Nagase criteria are the most effective for screening among the three CPRs due to their high NPV and swiftness.2021年05月, Brain & development, 43(5) (5), 616 - 625, 英語, 国際誌研究論文(学術雑誌)
- 2021年05月, Clinical and experimental nephrology, 25(5) (5), 564 - 564, 英語, 国内誌
- Transient receptor potential channel C6 encoded by TRPC6 is involved in slit diaphragm formation in podocytes, and abnormalities of the TRPC6 protein cause various glomerular diseases. The first identified pathogenic variant of TRPC6 was found to cause steroid-resistant nephrotic syndrome that typically developed in adulthood and then slowly led to end-stage renal disease, along with a renal pathology of focal segmental glomerulosclerosis. Here, we report a patient with rapidly progressing infantile nephrotic syndrome and a heterozygous missense TRPC6 variant. The patient, a 2-year-old Japanese boy, developed steroid-resistant nephrotic syndrome at age 11 months. His renal function deteriorated rapidly, and peritoneal dialysis was introduced at age 1 year and 6 months. His renal pathology, obtained at age 1 year and 1 month, was consistent with diffuse mesangial sclerosis (DMS). Clinical exome analysis and custom panel analysis for hereditary renal diseases revealed a reported heterozygous missense variant in TRPC6 (NM_004621.5:c.523C > T:p.Arg175Trp). This is the first report of a patient with a TRPC6-related renal disorder associated with DMS.2021年04月, American journal of medical genetics. Part A, 185(7) (7), 2175 - 2179, 英語, 国際誌
- Abnormal gut motility is a feature of several mitochondrial encephalomyopathies, and mutations in genes such as TYMP and POLG, have been linked to these rare diseases. The human genome encodes three DNA ligases, of which only one, ligase III (LIG3), has a mitochondrial splice variant and is crucial for mitochondrial health. We investigated the effect of reduced LIG3 activity and resulting mitochondrial dysfunction in seven patients from three independent families, who showed the common occurrence of gut dysmotility and neurological manifestations reminiscent of mitochondrial neurogastrointestinal encephalomyopathy. DNA from these patients was subjected to whole exome sequencing. In all patients, compound heterozygous variants in a new disease gene, LIG3, were identified. All variants were predicted to have a damaging effect on the protein. The LIG3 gene encodes the only mitochondrial DNA (mtDNA) ligase and therefore plays a pivotal role in mtDNA repair and replication. In vitro assays in patient-derived cells showed a decrease in LIG3 protein levels and ligase activity. We demonstrated that the LIG3 gene defects affect mtDNA maintenance, leading to mtDNA depletion without the accumulation of multiple deletions as observed in other mitochondrial disorders. This mitochondrial dysfunction is likely to cause the phenotypes observed in these patients. The most prominent and consistent clinical signs were severe gut dysmotility and neurological abnormalities, including leukoencephalopathy, epilepsy, migraine, stroke-like episodes, and neurogenic bladder. A decrease in the number of myenteric neurons, and increased fibrosis and elastin levels were the most prominent changes in the gut. Cytochrome c oxidase (COX) deficient fibres in skeletal muscle were also observed. Disruption of lig3 in zebrafish reproduced the brain alterations and impaired gut transit in vivo. In conclusion, we identified variants in the LIG3 gene that result in a mitochondrial disease characterized by predominant gut dysmotility, encephalopathy, and neuromuscular abnormalities. Bonora et al. identify a new mitochondrial recessive disorder caused by biallelic variants in the LIG3 gene encoding DNA ligase III, which is responsible for mitochondrial DNA repair. Clinical signs include gut dysmotility and neurological features such as leucoencephalopathy, epilepsy and stroke-like episodes.2021年04月, Brain : a journal of neurology, 144(5) (5), 1451 - 1466, 英語, 国際誌研究論文(学術雑誌)
- OBJECTIVES: To examine the association between the number of visits to the emergency department (ED) by children for night-time headaches and exposure to multifaceted factors, such as meteorological conditions and air pollution. DESIGN: We conducted a clinical observational time-series analysis study. SETTING: We reviewed consecutive patients younger than 16 years of age at the primary ED centre in Kobe city, Japan, during the night shift (19:30-7:00 hours) between 1 January 2011 and 31 December 2019. PARTICIPANTS: In total, 265 191 children visited the ED; 822 presented with headache during the study period. PRIMARY OUTCOME MEASURES: We investigated the effects of meteorological factors and air pollutants by multivariate analysis of Poisson regression estimates. A subanalysis included the relationship between the number of patients with night-time headaches and the above factors by sex. Furthermore, the effect of typhoon landing on patient visits for headache was also analysed. Headache was not classified because examinations were performed by general paediatricians (non-specialists). RESULTS: The number of patients with night-time headaches displayed distinct seasonal changes, with peaks during the summer. Multivariate analysis of Poisson regression estimates revealed a significant positive relationship between the number of patients for headache and mean temperature. Subanalysis by sex indicated a positive relationship between the number of patients with headache and mean temperature in both sexes; however, it was significant only for females. No relationship was found between the number of patients with headache and air pollution. There was no change in the number of patients for night-time headaches 3 days before and after typhoon landing. CONCLUSIONS: High temperature is the main factor for visiting ED for night-time headaches among children in Kobe city. Our results suggest that preventive measures against night-time headaches may be possible by reducing time spent outside during summer.2021年04月, BMJ open, 11(4) (4), e046520, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2021年04月, 日本小児腎臓病学会雑誌, 34(1) (1), 87 - 87, 日本語
- (一社)日本小児腎臓病学会, 2021年04月, 日本小児腎臓病学会雑誌, 34(1) (1), 91 - 91, 日本語
- (一社)日本小児腎臓病学会, 2021年04月, 日本小児腎臓病学会雑誌, 34(1) (1), 93 - 93, 日本語
- BACKGROUND: IgA nephropathy (IgAN) is characterized by predominant mesangial IgA deposition. Some patients with IgAN demonstrate IgA deposition in glomerular peripheral capillaries (cap-IgA). The clinicopathological significance of cap-IgA remains incompletely investigated in children. METHODS: We retrospectively analyzed 503 consecutive cases of biopsy-proven childhood IgAN between July 1976 and June 2013 to compare clinical and pathological features between IgAN patients with and without cap-IgA. RESULTS: Among the 503 patients, 30 (6.0%) had cap-IgA. We found significant differences in proteinuria (2.0 vs. 0.5 g/day/m2, p < 0.0001), time from onset to kidney biopsy (2.2 vs. 8.3 months, p < 0.0001), and rate of proteinuria remission after treatment (23.3% vs. 48.0%, p = 0.007) between both groups. Pathological analysis revealed significant differences in M1 (83.3% vs. 56.0%, p = 0.002), ratio of subendothelial electron dense deposits (EDDs, 58.6% vs. 16.5%, p < 0.0001) and subepithelial EDDs (48.3% vs. 16.5%, p = 0.0001), and glomerular basement membrane (GBM) lysis (58.6% vs. 27.1%, p = 0.0006) between both groups. More than half of cap-IgA patients (17/30, 56.7%), whereas only 26.2% of non-cap-IgA patients (124/473), were treated with immunosuppressive treatments. Six of 30 cases (20%) with cap-IgA reached glomerular filtration rate (GFR) categories G3a-G5 (estimated GFR < 60 ml/min/1.73 m2) at most recent observation (mean observation period: 7.0 ± 4.0 years). According to Kaplan-Meier analysis, patients with cap-IgA had significantly lower kidney survival curves than non-cap-IgA patients (72.8% vs. 97.2% at 10 years, p < 0.0001). CONCLUSIONS: Cap-IgA is associated with acute inflammation with GBM changes, resulting in refractory heavier proteinuria. Cap-IgA may represent a poor prognostic factor.2021年04月, Pediatric nephrology (Berlin, Germany), 36(4) (4), 899 - 908, 英語, 国際誌研究論文(学術雑誌)
- Neonatal jaundice has been suggested as a perinatal risk factor for autism spectrum disorder (ASD). We examined UGT1A1 polymorphisms to assess the potential of neonatal jaundice as a risk factor for ASD in children by using DNA extracted from preserved umbilical cord. In total, 79 children with ASD were genotyped for UGT1A1*28 (c.-41-40dup), UGT1A1*6 (c.211 G > A), and UGT1A1*27 (c.686 C > A). The allele frequency of UGT1A1*6 (OR = 1.34, p = 0.26) and UGT1A1*28 (OR = 0.80, p = 0.54) and the prevalence of UGT1A1*28/*6 diplotypes did not differ significantly from those in the control population. No UGT1A1*27 allele was detected in the subjects. ASD symptom assessment scores were not associated with UGT1A1*28/*6/*27 genotypes or UGT1A1*28/*6 diplotypes. These results suggest that neonatal jaundice is not significantly associated with ASD.2021年03月, Journal of autism and developmental disorders, 52(2) (2), 483 - 489, 英語, 国際誌研究論文(学術雑誌)
- Diamond-Blackfan anemia (DBA) is mainly caused by pathogenic variants in ribosomal proteins and 22 responsible genes have been identified to date. The most common causative gene of DBA is RPS19 [NM_001022.4]. Nearly 180 RPS19 variants have been reported, including three deep intronic variants outside the splicing consensus sequence (c.72-92A > G, c.356 + 18G > C, and c.411 + 6G > C). We also identified one case with a c.412-3C > G intronic variant. Without conducting transcript analysis, the pathogenicity of these variants is unknown. However, it is difficult to assess transcripts because of their fragility. In such cases, in vitro functional splicing assays can be used to assess pathogenicity. Here, we report functional splicing analysis results of four RPS19 deep intronic variants identified in our case and in previously reported cases. One splicing consensus variant (c.411 + 1G > A) was also examined as a positive control. Aberrant splicing with a 2-bp insertion between exons 5 and 6 was identified in the patient samples and minigene assay results also identified exon 6 skipping in our case. The exon 6 skipping transcript was confirmed by further evaluation using quantitative RT-PCR. Additionally, minigene assay analysis of three reported deep intronic variants revealed that none of them showed aberrant splicing and that these variants were not considered to be pathogenic. In conclusion, the minigene assay is a useful method for functional splicing analysis of inherited disease.2021年02月, Pediatric hematology and oncology, 38(6) (6), 1 - 16, 英語, 国際誌研究論文(学術雑誌)
- The identification of monogenic causes in patients with proteinuria has revealed that the encoded proteins functionally participate in distinct cellular tasks and signaling pathways in the slit diaphragms of the glomerular basement membrane. FAT1 is a member of a small family of vertebrate-cadherin-like genes, which is a crucial component in slit diaphragms and has a vital role in tubular regeneration. Only 5 cases with glomerulonephritis having FAT1 gene biallelic variants have been reported. However, only one had the biallelic truncating variant, and others had missense variants. Therefore, we need further evidence of this gene being responsible for steroid-resistant nephrotic syndrome (SRNS) or glomerulonephritis. Here we describe a 5-year-old boy in who proteinuria was detected at the age of 3 years without any extrarenal symptom. The pathological findings were examined, and targeted exome sequencing was performed. We also conducted reviews for all previously-reported cases of glomerulonephritis possessing FAT1 biallelic gene variants. We found two novel truncating variants in FAT1 (NM_005245.3), c.12867dup in exon 10, and, c.5480_5483del in exon 25. Our case showed mild proteinuria compared to previously-reported cases who showed SRNS and extrarenal symptoms that might have been because the latter variant in our patient was located on out of cadherin domains; however, our follow up period is short and we further need careful follow up. Our findings corroborate the evidence that individuals with FAT1-truncating variants can show isolated mild proteinuria. Further studies are needed to investigate the genotype-phenotype correlation in this disease. Therefore, our case will provide vital information regarding this rare condition.2021年02月, CEN case reports, 10(1) (1), 100 - 105, 英語, 国内誌研究論文(学術雑誌)
- We report a case of a preterm infant who developed cow's milk allergy. This male infant presented with recurrent ascites and was successfully treated with donated breast milk. He was born at 24 weeks' gestation with a birthweight of 506 g. From day 20, infant formula, soy protein-based formula, and casein-hydrolyzed formula were used due to insufficient maternal lactation. This resulted in abdominal distention, generalized edema, and recurrent ascites. We diagnosed him with cow's milk allergy since these symptoms improved on exclusive breast milk feeding. No recurrence of symptoms occurred when donated breast milk was used in combination with the mother's own milk. Ascites should be regarded as a clinical symptom of neonatal cow's milk allergy. Donated breast milk may be effective in the treatment of the allergy if breastfeeding is not available.2021年01月, International journal of environmental research and public health, 18(3) (3), 英語, 国際誌
- Biallelic pathogenic variants in the laminin β2 (LAMB2) gene, which encodes laminin β2, are associated with Pierson syndrome characterized by a congenital nephrotic syndrome that rapidly progresses to end-stage renal disease, distinct ocular maldevelopment with bilateral microcoria, and neurodevelopmental deficits. However, the phenotypic spectrum of LAMB2-associated disorder is broader than expected, and cases with milder phenotypes such as isolated congenital or infantile nephrotic syndrome have also been reported. We report a patient with LAMB2-associated renal disorder showing an extremely mild phenotype. A 5-year-old girl presented with asymptomatic proteinuria and hematuria detected by urinalysis screening. She had been previously healthy without any additional renal symptoms. The serum albumin and creatinine levels were normal. Renal biopsy revealed minor glomerular abnormalities with occasional focal mesangial proliferation. Electron microscopy showed no structural changes in the glomerular basement membrane. Targeted sequencing of podocyte-related genes using next-generation sequencing was performed. As a result, previously reported biallelic pathogenic variants of the truncating variant (c.5073_5076dupCCAG) and a splice site variant (c.3797 + 5G > A) in the LAMB2 gene were detected, and the patient was diagnosed with LAMB2-associated renal disorder. Interestingly, a previously reported case with this splicing variant also showed an atypically mild phenotype. We suggest that clinicians should consider LAMB2-associated nephritis as an important differential diagnosis in children with asymptomatic proteinuria and microscopic hematuria if there is no structural change in the glomerular basement membrane. A comprehensive gene-screening system using next-generation sequencing is useful for diagnosing these atypical cases with isolated urine abnormalities.2021年01月, CEN case reports, 10(3) (3), 359 - 363, 英語, 国内誌研究論文(学術雑誌)
- To date, the difference in neurodevelopmental outcomes between late preterm infants (LPI) born at 34 and 35 gestational weeks (LPI-34 and LPI-35, respectively) has not been elucidated. This retrospective study aimed to evaluate neurodevelopmental outcomes at 18 months of corrected age for LPI-34 and LPI-35, and to elucidate factors predicting neurodevelopmental impairment (NDI). Records of all LPI-34 (n = 93) and LPI-35 (n = 121) admitted to our facility from 2013 to 2017 were reviewed. Patients with congenital or chromosomal anomalies, severe neonatal asphyxia, and without developmental quotient (DQ) data were excluded. Psychomotor development was assessed as a DQ using the Kyoto Scale of Psychological Development at 18 months of corrected age. NDI was defined as DQ <80 or when severe neurodevelopmental problems made neurodevelopmental assessment impossible. We compared the clinical characteristics and DQ values between LPI-34 (n = 62) and LPI-35 (n = 73). To elucidate the factors predicting NDI at 18 months of corrected age, we compared clinical factors between the NDI (n = 17) and non-NDI (n = 118) groups. No significant difference was observed in DQ values at 18 months of corrected age between the groups in each area and overall. Among clinical factors, male sex, intraventricular hemorrhage (IVH), hyperbilirubinemia, and severe hyperbilirubinemia had a higher prevalence in the NDI group than in the non-NDI group, and IVH and/or severe hyperbilirubinemia showed the highest Youden Index values for predicting NDI. Based on the results of this study, we can conclude that no significant difference in neurodevelopmental outcomes at 18 months of corrected age was observed between LPI-34 and LPI-35. Patients with severe hyperbilirubinemia and/or IVH should be considered to be at high risk for developing NDI.2021年01月, International journal of environmental research and public health, 18(2) (2), 英語, 国際誌研究論文(学術雑誌)
- 日本ベーリンガーインゲルハイム(株), 2021年, 腎炎症例研究, 38, 46 - 67, 日本語再生検にて糸球体硬化病変の著明な進行とともに蛍光抗体法の染色パターンの変化を呈した巣状分節性糸球体硬化症の一例
- 日本ベーリンガーインゲルハイム(株), 2021年, 腎炎症例研究, 38, 46 - 67, 日本語再生検にて糸球体硬化病変の著明な進行とともに蛍光抗体法の染色パターンの変化を呈した巣状分節性糸球体硬化症の一例
- Patients with hemorrhagic shock and encephalopathy syndrome (HSES) have a high early mortality rate, which may be caused by a 'cytokine storm'. However, there is little information on how cytokines and chemokines change over time in these patients. We aimed to describe the characteristics of HSES by examining changes in serum biomarker levels over time. Six patients with HSES were included. We retrospectively evaluated their clinical course and imaging/laboratory data. We measured serum levels of multiple cytokines [interleukin 1β (IL-1β), IL-2, IL-4, IL-6, IL-10, IL-17, interferon-gamma, and tumor necrosis factor alpha], chemokines (IL-8, monocyte chemoattractant protein-1, interferon-inducible protein-10), and growth and differentiation factor (GDF)-15. The highest cytokine and chemokine levels were noted in the first 24 h, and decreased thereafter. The GDF-15 level was markedly high. Cytokine, chemokine, and GDF-15 levels were significantly higher in patients with HSES than in controls in the first 24 h, except for IL-2 and IL-4. Patients with HSES have high inflammatory cytokine and chemokine levels, a high GDF-15 level in the first 24 h, and high lactate levels. Our study provides new insights on the pathophysiology of HSES, a detailed clinical picture of patients with HSES, and potential biomarkers.2021年01月, Cytokine, 137, 155324 - 155324, 英語, 国際誌研究論文(学術雑誌)
- 2021年01月, Pediatrics and neonatology, 62(1) (1), 119 - 121, 英語, 国際誌
- This study aimed to investigate the long-term changes in awareness of and knowledge about mother-to-child infections across 6 years in Japan. A questionnaire survey was conducted at our facility from October 2012 to January 2018, and the study periods were divided into 4 phases comprising 16 months each. A multiple-choice questionnaire assessed participants' awareness of the following 13 pathogens of mother-to-child infections: cytomegalovirus (CMV), Toxoplasma gondii (T. gondii), hepatitis B virus, rubella virus, herpes simplex virus, parvovirus B19, hepatitis C virus, human immunodeficiency virus, human T cell leukemia virus type-1, measles virus, varicella-zoster virus, Chlamydia trachomatis, and Treponema pallidum. For the selected four pathogens (i.e., CMV, rubella virus, T. gondii, and parvovirus B19), the questionnaire also evaluated participants' knowledge of transmission routes, the most susceptible time of infection that could yield severe fetal disease during pregnancy, the maximum frequency of fetal infection in cases of maternal infection, and methods to prevent maternal infection. In total, 1433 pregnant Japanese women were included in this study. There was no secular change in awareness of the pathogens concerning mother-to-child infections over time, and we also clarified that the detailed knowledge of the four pathogens of typical mother-to-child infections did not improve. Since knowledge about methods to prevent maternal infection is still insufficient for all pathogens, further advocacy is required to prevent mother-to-child infections.2021年, PloS one, 16(1) (1), e0244945, 英語, 国際誌研究論文(学術雑誌)
- INTRODUCTION: Alport syndrome is a rare genetic disorder that affects as many as 60,000 persons in the USA and a total of 103,000 persons (<5 per 10,000) in the European Union [1, 2]. It is the second most common inherited cause of kidney failure and is characterized by progressive loss of kidney function that often leads to end-stage kidney disease. Currently, there are no approved disease-specific agents for therapeutic use. We designed a phase 3 study (CARDINAL; NCT03019185) to evaluate the safety, tolerability, and efficacy of bardoxolone methyl in patients with Alport syndrome. METHODS: The CARDINAL phase 3 study is an international, multicenter, double-blind, placebo-controlled, randomized registrational trial. Eligible patients were of ages 12-70 years with confirmed genetic or histologic diagnosis of Alport syndrome, eGFR 30-90 mL/min/1.73 m2, and urinary albumin to creatinine ratio (UACR) ≤3,500 mg/g. Patients with B-type natriuretic peptide values >200 pg/mL at baseline or with significant cardiovascular histories were excluded. Patients were randomized 1:1 to bardoxolone methyl or placebo, with stratification by baseline UACR. RESULTS: A total of 371 patients were screened, and 157 patients were randomly assigned to receive bardoxolone methyl (n = 77) or placebo (n = 80). The average age at screening was 39.2 years, and 23 (15%) were <18 years of age. Of the randomized population, 146 (93%) had confirmed genetic diagnosis of Alport syndrome, and 62% of patients had X-linked mode of inheritance. Mean baseline eGFR was 62.7 mL/min/1.73 m2, and the geometric mean UACR was 141.0 mg/g. The average annual rate of eGFR decline prior to enrollment in the study was -4.9 mL/min/1.73 m2 despite 78% of the patient population receiving ACE inhibitor (ACEi) or ARB therapy. DISCUSSION/CONCLUSION: CARDINAL is one of the largest interventional, randomized controlled trials in Alport syndrome conducted to date. Despite the use of ACEi or ARB, patients were experiencing significant loss of kidney function prior to study entry.2021年, American journal of nephrology, 52(3) (3), 180 - 189, 英語, 国際誌研究論文(学術雑誌)
- Alport syndrome (AS) is a progressive inherited kidney disease characterized by hearing loss and ocular abnormalities. There are three forms of AS depending on inheritance mode: X-linked Alport syndrome (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, which encodes type IV collagen α5 chain, while ADAS and ARAS are caused by variants in COL4A3 or COL4A4, which encode type IV collagen α3 or α4 chain, respectively. In male XLAS or ARAS cases, end-stage kidney disease (ESKD) develops around a median age of 20 to 30 years old, while female XLAS or ADAS cases develop ESKD around a median age of 60 to 70 years old. The diagnosis of AS is dependent on either genetic or pathological findings. However, determining the pathogenicity of the variants detected by gene tests can be difficult. Recently, we applied the following molecular investigation tools to determine pathogenicity: 1) in silico and in vitro trimer formation assay of α345 chains to assess triple helix formation ability, 2) kidney organoids constructed from patients' induced pluripotent stem cells to identify α5 chain expression on the glomerular basement membrane, and 3) in vitro splicing assay to detect aberrant splicing to determine the pathogenicity of variants. In this review article, we discuss the genetic background and novel assays for determining the pathogenicity of variants. We also discuss the current treatment approaches and introduce exon skipping therapy as one potential treatment option.2020年12月, Kidney research and clinical practice, 39(4) (4), 402 - 413, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Wilson disease (WD) is an autosomal recessive disorder caused by mutations in the ATP7B gene. In 1984, Scheinberg and Sternlieb estimated the prevalence of WD to be 1:30,000. However, recent epidemiological studies have reported increasing prevalence rates in different populations. The carrier frequency of ATP7B variants and the prevalence of WD in the Japanese population have not been reported using multiple databases. METHODS: Multiple public databases were used. First, we included mutations in the ATP7B gene that were registered in the Human Gene Mutation Database (HGMD) Professional, where 885 ATP7B variants were identified as pathogenic. Next, we investigated the allele frequencies of these 885 variants in Japanese individuals using the Human Genetic Variation Database (HGVD) and the Japanese Multi Omics Reference Panel (jMorp). RESULTS: Of the 885 variants of ATP7B, 7 and 12 missense and nonsense variants, 0 and 3 splicing variants, and 0 and 2 small deletions were found in the HGVD and in jMorp, respectively. The total allele frequencies of the ATP7B mutations were 0.011 in the HGVD and 0.014 in the jMorp. According to these data, the carrier frequencies were 0.022 (2.2%) and 0.028 (2.8%), respectively, and patient frequencies were 0.000121 (1.21/10,000 individuals) and 0.000196 (1.96/10,000 individuals), respectively. CONCLUSION: This is the first study to report the carrier frequency of ATP7B variants and the prevalence of WD in Japan using multiple databases. The calculated prevalence of WD was comparatively higher than that of previous reports, indicating previous underdiagnosis or the existence of less severe phenotypes.2020年12月, Pediatrics international : official journal of the Japan Pediatric Society, 63(8) (8), 918 - 922, 英語, 国際誌研究論文(学術雑誌)
- Extranodal natural killer/T-cell lymphoma (ENKTL) is difficult to identify and diagnose appropriately. Positron emission tomography imaging is a crucial method that leads to precise diagnosis. A proper regimen including stem cell transplantation would possibly improve prognosis of advanced ENKTL.2020年12月, Clinical case reports, 8(12) (12), 3658 - 3660, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Dent disease is associated with low molecular weight proteinuria and hypercalciuria and caused by pathogenic variants in either of two genes: CLCN5 (Dent disease 1) and OCRL (Dent disease 2). It is generally not accompanied by extrarenal manifestations and it is difficult to distinguish Dent disease 1 from Dent disease 2 without gene testing. We retrospectively compared the characteristics of these two diseases using one of the largest cohorts to date. METHODS: We performed gene testing for clinically suspected Dent disease, leading to the genetic diagnosis of 85 males: 72 with Dent disease 1 and 13 with Dent disease 2. A retrospective review of the clinical findings and laboratory data obtained from questionnaires submitted in association with the gene testing was conducted for these cases. RESULTS: The following variables had significantly higher levels in Dent disease 2 than in Dent disease 1: height standard deviation score (height SDS), serum creatinine-based estimated GFR (Cr-eGFR) (median: 84 vs. 127 mL/min/1.73 m2, p < 0.01), serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), serum lactate dehydrogenase (LDH), serum creatine phosphokinase (CK), serum potassium, serum inorganic phosphorus, serum uric acid, urine protein/creatinine ratio (median: 3.5 vs. 1.6 mg/mg, p < 0.01), and urine calcium/creatinine ratio. There were no significant differences in serum sodium, serum calcium, alkaline phosphatase (ALP), urine β2-microglobulin, incidence of nephrocalcinosis, and prevalence of intellectual disability or autism spectrum disorder. CONCLUSIONS: The clinical and laboratory features of Dent disease 1 and Dent disease 2 were shown in this study. Notably, patients with Dent disease 2 showed kidney dysfunction at a younger age, which should provide a clue for the differential diagnosis of these diseases.2020年12月, Pediatric nephrology (Berlin, Germany), 35(12) (12), 2319 - 2326, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Early kidney failure in the hereditary type IV collagen disease, Alport syndrome, can be delayed by renin-angiotensin inhibitors. However, whether all patients and all different genotypes respond equally well to this kidney-protective therapy remains unclear. Here, we performed a retrospective study on 430 patients with male X-linked Alport syndrome to examine the relationships among kidney prognosis, genotype, and treatment effect in a large cohort of Japanese patients. We analyzed the clinical features, genotype-phenotype correlation, and kidney survival period for patients treated with or without renin-angiotensin inhibitors. As a result, the median kidney survival period of patients in this cohort was found to be at 35 years with a strong genotype-phenotype correlation. The median age at the onset of end stage kidney disease (ESKD) significantly differed between patients treated with and without renin-angiotensin inhibitors (over 50 years versus 28 years, respectively). Moreover, these drugs delayed the onset of ESKD in patients with truncating variants for 12 years, extending the median age from 16 years to 28 years. Thus, our results confirmed a strong genotype-phenotype correlation in patients with male X-linked Alport syndrome. Additionally, it was suggested that renin-angiotensin inhibitors could significantly delay ESKD progression. Despite these therapies, patients with truncating variants developed ESKD at the median age of 28 years.2020年12月, Kidney international, 98(6) (6), 1605 - 1614, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Alport syndrome (AS) is a progressive kidney disease. Male cases with X-linked AS (XLAS) are reported to develop end-stage kidney disease (ESKD) at the age of around 20-30 years. One risk factor for developing ESKD at a young age is a genotype of having truncating variants in the COL4A5 gene. However, to date, other such factors have remained unclear. Here, we describe a 15-year-old Japanese boy with XLAS who had a missense variant in the COL4A5 gene. He presented with gross hematuria, severe proteinuria, oliguria, systemic edema, body weight gain, and hypertension after pharyngitis. Blood examination showed kidney dysfunction, hypocomplementemia, and elevated antistreptolysin-O level. We diagnosed him with poststreptococcal acute glomerulonephritis (PSAGN) and he was stopped treatment by lisinopril, and received supportive treatment. However, he showed an unusual clinical course for PSAGN and, consequently, developed ESKD 15 months after the onset of PSAGN without recovery from the kidney dysfunction. This case showed that the onset of PSAGN can be a risk factor for AS patients to develop ESKD at a young age.2020年11月, CEN case reports, 9(4) (4), 418 - 422, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- X-linked Alport syndrome (XLAS) is a progressive hereditary kidney disease caused by mutations in the COL4A5 gene encoding the type IV collagen α5 chain. To date, 11 cases having somatic mosaic variants in COL4A5 have been reported; however, all of them involved single-nucleotide variations (SNVs). Here, we report a female XLAS patient with somatic mosaicism identified by copy number variation (CNV) in COL4A5. The case was a 35-year-old female, the mother of the proband, whose only clinical symptom was hematuria. The proband, who was the son of this patient, was diagnosed with XLAS by gene testing, which showed a large hemizygous deletion from exon 3-51 in COL4A5 detected by next-generation sequencing and then confirmed by multiplex ligation-dependent probe amplification (MLPA). Then, MLPA analysis revealed that the female patient had the same deletion with only a 20% copy number reduction compared with a normal female control; she was thus diagnosed with XLAS with somatic mosaicism. CNVs in COL4A5 are relatively rare and, to the best of our knowledge, somatic mosaic variants with CNVs have never been reported. This case clearly featured a germline variant because the patient's son exhibited XLAS. This is thus the first case report on an XLAS patient having CNV in COL4A5 with somatic mosaicism. The obtained findings were very important for the genetic counseling of this family.2020年11月, CEN case reports, 9(4) (4), 431 - 436, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- Mutations in SLC4A1, encoding the chloride-bicarbonate exchanger known as anion exchanger 1, have been reported as the sole genetic cause of autosomal dominant distal renal tubular acidosis (dRTA). This disorder is extremely rare and most patients show no clinical symptoms during childhood. Here, we report a case of an infant with early-onset autosomal dominant dRTA caused by SLC4A1 mutation p.Gly609Arg that is detected as a hot spot world widely. Despite the fact that the patient's mother and sister had the same SLC4A1 mutation, all family members presented different clinical courses. A 9-month-old boy was referred to our hospital because of insufficient body weight gain. At the initial visit, his height and weight were 68.2 cm (-1.0 SD) and 6.4 kg (-2.2SD) respectively. Metabolic acidosis with a normal serum anion gap and inappropriate alkaline urine were detected. Abdominal ultrasound indicated bilateral renal medullary high-echoic lesions which suspected nephrocalcinosis. The genetic test revealed a heterozygous mutation c.1825G > A (p.Gly609Arg) in SLC4A1 that directed his diagnosis of autosomal dominant dRTA. The genetic test was performed on the patient's family members, indicating that the same SLC4A1 mutation was detected in his mother and sister. His mother had nephrocalcinosis and metabolic acidosis at the age of 35 years. However, his sister had no clinical symptoms at the age of 6 years without any laboratory abnormalities. This familial case demonstrated that the significant heterogeneity in clinical manifestations may develop even among familial members sharing the same variant.2020年11月, CEN case reports, 9(4) (4), 442 - 445, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- To understand the genetics of steroid-sensitive nephrotic syndrome (SSNS), we conducted a genome-wide association study in 987 childhood SSNS patients and 3,206 healthy controls with Japanese ancestry. Beyond known associations in the HLA-DR/DQ region, common variants in NPHS1-KIRREL2 (rs56117924, P=4.94E-20, odds ratio (OR) =1.90) and TNFSF15 (rs6478109, P=2.54E-8, OR=0.72) regions achieved genome-wide significance and were replicated in Korean, South Asian and African populations. Trans-ethnic meta-analyses including Japanese, Korean, South Asian, African, European, Hispanic and Maghrebian populations confirmed the significant associations of variants in NPHS1-KIRREL2 (Pmeta=6.71E-28, OR=1.88) and TNFSF15 (Pmeta=5.40E-11, OR=1.33) loci. Analysis of the NPHS1 risk alleles with glomerular NPHS1 mRNA expression from the same person revealed allele specific expression with significantly lower expression of the transcript derived from the risk haplotype (Wilcox test p=9.3E-4). Because rare pathogenic variants in NPHS1 cause congenital nephrotic syndrome of the Finnish type (CNSF), the present study provides further evidence that variation along the allele frequency spectrum in the same gene can cause or contribute to both a rare monogenic disease (CNSF) and a more complex, polygenic disease (SSNS).2020年11月, Kidney international, 98(5) (5), 1308 - 1322, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Approximately 15% of patients with Dent disease have pathogenic variants in the OCRL gene on Xq25-26, a condition that is referred to as Dent disease 2 (Dent-2). Dent-2 patients sometimes show mild extrarenal features of Lowe syndrome, such as mild mental retardation, suggesting that Dent-2 represents a mild form of Lowe syndrome. To date, eight female patients with Lowe syndrome have been reported, but no female Dent-2 patients have been reported. METHODS: In this study, we performed genetic testing of the first female Dent-2 patient to detect the presence of an OCRL variant. Aberrant splicing was demonstrated by in vivo, in vitro, and in silico assays, and skewed X-chromosome inactivation (XCI) in our patient and asymptomatic mothers of three Lowe patients with the heterozygous OCRL variant was evaluated by HUMARA assays using genomic DNA and RNA expression analysis. RESULTS: Our patient had an OCRL heterozygous intronic variant of c.1603-3G > C in intron 15 that led to a 169-bp insertion in exon 16, yielding the truncating mutation r.1602_1603ins (169) (p.Val535Glyfs*6) in exon 16. HUMARA assays of leukocytes obtained from this patient demonstrated incompletely skewed XCI (not extremely skewed). On the other hand, the asymptomatic mothers of 3 Lowe patients demonstrated random XCI. These results may lead to our patient's Dent-2 phenotype. CONCLUSIONS: This is the first report of a female patient clinically and genetically diagnosed with Dent-2 caused by an OCRL heterozygous splicing site variant and skewed XCI. Skewed XCI may be one of the factors associated with phenotypic diversity in female patients with Lowe syndrome and Dent-2.2020年10月, Clinical and experimental nephrology, 24(10) (10), 946 - 954, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Autosomal recessive Alport syndrome (ARAS) is an inherited renal disorder caused by homozygous and compound heterozygous mutations in COL4A3 or COL4A4, but the prognostic predictors for this disorder are not yet fully understood. Recently, the magnitude of the clinical spectrum of the COL4A3 and COL4A4 heterozygous state has attracted attention. This spectrum includes asymptomatic carriers of ARAS, benign familial hematuria, thin basement membrane disease, and autosomal dominant Alport syndrome. METHODS: We retrospectively analyzed 49 patients with ARAS from 41 families with a median age of 19 years to examine the clinical features and prognostic factors of ARAS, including the associated genotypes. RESULTS: The median age of patients with ARAS at ESKD onset was 27 years. There was no significant association between the presence or absence of hearing loss or truncating mutations and renal prognosis. However, there was a statistically significant correlation between renal prognosis and heterozygous variants that cause urinary abnormalities. Where the urinary abnormality-causing variant was absent or present in only one allele, the median age of ESKD onset was 45 years, whereas the same variant present on both alleles was associated with an age of onset of 15 years (P<0.001). CONCLUSIONS: This study was the first to demonstrate the clinical importance in ARAS of focusing on variants in COL4A3 or COL4A4 that cause urinary abnormalities in both the homozygous or heterozygous state. Although heterozygous mutation carriers of COL4A3 and COL4A4 comprise a broad clinical spectrum, clinical information regarding each variant is important for predicting ARAS prognosis.2020年09月, Kidney360, 1(9) (9), 936 - 942, 英語, 国際誌研究論文(学術雑誌)
- OBJECTIVE: To investigate the prevalence of seizures/febrile seizures in children up to 3 years of age and examine the effects of gestational age at birth on the risk for febrile seizures. DESIGN: Retrospective longitudinal population-based cohort study. SETTING: Kobe City public health center, Kobe, Japan, from 2010 to 2018. PARTICIPANTS: Children who underwent a medical check-up at 3 years of age. METHODS: Information regarding seizures was collected from the parents of 96 014 children. We identified the occurrence of seizure/febrile seizure in 74 017 children, whose gestational ages at birth were noted. We conducted a multivariate analysis with the parameter, gestational age at birth, to analyse the risk of seizure. We also stratified the samples by sex and birth weight (<2500 g or not) and compared the prevalence of seizure between those with the term and late preterm births. RESULTS: The prevalence of seizure was 12.1% (11.8%-12.3%), 13.2% (12.2%-14.4%), 14.6% (12.4%-17.7%) and 15.7% (10.5%-22.8%) in children born at 37-41, 34-36, 28-33 and 22-27 gestational weeks, respectively. The prevalence of febrile seizures was 9.0% (8.8%-9.2%), 10.5% (9.5%-11.5%), 11.8% (9.7%-14.5%) and 11.2% (6.9%-17.7%) in children born at 37-41, 34-36, 28-33 and 22-27 gestational weeks, respectively. Male was an independent risk factor for seizures (OR: 1.15, 95% CI 1.09 to 1.20; absolute risk increase 0.014, 95% CI 0.010 to 0.019) and febrile seizures (OR: 1.21, 95% CI 1.15 to 1.28; absolute risk increase 0.016, 95% CI 0.012 to 0.020), respectively. Late preterm birth was not associated with an increased risk of seizure/febrile seizure. CONCLUSIONS: Although very preterm birth may increase the risk of seizure/febrile seizure, the risk associated with late preterm birth is considerably small and less than that associated with male.2020年09月, BMJ open, 10(9) (9), e035977, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本腎臓学会, 2020年09月, 日本腎臓学会誌, 62(6) (6), 555 - 555, 日本語詳細な腎病理観察がきっかけとなりIgA腎症と鑑別しえたX連鎖型Alport症候群の1例
- Denys-Drash syndrome is characterized by progressive nephropathy, gonadal dysgenesis, and Wilms tumor caused by a WT1 gene mutation. Infants with Denys-Drash syndrome frequently experience severe hypertension, but detailed clinical manifestations have yet to be clarified. Cases of infantile-onset Denys-Drash syndrome with severe hypertension at our hospital were retrospectively analyzed and the pathogenesis of hypertension was investigated. Six infants who received the diagnosis of Denys-Drash syndrome at the median age of 10 days (range: 2-182 days) were enrolled. Five infants had the complication of severe hypertension within a few days of diagnosis. All the patients showed rapid progression to end-stage renal disease and urgently required dialysis due to anuria/oliguria and hypervolemia with a median duration of 7.5 days (range: 0-17 days) on the day after diagnosis. Even under dialysis, all the patients continued to need antihypertensive treatment. Five patients underwent a preventive nephrectomy for Wilms tumor, and one patient underwent a nephrectomy due to progression to Wilms tumor. Two patients developed hypotension after a nephrectomy. The main causes of hypertension were hypervolemia in the predialysis stage, renin-associated hypertension in the dialysis stage, and multiple factors, including increased plasma catecholamine-associated hypertension in the postnephrectomy dialysis stage. At last the follow-up after bilateral nephrectomy, four of the five patients required antihypertensive treatment. Not all the patients showed target organ complications caused by hypertension. Severe hypertension is a common complication of infantile-onset Denys-Drash syndrome. The possibility of hypotension after nephrectomy should be considered in patients with Denys-Drash syndrome.2020年09月, The Tohoku journal of experimental medicine, 252(1) (1), 45 - 51, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Mutations in the Wilms tumor 1 gene cause a spectrum of podocytopathy ranging from diffuse mesangial sclerosis to focal segmental glomerulosclerosis. In a considerable fraction of patients with Wilms tumor 1 mutations, the distinctive histology of immune-complex-type glomerulonephritis has been reported. However, the clinical relevance and etiologic mechanisms remain unknown. CASE PRESENTATION: A 5-year-old child presented with steroid-resistant nephrotic range proteinuria. Initial renal biopsy revealed predominant diffuse mesangial proliferation with a double-contour and coexisting milder changes of focal segmental glomerulosclerosis. Immunofluorescence and electron microscopy revealed a full-house-pattern deposition of immune complexes in the subendothelial and paramesangial areas. Serial biopsies at 6 and 8 years of age revealed that more remarkable changes of focal segmental glomerulosclerosis had developed on top of the initial proliferative glomerulonephritis. Identification of a de novo Wilms tumor 1 splice donor-site mutation in intron 9 (NM_024426.6:c.1447 + 4C > T) and 46,XY-gonadal dysgenesis led to the diagnosis of Frasier syndrome. CONCLUSIONS: Our findings, together with those of others, point to the importance of heterogeneity in clinicopathological phenotypes caused by Wilms tumor 1 mutations and suggest that immune-complex-mediated membranoproliferative glomerulopathy should be considered as a histological variant.2020年08月, BMC nephrology, 21(1) (1), 362 - 362, 英語, 国際誌研究論文(学術雑誌)
- Galactose-deficient IgA1 (Gd-IgA1) is important in the pathogenesis of IgA nephropathy (IgAN). A Gd-IgA1-specific monoclonal antibody (KM55) has revealed glomerular Gd-IgA1 deposition solely in patients with IgAN and IgA vasculitis with nephritis (IgAV-N). However, this specificity is controversial and has not been demonstrated in pediatric patients. Here, we conducted double-immunofluorescence staining of IgA and Gd-IgA1 in 60 pediatric patients with various glomerular diseases. We divided patients into four groups: (1) patients with IgAN and IgAV-N (n = 23); (2) patients with immunocomplex-mediated glomerulonephritis accompanied by IgA deposition, including lupus nephritis, membranoproliferative glomerulonephritis, and membranous nephropathy (n = 14); (3) patients with other glomerular diseases involving IgA deposition, including idiopathic nephrotic syndrome (INS), oligomeganephronia, Alport syndrome, dense deposit disease, and crescentic glomerulonephritis (n = 11); and (4) patients with IgA-negative diseases including INS, membranoproliferative glomerulonephritis, membranous nephropathy, oligomeganephronia, Alport syndrome, C3 glomerulonephritis, poststreptococcal acute glomerulonephritis, and hemolytic uremic syndrome (n = 12). KM55 staining revealed Gd-IgA1-positive findings in 23/23 patients in Group 1 and 13/14 patients in Group 2, but not in patients in Groups 3 or 4. Therefore, KM55 may detect incidental IgA deposition in pediatric patients. Gd-IgA1 may be involved in the pathogenesis of these immune-related diseases; alternatively, KM55 may recognize IgA-related immunocomplexes in a non-specific manner.2020年08月, Scientific reports, 10(1) (1), 14026 - 14026, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: X-linked Alport syndrome (XLAS) is a progressive, hereditary glomerular nephritis of variable severity caused by pathogenic COL4A5 variants. Currently, genetic testing is widely used for diagnosing XLAS; however, determining the pathogenicity of variants detected by such analyses can be difficult. Intronic variants or synonymous variants may cause inherited diseases by inducing aberrant splicing. Transcript analysis is necessary to confirm the pathogenicity of such variants, but it is sometimes difficult to extract mRNA directly from patient specimens. METHODS: In this study, we conducted in vitro splicing analysis using a hybrid minigene assay and specimens from three XLAS patients with synonymous variants causing aberrant splicing, including previously reported pathogenic mutations in the same codon. The variants were c.876 A>T (p.Gly292=), c.2358 A>G (p.Pro786=), and c.3906 A>G (p.Gln1302=). RESULTS: The results from our hybrid minigene assay were sufficient to predict splicing abnormalities; c.876 A>T cause 17-bp del and 35-bp del, c.2358 A>G cause exon 29 skipping, c.3906 A>G cause exon 42 skipping, which are very likely to cause pathogenicity. Further, patients carrying c.2358 A>G exhibited a mild phenotype that may have been associated with the presence of both normal and abnormally spliced transcripts. CONCLUSION: The minigene system was shown to be a sensitive assay and a useful tool for investigating the pathogenicity of synonymous variants.2020年08月, Molecular genetics & genomic medicine, 8(8) (8), e1342, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- PURPOSE: To evaluate barbiturate anaesthetic therapy using thiamylal for febrile refractory status epilepticus (fRSE) in children. METHODS: This was a review of a prospectively-collected database between April 2012-March 2016 for fRSE cases treated with thiamylal anaesthetic therapy in a single paediatric hospital in Japan. The sample comprised 23 children (median age, 23 months) with fRSE that underwent thiamylal anaesthetic therapy for convulsive seizures lasting longer than 60 min, sustained after intravenous administration of benzodiazepine and non-benzodiazepine anticonvulsants. The intervention comprised protocol-based thiamylal anaesthetic therapy with bolus administration. We measured the dose and time required to achieve the burst suppression pattern (BSP) on electroencephalography, seizure recurrence, death, neurological sequelae, and complications. RESULTS: All patients except one reached the BSP. The thiamylal median dose until reaching the BSP was 27.5 mg/kg, and the median time from thiamylal administration to reaching the BSP was 109.5 min. There was one case of immediate treatment failure and one of withdrawal seizure, but no breakthrough seizure. No deaths occurred during treatment, and neurological sequelae occurred in four cases (17%). Vasopressors were administered in all cases. Other complications included 11 cases of pneumonia and one of enterocolitis. CONCLUSION: We revealed the time and dose required to reach the BSP with thiamylal anaesthetic therapy using bolus administration in children. Our results suggested that reaching the BSP with bolus administration requires markedly less time than without bolus administration, rarely causes seizure recurrence in paediatric fRSE, and causes haemodynamic dysfunction and infections as often as observed without bolus administration.2020年08月, Seizure, 80, 12 - 17, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2020年07月, 日本腎臓学会誌, 62(4) (4), 362 - 362, 日本語Alport症候群患者に対するエクソンスキッピング(ES)療法の開発
- (一社)日本腎臓学会, 2020年07月, 日本腎臓学会誌, 62(4) (4), 255 - 255, 日本語小児における糖鎖不全IgA1免疫染色
- (一社)日本腎臓学会, 2020年07月, 日本腎臓学会誌, 62(4) (4), 257 - 257, 日本語スプライシング異常が疑われるCLCN5遺伝子変異のDent病発症メカニズムの解明
- (一社)日本腎臓学会, 2020年07月, 日本腎臓学会誌, 62(4) (4), 293 - 293, 日本語WT1遺伝子exon8-9ミスセンス変異における遺伝子型-臨床型の相関に関する検討
- (一社)日本腎臓学会, 2020年07月, 日本腎臓学会誌, 62(4) (4), 293 - 293, 日本語Lowe症候群とDent disease-2の2疾患における分子生物学的発症機序の解明
- 日本小児腎不全学会, 2020年07月, 日本小児腎不全学会雑誌, 40, 261 - 264, 日本語
- BACKGROUND: In recent years, the elucidation of splicing abnormalities as a cause of hereditary diseases has progressed. However, there are no comprehensive reports of suspected splicing variants in the CLCN5 gene in Dent disease cases. We reproduced gene mutations by mutagenesis, inserted the mutated genes into minigene vectors, and investigated the pathogenicity and onset mechanisms of these variants. METHODS: We conducted functional splicing assays using a hybrid minigene for six suspected splicing variants (c.105G>A, c.105+5G>C, c.106-17T>G, c.393+4A>G, c.517-8A>G, c.517-3C>A) in CLCN5. We extracted information on these variants from the Human Gene Mutation Database. We reproduced minigene vectors with the insertion of relevant exons with suspected splicing variants. We then transfected these minigene vectors into cultured cells and extracted and analyzed the mRNA. In addition, we conducted in silico analysis to confirm our minigene assay results. RESULTS: We successfully determined that five of these six variants are pathogenic via the production of splicing abnormalities. One showed only normal transcript production and was thus suspected of not being pathogenic (c.106-17T>G). CONCLUSION: We found that five CLCN5 variants disrupted the original splice site, resulting in aberrant splicing. It is sometimes difficult to obtain mRNA from patient samples because of the fragility of mRNA or its low expression level in peripheral leukocytes. Our in vitro system can be used as an alternative to in vivo assays to determine the pathogenicity of suspected splicing variants.2020年07月, Clinical and experimental nephrology, 24(7) (7), 606 - 612, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- Currently, there are no treatments for Alport syndrome, which is the second most commonly inherited kidney disease. Here we report the development of an exon-skipping therapy using an antisense-oligonucleotide (ASO) for severe male X-linked Alport syndrome (XLAS). We targeted truncating variants in exon 21 of the COL4A5 gene and conducted a type IV collagen α3/α4/α5 chain triple helix formation assay, and in vitro and in vivo treatment efficacy evaluation. We show that exon skipping enabled trimer formation, leading to remarkable clinical and pathological improvements including expression of the α5 chain on glomerular and the tubular basement membrane. In addition, the survival period was clearly prolonged in the ASO treated mice group. This data suggests that exon skipping may represent a promising therapeutic approach for treating severe male XLAS cases.2020年06月, Nature communications, 11(1) (1), 2777 - 2777, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2020年06月, 日本小児科学会雑誌, 124(6) (6), 1044 - 1044, 日本語アルドステロン高値により診断に至った早産児の偽性低アルドステロン症1型の1例
- OBJECTIVES: Crescentic IgA nephropathy (C-IgAN) is defined as IgAN with more than 50% of glomeruli showing crescents. C-IgAN in children is rare; we investigate in detail for the first time. METHODS: We retrospectively analyzed the 515 consecutive children who were newly diagnosed with biopsy-proven IgAN between June 1976 and May 2010. We compared clinical and pathological findings between C-IgAN and non-C-IgAN. RESULTS: Among 515 cases of childhood IgAN, 25 children (4.9%) had C-IgAN. Of these 25, 16 children (64%) were referred to hospitals by annual school screening. Clinical findings showed significant differences in gross hematuria (76 vs. 50%, p = .03), excretion of proteinuria (1.9 vs. 0.5 g/day/m2, p < .0001), eGFR (102 vs. 108 ml/min/1.73 m2, p = .03), and duration from onset to renal biopsy (4.0 vs. 8.0 months, p = .04) between groups. Pathological findings showed significant differences in M1 (88 vs. 55%, p = .02), E1 (83 vs. 53%, p = .008), and presence of tubular atrophy/interstitial fibrosis (88 vs. 53%, p < .0001) between groups. The 16 children with C-IgAN were treated with prednisolone and immunosuppressant. Four cases (16%) reached chronic renal failure (eGFR < 60) at the latest observation (mean observation period: 6.0 ± 3.6 years). Patients with C-IgAN had significantly lower renal survival curve than non-C-IgAN patients according to Kaplan-Meier analysis (77.1% vs. 92.6% at 13 years, p < .0001). Compared with previous reports, however, they had better renal outcome. CONCLUSIONS: We confirmed the importance of school screening to find C-IgAN. Although most crescents (mean: 98.1%) of C-IgAN were cellular/fibrocellular, and acute lesions were well modified with combination therapy, the presence of tubular atrophy in C-IgAN may be the reason for poorer prognosis.2020年06月, Pediatric nephrology (Berlin, Germany), 35(6) (6), 1005 - 1014, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本小児科学会, 2020年06月, 日本小児科学会雑誌, 124(6) (6), 1036 - 1036, 日本語母児間輸血症候群後に慢性腎臓病(CKD)に至った3例
- (公社)日本小児科学会, 2020年06月, 日本小児科学会雑誌, 124(6) (6), 1044 - 1044, 日本語小児期に腎低形成と診断された新生児高β2ミクログロブリン尿症の1例
- Pathogenic variants of paired box gene 2 (PAX2) cause autosomal-dominant PAX2-related disorder, which includes renal coloboma syndrome (RCS). Patients with PAX2-related disorder present with renal and ophthalmological pathologies, as well as with other abnormalities, including developmental problems and hearing loss. We sequenced PAX2 in 457 patients with congenital anomalies of the kidney and urinary tract or with renal dysfunction of unknown cause and identified 19 different pathogenic variants in 38 patients from 30 families (6.5%). Thirty-four patients had renal hypodysplasia or chronic kidney disease of unknown cause, and three had focal segmental glomerulosclerosis. Although no obvious genotype-phenotype correlation was observed, six of the seven patients who developed end-stage renal disease in childhood had truncating variants. Twenty-three patients had ocular disabilities, mostly optic disc coloboma. Non-renal and non-ophthalmological manifestations included developmental disorder, electrolyte abnormality, and gonadal abnormalities. Two unrelated patients had congenital cystic adenomatoid malformations in their lungs. Six of ten probands with PAX2 mutation identified by next-generation sequencing did not show typical RCS manifestations. We conclude that PAX2-related disorder has a variable clinical presentation and can be diagnosed by next-generation sequencing even in the absence of typical RCS manifestations.2020年06月, Journal of human genetics, 65(6) (6), 541 - 549, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2020年05月, Kidney international reports, 5(5) (5), 718 - 726, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Pierson syndrome (PS) is a rare autosomal recessive disorder, characterized by congenital nephrotic syndrome and microcoria. Advances in renal replacement therapies have extended the lifespan of patients, whereas the full clinical spectrum of PS in infancy and beyond remains elusive. CASE PRESENTATION: We present the case of a 12-month-old boy with PS, manifesting as the bilateral microcoria and congenital nephrotic syndrome. He was born without asphyxia, and was neurologically intact from birth through the neonatal period. Generalized muscle weakness and hypotonia were recognized from 3 months of age. The infant showed recurrent vomiting at age 5 months of age, and was diagnosed with gastroesophageal reflux and intestinal malrotation. Despite the successful surgical treatment, vomiting persisted and led to severely impaired growth. Tulobuterol treatment was effective in reducing the frequency of vomiting. Targeted sequencing confirmed that he had a compound heterozygous mutation in LAMB2 (NM_002292.3: p.Arg550X and p.Glu1507X). A search of the relevant literature identified 19 patients with severe neuro-muscular phenotypes. Among these, only 8 survived the first 12 months of life, and one had feeding difficulty with similar gastrointestinal problems. CONCLUSIONS: This report demonstrated that severe neurological deficits and gastrointestinal dysfunction may emerge in PS patients after the first few months of life.2020年04月, BMC medical genetics, 21(1) (1), 80 - 80, 英語, 国際誌研究論文(学術雑誌)
- OBJECTIVE: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a syndrome characterized by biphasic seizures with impaired consciousness. AESD is rare outside Asia, and consecutive cohort studies are therefore scarce. Herein, we aimed to describe the detailed characteristics of AESD, including clinical course, electroencephalogram data, laboratory data, imaging findings, treatment, and outcomes. METHODS: We reviewed the clinical database and medical charts of 43 consecutive pediatric patients (<18 years old) who developed AESD between October 1, 2002, and September 30, 2019. RESULTS: We found that AESD occurred even though patients did not develop prolonged seizures. A comparison between the two groups (first seizure duration <30 min and first seizure duration ≥30 min) revealed three main findings: first, patients with AESD who had shorter seizures had better prognosis than those with prolonged seizures; second, patients with AESD who had shorter seizures tended to have earlier occurrence of a second seizure; and third, high signal intensity on diffusion-weighted magnetic resonance imaging was observed mainly in frontal areas, not diffusely, in patients with shorter seizures, and in a broader area in patients with prolonged seizures. CONCLUSIONS: Our description of the detailed clinical picture of AESD may add new insight into its pathophysiology.2020年04月, Journal of the neurological sciences, 411, 116684 - 116684, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Bardet-Biedl syndrome (BBS) is a rare autosomal recessive ciliopathy characterized by retinitis pigmentosa (RP), truncal obesity, cognitive impairment, hypogonadism in men, polydactyly, and renal abnormalities with severe renal dysfunction. Twenty-two causative genes have already been reported for this disorder. In this study, we identified two unrelated Japanese patients with clinical diagnoses of BBS associated with compound heterozygous SCLT1 mutation. Patient 1 was a 10-year-old girl, and patient 2 was a 22-year-old man. Both the patients showed severe renal dysfunction in childhood, RP, mild intellectual disability, short stature, and truncal obesity, without oral aberrations and polydactyly. Patient 2 also had hypogonadism. We identified two missense variants in SCLT1, c.[1218G > A] and [1631A > G], in both the patients by next-generation sequencing. Subsequent cDNA analysis revealed that c.1218G > A affected exon 14 skipping in SCLT1. To date, SCLT1 has been reported as the causative gene of oral-facial-digital syndrome type IX, and Senior-Løken syndrome. The phenotypes of both the present patients were compatible with BBS. These results highlight SCLT1 as an additional candidate for BBS phenotype in an autosomal recessive manner.2020年04月, CEN case reports, 英語, 国内誌[査読有り]
- Mutations in the TTC21B gene have been identified in patients with nephronophthisis and were recently found in some patients with focal segmental glomerulosclerosis. We herein report a Japanese boy with end-stage renal disease due to medullary polycystic kidney disease and primary focal segmental glomerulosclerosis. Next-generation sequencing detected a new compound heterozygous missense mutation in the TTC21B gene. His renal pathological findings and gene mutations have not been previously reported in patients with ciliopathy. For children with severe renal dysfunction, mutations in the TTC21B gene cause both ciliopathy characterized by bilateral polycystic kidney disease and primary focal segmental glomerulosclerosis.2020年04月, Internal medicine (Tokyo, Japan), 英語, 国内誌[査読有り]
- 発達腎研究会, 2020年04月, 発達腎研究会誌, 28(1) (1), 29 - 32, 日本語WT1遺伝子異常症
- (一社)日本小児腎臓病学会, 2020年04月, 日本小児腎臓病学会雑誌, 33(1) (1), 43 - 50, 日本語
- BACKGROUND: Congenital cytomegalovirus (CMV) disease, a common mother-to-child infection, can lead to neurological sequelae. Some clinical trials have shown that oral valganciclovir (VGCV) can improve hearing and neurodevelopmental impairment in infants with congenital CMV disease. However, VGCV has neither been approved in Japan nor other countries as a treatment for this disease by the government health insurance. METHODS: This study is a non-randomized, prospective, open-label, multicenter, single-arm clinical trial and will include subjects meeting the following criteria: confirmation of positive CMV-DNA amplification in urine by an in vitro diagnostic test within 21 days of age; congenital CMV disease with one or more central nervous system disorders-microcephaly, hydrocephalus or ventricular enlargement, periventricular calcification, cortical hypoplasia or white matter injury, retinal choroiditis, and abnormal auditory brainstem response (ABR); and infants within 2 months of age with a gestational age ≥32 weeks at birth and weighing ≥1800 g at the time of registration. Subjects will be orally administered 16 mg/kg VGCV twice daily for 6 months. The target number of cases for enrollment between February 3, 2020 and July 31, 2021 is 25. Primary endpoint is the change in whole blood CMV loads before and after 6 months of treatment. The important secondary endpoint is the change in ABR (both best and total ear hearing assessments) before and after 6 months of treatment. The safety endpoints are adverse events and drug side effects. DISCUSSION: To the best of our knowledge, this multicenter, open-label, single-arm study will be the first well-designed clinical trial to evaluate the efficacy of oral VGCV in infants with congenital CMV diseases. The findings will reveal the efficacy and safety of oral VGCV treatments and enable the approval of oral VGCV as a treatment for infants with congenital CMV disease by the government health insurance of Japan.2020年04月, Medicine, 99(17) (17), e19765, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Null variants in LAMB2 cause Pierson syndrome (PS), a severe congenital nephrotic syndrome with ocular and neurological defects. Patients' kidney specimens show complete negativity for laminin β2 expression on glomerular basement membrane (GBM). In contrast, missense variants outside the laminin N-terminal (LN) domain in LAMB2 lead to milder phenotypes. However, we experienced cases not showing these typical genotype-phenotype correlations. In this paper, we report six PS patients: four with mild phenotypes and two with severe phenotypes. We conducted molecular studies including protein expression and transcript analyses. The results revealed that three of the four cases with milder phenotypes had missense variants located outside the LN domain and one of the two severe PS cases had a homozygous missense variant located in the LN domain; these variant positions could explain their phenotypes. However, one mild case possessed a splicing site variant (c.3797 + 5G>A) that should be associated with a severe phenotype. Upon transcript analysis, this variant generated some differently sized transcripts, including completely normal transcript, which could have conferred the milder phenotype. In one severe case, we detected the single-nucleotide substitution of c.4616G>A located outside the LN domain, which should be associated with a milder phenotype. However, we detected aberrant splicing caused by the creation of a novel splice site by this single-base substitution. These are novel mechanisms leading to an atypical genotype-phenotype correlation. In addition, all four cases with milder phenotypes showed laminin β2 expression on GBM. We identified novel mechanisms leading to atypical genotype-phenotype correlation in PS.2020年04月, Journal of human genetics, 65(4) (4), 355 - 362, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Bartter syndrome (BS) and Gitelman syndrome (GS) are syndromes associated with congenital tubular dysfunction, characterized by hypokalemia and metabolic alkalosis. Clinically, BS is classified into two types: the severe antenatal/neonatal type, which develops during the fetal period with polyhydramnios and preterm delivery; and the relatively mild classic type, which is usually found during infancy with failure to thrive. GS can be clinically differentiated from BS by its age at onset, usually after school age, or laboratory findings of hypomagnesemia and hypocalciuria. Recent advances in molecular biology have shown that these diseases can be genetically classified into type 1 to 5 BS and GS. As a result, it has become clear that the clinical classification of antenatal/neonatal BS, classic BS, and GS does not always correspond to the clinical symptoms associated with the genotypes in a one-to-one manner; and there is clinically no clear differential border between type 3 BS and GS. This has caused confusion among clinicians in the diagnosis of these diseases. It has been proposed that the disease name "inherited salt-losing tubulopathy" can be used for cases of tubulopathies accompanied by hypokalemia and metabolic alkalosis. It is reasonable to use this term prior to genetic typing into type 1-5 BS or GS, to avoid confusion in a clinical setting. In this article, we review causative genes and phenotypic correlations, diagnosis, and treatment strategies for salt-losing tubulopathy as well as the clinical characteristics of pseudo-BS/GS, which can also be called a "salt-losing disorder".2020年04月, Pediatrics international : official journal of the Japan Pediatric Society, 62(4) (4), 428 - 437, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (一社)日本病理学会, 2020年03月, 日本病理学会会誌, 109(1) (1), 437 - 437, 日本語Oligomeganephronia9例の臨床病理学的検討
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 237 - 237, 日本語X染色体連鎖型Alport症候群患者におけるサイレント変異の病的意義の検討
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 238 - 238, 日本語Dent disease-1とDent disease-2の臨床像の差異に関する検討
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 305 - 305, 日本語日本人における遺伝性ネフローゼ症候群の網羅的遺伝子診断体制
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 305 - 305, 日本語糖鎖不全IgA1免疫染色が診断に有用であったステロイド抵抗性ネフローゼ症候群の1例
- NLM (Medline), 2020年02月, CEN case reports, 9(1) (1), 81 - 86, 英語研究論文(学術雑誌)
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 303 - 303, 日本語小児IgA腎症の組織学的軽症例と重症例における多剤併用療法の効果に関する比較
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 421 - 421, 日本語アルカリ化療法開始後,精神発達の伸びを認めた近位尿細管性アシドーシスの1例
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 417 - 417, 日本語2度の腎生検で診断に至らなかったX染色体連鎖型Alport症候群の一女児例
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 271 - 271, 日本語NICU退院児における感覚特性,発達障害特性の検討
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 378 - 378, 日本語症候性先天性サイトメガロウイルス感染症を対象とした抗ウイルス薬治療の医師主導治験
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 418 - 418, 日本語小児期に腎低形成と診断された新生児高β2ミクログロブリン尿症の1例
- (公社)日本小児科学会, 2020年02月, 日本小児科学会雑誌, 124(2) (2), 417 - 417, 日本語2度の腎生検で診断に至らなかったX染色体連鎖型Alport症候群の一女児例
- Springer Science and Business Media LLC, 2020年02月, CEN Case Reports, 9(1) (1), 19 - 23[査読有り]研究論文(学術雑誌)
- Numerous disease-causing gene mutations have been identified in proteinuric diseases, such as nephrotic syndrome and glomerulosclerosis. This report describes the results of comprehensive genetic diagnosis of Japanese patients with severe proteinuria. In addition, the report describes the clinical characteristics of patients with monogenic disease-causing mutations. We conducted comprehensive gene screening of patients who had either congenital nephrotic syndrome, infantile nephrotic syndrome, steroid-resistant nephrotic syndrome, or focal segmental glomerular sclerosis. Using targeted next-generation sequencing, 60 podocyte-related genes were screened in 230 unrelated patients with proteinuria. A retrospective review of clinical data was conducted for these patients. We detected monogenic disease-causing mutations in 30% (69 of 230) of patients among 19 of the screened genes. Common genes with disease-causing mutations were WT1 (25%), NPHS1 (12%), INF2 (12%), TRPC6 (10%), and LAMB2 (9%). With various immunosuppressive or renoprotective therapies, remission of proteinuria in patients with unknown causative mutations was observed in 26% of patients, whereas only 5% of patients with monogenic disease-causing mutations exhibited complete remission. We assessed the genetic backgrounds of Japanese patients with severe proteinuria. The proportion of patients with gene defects was similar to that of other reports, but the disease-causing gene mutation frequency was considerably different.2020年01月, Scientific reports, 10(1) (1), 270 - 270, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- NAA10-related syndrome is an extremely rare X-chromosomal disorder, the symptoms of which include intellectual disability (ID), ocular anomalies, or congenital heart diseases, such as hypertrophic cardiomyopathy (HCM). Here, we describe a 4-year-old Japanese male patient who exhibited mild ID, HCM, and specific facial features. A hemizygous mutation (NM_003491.3: c.455_458del, p. Thr152Argfs*6) in exon 7 of NAA10 was detected. We recommend that patients undergo precise medical follow-up considering the characteristics of NAA10-related syndrome.2020年, Human genome variation, 7, 23 - 23, 英語, 国際誌研究論文(学術雑誌)
- Wiley, 2020年01月, Pediatrics International, 62(1) (1), 101 - 103[査読有り]研究論文(学術雑誌)
- 2020年, Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology, 29(3) (3), 127 - 130, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- Patients with steroid-resistant nephrotic syndrome (SRNS) who develop resistance to immunosuppressive agents, defined as refractory SRNS, have poor renal outcomes. Although the chimeric anti-CD20 monoclonal antibody rituximab has shown efficacy for frequently relapsing nephrotic syndrome and steroid-dependent nephrotic syndrome, its efficacy for refractory SRNS remains uncertain due to limited data. According to previous case reports, 50.4% of patients with refractory SRNS showed clinical improvements after rituximab treatment. Remission rates in patients with initial steroid resistance and late steroid resistance were 43.9 and 57.7%, respectively, and 41.5 and 63.6% in patients with focal segmental glomerulosclerosis and minor glomerular abnormalities, respectively. However, various factors (race, disease severity, number of rituximab doses, concomitant treatments, and observation period) differed among these observational studies and their consensus may also have been affected by potential publication bias. Rituximab monotherapy may have some degree of efficacy and lead to satisfactory outcomes in a subset of patients with refractory SRNS. However, administration of concomitant treatments during rituximab-mediated B cell depletion, such as methylprednisolone pulse therapy, daily oral prednisolone therapy, and immunosuppressive agents, may lead to better outcomes in these patients. Large-scale, multi-center prospective studies are needed to evaluate the efficacy and safety of such regimens.2020年01月, Pediatric nephrology (Berlin, Germany), 35(1) (1), 17 - 24, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- A 21-year-old man presented with hyperthyroidism and hypokalemia and was treated for thyrotoxic hypokalemic periodic paralysis caused by Graves' disease. Thyroid function soon normalized but hypokalemia persisted. Laboratory data revealed hyperreninemic hyperaldosteronism and metabolic alkalosis consistent with Gitelman Syndrome. The patient was found to have a previously unreported compound heterozygous mutation of T180K and L858H in the SLC12A3 gene, and Gitelman Syndrome was diagnosed. He was started on eplerenone to control serum potassium level. Alternative diagnoses should be considered when electrolyte imbalances persist after disease resolution.2019年12月, Journal of Nippon Medical School = Nippon Ika Daigaku zasshi, 86(5) (5), 301 - 306, 英語, 国内誌研究論文(学術雑誌)
- (株)東京医学社, 2019年12月, 周産期医学, 49(12) (12), 1675 - 1678, 日本語
- (一社)日本小児腎臓病学会, 2019年11月, 日本小児腎臓病学会雑誌, 32(2) (2), 139 - 139, 日本語
- (株)日本医事新報社, 2019年11月, 日本医事新報, (4984) (4984), 36 - 36, 日本語治療法の再整理とアップデートのために 専門家による私の治療 バーター(Bartter)症候群[査読有り]
- (株)日本医事新報社, 2019年11月, 日本医事新報, (4984) (4984), 37 - 37, 日本語治療法の再整理とアップデートのために 専門家による私の治療 ギッテルマン(Gitelman)症候群[査読有り]
- (株)東京医学社, 2019年11月, 小児内科, 51(増刊) (増刊), 644 - 647, 日本語【小児の救急・搬送医療】病態と疾患 腎尿路系 ネフローゼ症候群[査読有り]
- (一社)日本腎臓学会, 2019年11月, 日本腎臓学会誌, 61(8) (8), 1136 - 1138, 日本語X染色体連鎖型Alport症候群におけるsplicing異常の同定と臨床遺伝学的検討[査読有り]
- Orofaciodigital syndrome 1 (OFD-1) is a rare, X-linked, dominantly inherited disorder caused by an OFD1 mutation that can cause polycystic kidneys. A 37-year-old woman on hemodialysis therapy was admitted to our hospital for trans-catheter arterial embolization therapy for enlarged polycystic kidneys. Lobulated tongue and brachydactyly were noticed, prompting an OFD1 sequencing analysis. Sequencing revealed a causal four-base-pair deletion in exon 13, both in the patient and in her mother, whose renal function had been retained. The peripheral leukocyte X chromosome inactivation pattern was skewed in the patient but not in her mother, suggesting some role in their phenotypic difference.2019年10月, Internal medicine (Tokyo, Japan), 58(20) (20), 2989 - 2992, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- 2019年10月, JOURNAL OF NIPPON MEDICAL SCHOOL, 86(5) (5), 301 - 306, 英語研究論文(学術雑誌)
- (株)東京医学社, 2019年10月, 腎と透析, 87(4) (4), 660 - 663, 日本語【腎生検から病因と病態を読む】病理診断で遺伝子検査を依頼されたら?[査読有り]
- (一社)日本腎臓学会, 2019年10月, 日本腎臓学会誌, 61(7) (7), 1102 - 1107, 日本語【嚢胞性腎疾患】ネフロン癆の最近の知見[査読有り]
- X-linked Alport syndrome (XLAS) is a congenital renal disease caused by mutations in COL4A5. In XLAS cases suspected of being caused by aberrant splicing, transcript analysis needs to be conducted to determine splicing patterns and assess the pathogenicity. However, such analysis is not always available. We conducted a functional splicing assay using a hybrid minigene for seven COL4A5 intronic mutations: one was identified by us and six were found in the Human Gene Mutation Database. The minigene assay revealed exon skipping in four variants, exon skipping and a 10-bp insertion in one variant, and no change in one variant, which appeared not to be pathogenic. For one variant, our assay did not work. The results of all three cases for which transcript data were available were consistent with our assay results. Our findings may help to increase the accuracy of genetic test results and clarify the mechanisms causing aberrant splicing.2019年09月, Scientific reports, 9(1) (1), 12696 - 12696, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Nephronophthisis (NPHP) is an autosomal recessive cystic kidney disease that is characterized by primary ciliary dysfunction (ciliopathy) and progresses to end-stage kidney disease (ESKD) during the second decade of life (juvenile and adolescent NPHP) or before the age of 3 years (infantile NPHP). Here we describe the case of an infant with NPHP who carries a homozygous mutation in SDCCAG8 (also called NPHP10 or BBS16) that encodes SDCCAG8 (serologically defined colon cancer antigen 8). SDCCAG8 is localized at the centrioles of both renal epithelial cells and retinal photoreceptor cells. A mutation in SDCCAG8 is also associated with Bardet-Biedl syndrome (BBS), characterized by NPHP, obesity, polydactyly, and rod-cone dystrophy. A 2-year-old boy was referred to our hospital due to kidney dysfunction of unknown etiology; the patient presented with delayed development and opsoclonus but did not exhibit the clinical characteristics of BBS. Histological findings such as dilatation of tubules and irregular thickness of tubular basement membrane confirmed the diagnosis of NPHP. Four months after referral, the patient's renal function was rapidly deteriorated, and emergency peritoneal dialysis was initiated. Next-generation sequencing (NGS) was performed, showing that the patient carries a homozygous four-base-pair deletion in SDCCAG8 (c.849_852delTTTG, p.Cys283Ter). The patient's parents were also found to be heterozygous for this loss-of-function mutation. To the best of our knowledge, the present patient is the first case of biopsy-proven infantile NPHP with a homozygous SDCCAG8 mutation. We conclude that NGS is extremely useful in the identification of SDCCAG8-related NPHP as a cause of sudden-onset ESKD during infancy.2019年09月, The Tohoku journal of experimental medicine, 249(1) (1), 29 - 32, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- OBJECTIVE: Although the mortality among previously healthy children with acute encephalopathy (AE) is approximately 5%, their detailed clinical course has not been clarified. The objective of the present study was to describe the detailed clinical course, in minutes, of fatal AE. METHODS: We retrospectively reviewed the medical records of five patients (from 6 months to 14 years of age) who previously had no neurological disorders and were diagnosed with brain death due to AE between 2002 and 2018 at Kobe Children's Hospital. RESULTS: The initial clinical symptoms were convulsion in three cases and impaired consciousness in two. The earliest noted brain imaging abnormality was 7.5 h after neurological symptom detection. Liver enzymes and creatinine levels increased at initial examination, and sodium elevated gradually. All patients met the criteria of systemic inflammatory response syndrome, disseminated intravascular coagulation, and shock within 14 h of symptom detection. High dose steroids and targeted temperature management were initiated 3.5-14 h after onset. Despite these therapies, patients were diagnosed with brain death from 16 h to 4 days after initial neurological symptoms. AE diagnoses were made between 4 h 29 min and 4 days after initial neurological symptoms and included hemorrhagic shock and encephalopathy syndromes, Reye-like syndrome, and acute necrotizing encephalopathy in two, two, and one patient(s), respectively. CONCLUSIONS: We revealed the time series' of clinical events (e.g. SIRS, shock, DIC, AE diagnosis, brain death, and treatments) and laboratory findings relative to initial neurological symptom in fatal AE.2019年09月, Brain & development, 41(8) (8), 691 - 698, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Hepatocyte nuclear factor 1β (HNF1B), located on chromosome 17q12, causes renal cysts and diabetes syndrome (RCAD). Moreover, various phenotypes related to congenital anomalies of the kidney and urinary tract (CAKUT) or Bartter-like electrolyte abnormalities can be caused by HNF1B variants. In addition, 17q12 deletion syndrome presents with multi-system disorders, as well as RCAD. As HNF1B mutations are associated with different phenotypes and genotype-phenotype relationships remain unclear, here, we extensively studied these mutations in Japan. METHODS: We performed genetic screening of RCAD, CAKUT, and Bartter-like syndrome cases. Heterozygous variants or whole-gene deletions in HNF1B were detected in 33 cases (19 and 14, respectively). All deletion cases were diagnosed as 17q12 deletion syndrome, confirmed by multiplex ligation probe amplification and/or array comparative genomic hybridization. A retrospective review of clinical data was also conducted. RESULTS: Most cases had morphological abnormalities in the renal-urinary tract system. Diabetes developed in 12 cases (38.7%). Hyperuricemia and hypomagnesemia were associated with six (19.3%) and 13 cases (41.9%), respectively. Pancreatic malformations were detected in seven cases (22.6%). Ten patients (32.3%) had liver abnormalities. Estimated glomerular filtration rates were significantly lower in the patients with heterozygous variants compared to those in patients harboring the deletion (median 37.6 vs 58.8 ml/min/1.73 m2; p = 0.0091). CONCLUSION: We present the clinical characteristics of HNF1B-related disorders. To predict renal prognosis and complications, accurate genetic diagnosis is important. Genetic testing for HNF1B mutations should be considered for patients with renal malformations, especially when associated with other organ involvement.2019年09月, Clinical and experimental nephrology, 23(9) (9), 1119 - 1129, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Alport syndrome (AS) is a hereditary disease caused by mutations in COL4A3-5 genes. Recently, comprehensive genetic analysis has become the first-line diagnostic tool for AS. However, no reports comparing mutation identification rates between conventional sequencing and comprehensive screening have been published. METHODS: In this study, 441 patients clinically suspected of having AS were divided into two groups and compared. The initial mutational analysis method involved targeted exome sequencing using next-generation sequencing (NGS) (n = 147, NGS group) or Sanger sequencing for COL4A3/COL4A4/COL4A5 (n = 294, Sanger group). RESULTS: In the NGS group, 126 patients (86%) were diagnosed with AS by NGS, while two had pathogenic mutations in other genes, NPHS1 and EYA1. Further, 239 patients (81%) were diagnosed with AS by initial analysis in the Sanger group. Thirteen patients who were negative for mutation detection in the Sanger group were analyzed by NGS; three were diagnosed with AS. Two had mutations in CLCN5 or LAMB2. The final variant detection rate was 90%. DISCUSSION: Our results reveal that Sanger sequencing and targeted exome sequencing have high diagnostic ability. NGS also has the advantage of detecting other inherited kidney diseases and pathogenic mutations missed by Sanger sequencing.2019年09月, Molecular genetics & genomic medicine, 7(9) (9), e883, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2019年08月, 日本腎臓学会誌, 61(6) (6), 740 - 740, 日本語急速に末期腎不全に至りSDCCAG8遺伝子異常が同定されたネフロン癆関連ciliopathyの2歳男児
- (一社)日本腎臓学会, 2019年08月, 日本腎臓学会誌, 61(6) (6), 746 - 746, 日本語WT-1遺伝子exon7に新規ミスセンス変異が同定されたステロイド抵抗性ネフローゼ症候群の12歳女児
- (一社)日本腎臓学会, 2019年08月, 日本腎臓学会誌, 61(6) (6), 747 - 747, 日本語生後3ヵ月時発症のステロイド感受性ネフローゼ症候群の一例
- (一社)日本腎臓学会, 2019年08月, 日本腎臓学会誌, 61(6) (6), 883 - 883, 日本語IV型コラーゲンα5鎖染色正常巣状分節性糸球体硬化症で遺伝子診断にてAlport症候群と診断した1例
- BACKGROUND: Neonatal-onset Denys-Drash syndrome (NODDS) is a distinctive clinical entity and has a poor renal and life outcome. Early diagnosis of NODDS is important for managing disorders of sexual development and determining assigned gender. Although patients with NODDS and congenital nephrotic syndrome of the Finnish type (CNF) present with nephrotic syndrome in neonatal life or infancy, the clinical course of NODDS and factors distinguishing these diseases at onset is unknown. METHODS: We performed a retrospective cohort study of patients with NODDS and CNF between 1997 and 2017. Patients with nephrotic syndrome and WT1 or NPHS1 mutations with neonatal onset (within 30 days) were eligible. RESULTS: We studied eight patients with NODDS and 15 with CNF. The median serum creatinine level at onset in the NODDS group was significantly higher (1.85 mg/dL) than that in the CNF group (0.15 mg/dL; P = 0.002). The median placental/fetal weight ratio in the NODDS and CNF group was 41.8% and 21.0%, respectively (P = 0.001). Kaplan-Meier analysis showed that the median number of days for progression to ESRD from onset in the NODDS and CNF groups was 6 and 910 days, respectively (P < 0.001). All patients in the NODDS group were alive at follow-up. Only one patient in the CNF group died of cardiac complications during follow-up. CONCLUSION: CNS, renal dysfunction at onset, and a relatively large placenta are prominent signs of NODDS. Prognosis for patients with NODDS is satisfactory if appropriate and active management is performed.2019年08月, Clinical and experimental nephrology, 23(8) (8), 1058 - 1065, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- (一社)日本内科学会, 2019年08月, 日本内科学会雑誌, 108(8) (8), 1598 - 1606, 日本語医学と医療の最前線 腎疾患の遺伝子診断と遺伝子標的療法[査読有り]
- BACKGROUND: The association between the clinical presentation of congenital anomalies of the kidney and urinary tract (CAKUT) and gene mutations has yet to be fully explored. METHODS: In this retrospective cohort study, we examined patients with CAKUT who underwent gene analysis. The analysis was performed in patients with bilateral renal lesions, extrarenal complications, or a family history of renal disease. The data from the diagnosis, gene mutations, and other complications were analyzed. RESULTS: In total, 66 patients with CAKUT were included. Of these, gene mutations were detected in 14 patients. Bilateral renal lesions were significantly related to the identification of gene mutations (p = 0.02), and no gene mutations were observed in patients with lower urinary tract obstruction (six patients). There was no significant difference in the rate of gene mutations between those with or without extrarenal complications (p = 0.76). The HNF1β gene mutation was identified in most of the patients with hypodysplastic kidney with multicystic dysplastic kidney (six of seven patients). There was no significant difference in the presence or absence of gene mutations with respect to the renal survival rate (log-rank test p = 0.53). The renal prognosis varied, but the differences were not statistically significant for any of the gene mutations. CONCLUSIONS: CAKUT with bilateral renal lesions were significantly related to gene mutations. We recommend that CAKUT-related gene analysis be considered in cases of bilateral renal lesions. No gene mutations were observed in patients with lower urinary tract obstruction. The renal prognosis varied for each gene mutation.2019年08月, Pediatric nephrology (Berlin, Germany), 34(8) (8), 1457 - 1464, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Seizures and/or impaired consciousness accompanied by fever without known etiology (SICF) is common in the pediatric emergency setting. No optimal strategy for the management of SICF in childhood currently exists. We previously demonstrated the effectiveness of targeted temperature management (TTM) against SICF with a high risk of morbidity; however, some patients with SICF develop neurological sequelae despite TTM, which necessitate additional neuroprotective treatment. The clinical characteristics of these severe cases have not been studied. Accordingly, the aim of this study was to identify the clinical characteristics of children with SICF who exhibit poor outcomes after TTM. METHODS: The medical records of children admitted to Kobe Children's Hospital (Kobe, Japan) between October 2002 and September 2016 were retrospectively reviewed. Patients with SICF treated using TTM were included and divided into the satisfactory and poor outcome groups. Univariate and multivariate logistic regression analyses were used to compare clinical characteristics and laboratory findings between the two groups. RESULTS: Of the 73 included children, 10 exhibited poor outcomes. Univariate logistic regression analysis revealed that acute circulatory failure before TTM initiation, the use of four or more types of anticonvulsants, methylprednisolone pulse therapy, and an aspartate aminotransferase (AST) level ≥73 IU/L were associated with poor outcomes. Multivariate logistic regression analysis identified an elevated AST level as a significant independent predictor of a poor outcome. CONCLUSIONS: An elevated AST level within 12 h of onset in children with SICF is an independent predictor of a poor outcome after TTM initiated within 24 h of onset.2019年08月, Brain & development, 41(7) (7), 604 - 613, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Eighty percent of children with idiopathic nephrotic syndrome respond well to steroid therapy, but up to 50% of patients with steroid-sensitive nephrotic syndrome exhibit frequently relapsing (FRNS) or steroid-dependent nephrotic syndrome (SDNS). Several studies identified the chimeric anti-CD20 monoclonal antibody rituximab as an effective treatment for patients with complicated FRNS/SDNS. Recent studies suggested that rituximab could also be a first-line treatment for early-stage uncomplicated FRNS/SDNS, although further studies are required to confirm its efficacy and safety. METHODS/DESIGN: We are conducting a multicenter, double-blind, randomized placebo controlled trial to investigate the efficacy and safety of rituximab for the treatment of childhood-onset early-stage uncomplicated FRNS/SDNS. Patients will be allocated to receive two 375 mg/m2 doses (maximum dose: 500 mg) of either rituximab or placebo. Investigators are permitted to request the disclosure of a subject's allocation code if he or she exhibits treatment failure. Additionally, if placebo-treated subjects display early relapse (a sign of treatment failure), they have the option to receive rituximab in an unblinded phase. The primary endpoint is relapse-free survival during the observation period. DISCUSSION: The results will provide important data on the use of rituximab for patients with uncomplicated FRNS/SDNS. In the future, rituximab treatment will enable most patients with uncomplicated FRNS/SDNS to discontinue or reduce steroid therapy without relapse, and it is possible that rituximab could represent an immunosuppressive therapy for these diseases. TRIAL REGISTRATION: This trial was prospectively registered to the JMACCT Clinical Trials Registry on September 6, 2018 (Trial ID: JMA-IIA00380 ).2019年08月, BMC nephrology, 20(1) (1), 293 - 293, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BioMed Central Ltd., 2019年07月, BMC Nephrology, 20(1) (1), 英語研究論文(学術雑誌)
- 日本小児高血圧研究会, 2019年07月, 日本小児高血圧研究会誌, 16(1) (1), 14 - 21, 日本語当科における24時間自由行動下血圧測定(ABPM)の使用経験
- BMJ Publishing Group, 2019年07月, BMJ Case Reports, 12(7) (7), 英語研究論文(学術雑誌)
- (公社)神奈川県医師会, 2019年07月, 神奈川医学会雑誌, 46(2) (2), 228 - 228, 日本語腎石灰化、低Mg血症を契機に診断に至った遺伝性Mg喪失性腎症の一例
- 日本小児腎不全学会, 2019年07月, 日本小児腎不全学会雑誌, 39, 207 - 210, 日本語無症候性蛋白尿の精査でWT1遺伝子異常が判明した17歳女児例[査読有り]
- 日本小児腎不全学会, 2019年07月, 日本小児腎不全学会雑誌, 39, 108 - 110, 日本語[査読有り]
- 2019年07月, Pediatrics international : official journal of the Japan Pediatric Society, 61(7) (7), 726 - 727, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- X-linked dominant chondrodysplasia punctata (Conradi-Hunermann-Happle syndrome, CDPX2) caused by mutations in the emopamil-binding protein (EBP) gene and congenital hemidysplasia with ichthyosiform nevus and limb defects (CHILD) syndrome caused by mutation in the NAD(P)H steroid dehydrogenase-like (NSDHL) gene are rare, typically male lethal disorders. CDPX2 skin lesions are characterized by transient severe congenital ichthyosis following the lines of Blaschko, whereas in CHILD syndrome, the lesions show striking lateralization. Here, we report a male CDPX2 patient with postzygotic mosaicism of the EBP gene presenting with lateralized skin lesions with strict midline demarcation as seen in CHILD syndrome (although this diagnosis was ruled out based on analysis of NSDHL), but also partly distributed along Blaschko's lines as seen in CDPX2. The lesions resolved within a few months, but the patient had other abnormalities, including shortening of the limbs, epiphyseal stippling, and forearm asymmetry; he also had problems with respiration and feeding in the first 4 years after birth. Kyphoscoliosis with dysplastic vertebral bodies progressed rapidly and required posterior spinal fusion surgery at 6 years old. These findings provide insights into the pathophysiology of CDPX2 and the mechanism of asymmetric lesion formation during development.2019年07月, American journal of medical genetics. Part A, 179(7) (7), 1315 - 1318, 英語, 国際誌[査読有り]
- Advances in molecular genetics have revealed that approximately 30% of cases with steroid-resistant nephrotic syndrome (SRNS) are caused by single-gene mutations. More than 50 genes are responsible for SRNS. One such gene is the nucleoporin, 93-KD (NUP93). Thus far, few studies have reported mutations of NUP93 in SRNS. Here, we describe an NUP93 biallelic mutation in a 9-year-old boy with focal segmental glomerular sclerosis (FSGS). Notably, one mutation comprised an intronic variant; we conducted in vivo and in vitro analysis to characterize this variant. We found two heterozygous mutations in NUP93: c.2137-18G>A in intron 19 and a novel nonsense mutation c.727A>T (p.Lys243*) in exon 8. We conducted RNA sequencing and in vitro splicing assays by using minigene construction, combined with protein expression analysis to determine the pathogenicity of the intronic variant. Both RNA sequencing and in vitro splicing assay showed exon 20-skipping by the intronic variant. In protein expression analysis, aberrant subcellular localization with small punctate vesicles in the cytoplasm was observed for the intronic variant. Taken together, we concluded that c.2137-18G>A was linked to pathogenicity due to aberrant splicing. NUP93 variants are quite rare; however, we have shown that even intronic variants in NUP93 can cause SRNS. This study provides a fundamental approach to validate the intronic variant, as well as new insights regarding the clinical spectrum of SRNS caused by rare gene variants.2019年07月, Journal of human genetics, 64(7) (7), 673 - 679, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (公社)日本医師会, 2019年06月, 日本医師会雑誌, 148(特別1) (特別1), S249 - S249, 日本語【指定難病ペディア 2019】個別の指定難病 腎・泌尿器系 アルポート症候群[指定難病218][査読有り]
- The detailed clinical time course in acute disseminated encephalomyelitis (ADEM) from initial symptoms, through exacerbation, to remission has not been widely reported. Hence, this study aimed to investigate the clinical time course of pediatric ADEM. This was a multicenter retrospective study based on registry data from medical chart reviews. The study included children who met the international consensus diagnostic criteria for ADEM. The patients comprised 18 boys and 6 girls, with a mean age of 5.5 ± 3.3 years at onset. From onset, the time until peak neurological symptoms, time until initial improvement, and time until full recovery was 3.1 ± 3.7 days, 6.0 ± 4.5 days, and 26 ± 34 days, respectively. Twenty-three (96%) patients were treated with high-dose methylprednisolone (mPSL) with a mean duration of 4.1 ± 4.0 days from onset. The condition of 15 patients (65%) improved within 3 days of high-dose mPSL initiation, whereas, that of four patients began to improve after >5 days of high-dose mPSL initiation. Only one patient (4%) did not achieve full recovery despite treatment with high-dose mPSL, intravenous immunoglobulin, and plasma exchange. This study presents the detailed clinical time course in pediatric ADEM in Japan. Progression of neurologic deficits typically lasts a few days, with initial improvement in 1 week leading to full recovery within 1 month.2019年06月, Brain & development, 41(6) (6), 531 - 537, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Persistent proteinuria seems to be a risk factor for progression of renal disease. Its reduction by angiotensin-converting inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) is renoprotective. Our previous pilot study showed that 2-year lisinopril therapy is effective and safe for children with mild IgA nephropathy. When combined with ACEI and ARB, reported results are of greater decrease in proteinuria than monotherapy in chronic glomerulonephritis, including IgA nephropathy. To date, however, there have been no randomized controlled trials in children. METHODS: This is an open-label, multicenter, prospective, and randomized phase II controlled trial of 63 children with biopsy-proven proteinuric mild IgA nephropathy. We compared efficacy and safety between patients undergoing lisinopril monotherapy and patients undergoing combination therapy of lisinopril and losartan to determine better treatment for childhood proteinuric mild IgA nephropathy. RESULTS: There was no difference in proteinuria disappearance rate (primary endpoint) between the two groups (cumulative disappearance rate of proteinuria at 24 months: 89.3% vs 89% [combination vs monotherapy]). Moreover, there were no significant differences in side effects between the two groups. CONCLUSIONS: We propose lisinopril monotherapy as treatment for childhood proteinuric mild IgA nephropathy as there are no advantages of combination therapy. CLINICAL TRIAL REGISTRATION: Clinical trial registry, UMIN ID C000000006, https://www.umin.ac.jp .2019年05月, Pediatric nephrology (Berlin, Germany), 34(5) (5), 837 - 846, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 298 - 298, 日本語NPHS1は小児ステロイド感受性ネフローゼ症候群の疾患感受性遺伝子である
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 318 - 318, 日本語常染色体劣性Alport症候群39家系46人の臨床遺伝学的検討
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 100 - 100, 日本語
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 303 - 303, 日本語遺伝性ネフローゼ症候群における臨床的特徴の検討
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 355 - 355, 日本語Dent病およびLowe症候群の臨床遺伝学的検討
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 91 - 91, 日本語
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 92 - 92, 日本語
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 180 - 180, 日本語
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 342 - 342, 日本語小児IgA腎症における蛋白尿再燃因子の検討
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 104 - 104, 日本語
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 119 - 119, 日本語
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 120 - 120, 日本語
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 267 - 267, 日本語ミトコンドリア病関連腎疾患の全国調査
- (一社)日本腎臓学会, 2019年05月, 日本腎臓学会誌, 61(3) (3), 317 - 317, 日本語ADTKD-MUC1/UMODの抗体診断法確立へ向けた検討
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 179 - 179, 日本語
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 106 - 106, 日本語
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 56 - 56, 日本語
- BACKGROUND: Recently, comprehensive genetic approaches for steroid-resistant nephrotic syndrome (SRNS) using next-generation sequencing (NGS) have been established, but causative gene mutations could not be detected in almost 70% of SRNS patients. Main reason for the low variant detection rate is that most of them are SRNS caused not by genetic but by immunological factors. But some of them are probably because of the difficulty of detecting copy number variations (CNVs) in causative genes by NGS. METHODS: In this study, we performed two analytical methods of NGS data-dependent pair analysis and custom array comparative genomic hybridization (aCGH) in addition to NGS analysis in an infantile nephrotic syndrome case. RESULTS: We detected only one known pathogenic heterozygous missense mutation in exon 7 of COQ6 c.782C > T, p.(Pro261Leu) by NGS. With pair analysis, heterozygous exon 1-2 deletion was suspected and was confirmed by custom aCGH. As a result, a small CNV was successfully detected in the COQ6 gene. Because we could detect variants in COQ6 and could start treatment by coenzyme Q10 (CoQ10) in his very early stage of SRNS, the patient achieved complete remission. CONCLUSIONS: These relatively novel methods should be adopted in cases with negative results in gene tests by NGS analysis. Especially, in cases with CoQ10 deficiency, it is possible to delay initiating dialysis by starting treatment at their early stages.2019年05月, Clinical and experimental nephrology, 23(5) (5), 669 - 675, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2019年04月, 日本小児腎臓病学会雑誌, 32(1) (1), 54 - 55, 日本語
- (一社)日本小児腎臓病学会, 2019年04月, 日本小児腎臓病学会雑誌, 32(1) (1), 31 - 36, 日本語
- (株)東京医学社, 2019年04月, 小児内科, 51(4) (4), 563 - 564, 日本語【小児の負荷試験2019】腎機能検査 アルドステロン症診断のための確認試験 カプトプリル負荷試験、フロセミド立位負荷試験、生理食塩水負荷試験[査読有り]
- 発達腎研究会, 2019年04月, 発達腎研究会誌, 27(1) (1), 31 - 34, 日本語PAX2関連腎疾患の遺伝子型と臨床像[査読有り]
- 発達腎研究会, 2019年04月, 発達腎研究会誌, 27(1) (1), 7 - 8, 日本語オリゴメガネフロニアと角膜ジストロフィ[査読有り]
- 発達腎研究会, 2019年04月, 発達腎研究会誌, 27(1) (1), 9 - 11, 日本語男性腎不全の家族歴からネフロン癆関連シリオパチーの診断に至った3歳男児例[査読有り]
- OBJECTIVES: To evaluate the proportion of children presenting to the emergency department (ED) with altered mental status who demonstrate nonconvulsive seizures on reduced-lead electroencephalography (EEG), and to further investigate the characteristics, treatment, and outcomes in these patients compared with patients without nonconvulsive seizures. STUDY DESIGN: In this retrospective cohort study, we reviewed the database and medical records of pediatric patients (aged <18 years) in a single ED between May 1, 2016, and April 30, 2018. We first determined the proportion of nonconvulsive seizures among patients with altered mental status (Glasgow Coma Scale <15). We then compared the clinical presentation, demographic data, clinical diagnosis, EEG results, treatment, and outcomes of patients with altered mental status with nonconvulsive seizures and those without nonconvulsive seizures. RESULTS: In total, 16.9% of the patients with altered mental status (41 of 242; 95% CI, 12.2%-21.6%) evaluated by EEG had detectable nonconvulsive seizure, equivalent to 4.4% (41 of 932) of all patients with altered mental status presenting at our hospital. More than 80% of patients monitored for nonconvulsive seizures had a previous history of seizures, often febrile. Patients with nonconvulsive seizures were older (median, 68.5 vs 36.1 months) and had a higher Pediatric Cerebral Performance Category score at presentation (median, 2.0 vs 1.0). In addition, the proportion of patients admitted to the intensive care unit was significantly higher in the patients with nonconvulsive seizures (30.3% vs 15.0%). However, total duration of hospitalization, neurologic sequelae, and 30-day mortality rate did not differ between the 2 groups. CONCLUSIONS: A relatively high percentage of pediatric patients with altered mental status in the ED experience nonconvulsive seizures. The use of reduced-lead EEG monitoring in the ED might facilitate the recognition and treatment of nonconvulsive seizures, especially among patients with a history of seizures.2019年04月, The Journal of pediatrics, 207, 213 - 219, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2019年03月, 日本小児科学会雑誌, 123(3) (3), 621 - 621, 日本語無症候性血尿にて長期経過の後に蛋白尿が出現し常染色体劣性Alport症候群の診断に至った1例
- (公社)日本小児科学会, 2019年03月, 日本小児科学会雑誌, 123(3) (3), 628 - 628, 日本語クラリスロマイシンによりカルシニューリン阻害薬血中濃度の異常上昇をきたした2例
- 2019年03月, Biochemistry and biophysics reports, 17, 81 - 86[査読有り]
- (公社)日本小児科学会, 2019年02月, 日本小児科学会雑誌, 123(2) (2), 217 - 217, 日本語腎生検後のADH上昇と生理食塩水輸液の安全性に関する検討
- (公社)日本小児科学会, 2019年02月, 日本小児科学会雑誌, 123(2) (2), 217 - 217, 日本語先天性/乳児およびステロイド抵抗性ネフローゼ症候群における網羅的遺伝子診断体制
- (公社)日本小児科学会, 2019年02月, 日本小児科学会雑誌, 123(2) (2), 507 - 507, 日本語急速に末期腎不全に至りSDCCAG8遺伝子異常を認めたネフロン癆関連ciliopathyの2歳男児
- (株)東京医学社, 2019年02月, 腎と透析, 86(2) (2), 195 - 199, 日本語【マグネシウム代謝-その新たな臨床的意義】腎疾患とマグネシウム 低マグネシウム血症を呈する先天性腎疾患[査読有り]
- Alport syndrome (AS) is a progressive hereditary renal disease that is characterized by sensorineural hearing loss and ocular abnormalities. It is divided into three modes of inheritance, namely, X-linked Alport syndrome (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ADAS and ARAS are caused by those in COL4A3/COL4A4. Diagnosis is conventionally made pathologically, but recent advances in comprehensive genetic analysis have enabled genetic testing to be performed for the diagnosis of AS as first-line diagnosis. Because of these advances, substantial information about the genetics of AS has been obtained and the genetic background of this disease has been revealed, including genotype-phenotype correlations and mechanisms of onset in some male XLAS cases that lead to milder phenotypes of late-onset end-stage renal disease (ESRD). There is currently no radical therapy for AS and treatment is only performed to delay progression to ESRD using nephron-protective drugs. Angiotensin-converting enzyme inhibitors can remarkably delay the development of ESRD. Recently, some new drugs for this disease have entered clinical trials or been developed in laboratories. In this article, we review the diagnostic strategy, genotype-phenotype correlation, mechanisms of onset of milder phenotypes, and treatment of AS, among others.SPRINGER, 2019年02月, Clinical and experimental nephrology, 23(2) (2), 158 - 168, 英語, 国内誌研究論文(学術雑誌)
- Transforming growth factor beta-induced (TGFBI)-associated corneal dystrophies are a group of inherited progressive corneal diseases. One of these TGFBI-associated corneal dystrophies is Avellino corneal dystrophy, an autosomal dominant corneal dystrophy characterized by multiple asymmetric stromal opacities that potentially impair vision. Recently, a case with corneal dystrophy complicated by nephropathy possessing a pathogenic variant of the TGFBI gene was reported for the first time. Here, we report the second case with the same condition and the same mutation in the TGFBI gene. The patient was an 18-year-old male. He and his father had already been diagnosed with corneal dystrophy. Proteinuria was revealed in the patient during urine screening at school. Since his serum creatinine level was raised, a percutaneous renal biopsy was performed. Light microscopy demonstrated oligomeganephronia. Electron microscopy demonstrated an irregular basement membrane. TGFBI was analyzed by direct sequencing. A heterozygous mutation c.371G > A in exon 4, which caused an amino acid substitution from arginine to histidine at codon 124, was identified in the patient and his father. Although only one case of TGFBI-associated corneal dystrophy and nephropathy has been reported, our case's clinical and pathological findings were almost identical to those in that reported case. Further investigations of this new disease entity should be reported to all nephrologists and ophthalmologists.2019年02月, CEN case reports, 8(1) (1), 14 - 17, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- Alport syndrome (AS) is a progressive hereditary renal disease that is characterized by sensorineural hearing loss and ocular abnormalities. It is divided into three modes of inheritance, namely, X-linked Alport syndrome (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ADAS and ARAS are caused by those in COL4A3/COL4A4. Diagnosis is conventionally made pathologically, but recent advances in comprehensive genetic analysis have enabled genetic testing to be performed for the diagnosis of AS as first-line diagnosis. Because of these advances, substantial information about the genetics of AS has been obtained and the genetic background of this disease has been revealed, including genotype-phenotype correlations and mechanisms of onset in some male XLAS cases that lead to milder phenotypes of late-onset end-stage renal disease (ESRD). There is currently no radical therapy for AS and treatment is only performed to delay progression to ESRD using nephron-protective drugs. Angiotensin-converting enzyme inhibitors can remarkably delay the development of ESRD. Recently, some new drugs for this disease have entered clinical trials or been developed in laboratories. In this article, we review the diagnostic strategy, genotype-phenotype correlation, mechanisms of onset of milder phenotypes, and treatment of AS, among others.2019年02月, Clinical and experimental nephrology, 23(2) (2), 158 - 168, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- 2019年02月, Journal of clinical medicine, 8(2) (2)[査読有り]
- Bentham Science Publishers, 2019年, Open Urology and Nephrology Journal, 12(1) (1), 27 - 32, 英語研究論文(学術雑誌)
- 日本ベーリンガーインゲルハイム(株), 2019年, 腎炎症例研究, 36, 150 - 162, 日本語偶発的に貧血、腎機能障害、高K血症が発見され、遺伝子検査でADTKD-RENと診断した男児例
- 日本ベーリンガーインゲルハイム(株), 2019年, 腎炎症例研究, 36, 150 - 162, 日本語偶発的に貧血、腎機能障害、高K血症が発見され、遺伝子検査でADTKD-RENと診断した男児例[査読有り]
- (一社)日本腎臓学会, 2019年01月, 日本腎臓学会誌, 61(1) (1), 18 - 22, 日本語【腎臓学 この一年の進歩】遺伝性腎疾患[査読有り]
- CLOVES syndrome is characterized by congenital lipomatous overgrowth, vascular malformation, epidermal nevi, and scoliosis/spinal malformation. It is caused by somatic mosaicism of gain-of-function variants of PIK3CA. Here, we describe a novel case of a 5-year-old Japanese girl with CLOVES and concurrent pancreatic steatosis. She had a recurrent somatic mutation in PIK3CA (NM_006218.3: c.1357G>A, p.Glu453Lys), elevated HbA1c levels, and pancreatic steatosis. This case indicates that pancreatic screening is critical for PIK3CA-related disorders.2019年, Human genome variation, 6, 31 - 31, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Oral-facial-digital syndrome type 1 (OFD1) is a ciliopathy characterized by oral, facial, and digital malformations that are often accompanied by polycystic lesion of the kidney and central nervous involvement. OFD1 shows an X-linked recessive inheritance caused by mutation in the OFD1 gene (Xp22.2). The disease is generally considered embryonic lethal for hemizygous males. However, males with OFD1 mutations were recently reported. Here, we report four additional Japanese male patients with OFD1 variants and describe the variable clinical manifestation and disease severity among the four patients. Patient 1 with pathogenic indels including a 19-bp deletion and 4-bp insertion (c.2600-18_2600delinsACCT) had end-stage renal disease (ESRD) with bilateral cystic kidneys and sensory hearing loss. He showed neither intellectual disability nor facial or digital dysmorphism. Patient 2 with a missense variant in exon 7 (c.539 A > T, p.Asp180Val) presented head circumference enlargement, brachydactyly, high-arched palate, micropenis, severe global developmental delay, and ESRD. Patient 3 had a single base substitution at the splice donor site of intron 16 (c.2260 + 2 T > G) causing a 513-bp deletion at the transcript level. The patient had chronic kidney disease and speech delay, but no oral, facial, or digital dysmorphism. His uncle (patient 4) carried the same OFD1 variant and showed ESRD with extra-renal malformations including obesity and micropenis, which was previously diagnosed as Bardet-Biedl syndrome. The OFD1 mutations were not lethal in these four male patients, likely because the three mutations were in-frame or missense. This report provided insights into the onset mechanism and phenotype-genotype association in patients with OFD1 mutations.2019年01月, Journal of human genetics, 64(1) (1), 3 - 9, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Although previous studies have investigated the influence of antiepileptic drugs (AEDs) on lipid profiles and thyroid hormone levels, there is little evidence regarding the effects of levetiracetam (LEV). Therefore, we conducted a prospective longitudinal study to evaluate the effects of LEV and carbamazepine (CBZ) treatment on lipid profile and thyroid hormone levels in patients newly diagnosed with epilepsy. Inclusion criteria were as follows: (a) age between 4 and 15 years, (b) diagnosis of epilepsy with at least two focal seizures within a year, and (c) newly treated with LEV or CBZ monotherapy. Serum lipid profile and thyroid hormone levels were measured before and after 1 and 6 months of AED initiation. Among the 21 included patients (LEV: 13 patients, CBZ: 8 patients), all but one patient in the LEV group continued AED monotherapy during the study period. Although triglyceride (TG) levels tended to be increased in the CBZ group (baseline: 58.3 ± 22.0 mg/dl, 1 month: 63.8 ± 21.6 mg/dl, 6 months: 92.3 ± 63.6 mg/dl, p = 0.22, analyses of variance (ANOVA)), there were no significant changes in total cholesterol (TC), TG levels, high-density lipoprotein cholesterol (HDL-C), or low-density lipoprotein cholesterol (LDL-C) in either group. Serum free thyroxine (fT4) levels were significantly decreased in the CBZ group (baseline: 1.15 ± 0.06 ng/dl, 1 month: 1.00 ± 0.16 ng/dl, 6 months: 0.98 ± 0.14 ng/dl, p = 0.03, ANOVA). In contrast, there were no significant changes in fT4 or thyroid-stimulating hormone (TSH) levels in the LEV group. The results of the present study suggest that LEV monotherapy does not affect lipid profile or thyroid function while CBZ monotherapy may cause thyroid dysfunction.2019年01月, Epilepsy & behavior : E&B, 90, 15 - 19, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Introduction: Gitelman syndrome (GS) is a tubulopathy exhibited by salt loss. GS cases are most often diagnosed by chance blood test. Aside from that, some cases are also diagnosed from tetanic symptoms associated with hypokalemia and/or hypomagnesemia or short stature. As for complications, thyroid dysfunction and short stature are known, but the incidence rates for these complications have not yet been elucidated. In addition, no genotype-phenotype correlation has been identified in GS. Methods: We examined the clinical characteristics and genotype-phenotype correlation in genetically proven GS cases with homozygous or compound heterozygous variants in SLC12A3 (n = 185). Results: In our cohort, diagnostic opportunities were by chance blood tests (54.7%), tetany (32.6%), or short stature (7.2%). Regarding complications, 16.3% had short stature, 13.7% had experienced febrile convulsion, 4.3% had thyroid dysfunction, and 2.5% were diagnosed with epilepsy. In one case, QT prolongation was detected. Among 29 cases with short stature, 10 were diagnosed with growth hormone (GH) deficiency and GH replacement therapy started. Interestingly, there was a strong correlation in serum magnesium levels between cases with p.Arg642Cys and/or p.Leu858His and cases without these variants, which are mutational hotspots in the Japanese population (1.76 mg/dl vs. 1.43 mg/dl, P < 0.001). Conclusion: This study has revealed, for the first time, clinical characteristics in genetically proven GS cases in the Japanese population, including prevalence of complications. Patients with hypokalemia detected by chance blood test should have gene tests performed. Patients with GS need attention for developing extrarenal complications, such as short stature, febrile convulsion, thyroid dysfunction, epilepsy, or QT prolongation. It was also revealed for the first time that hypomagnesemia was not severe in some variants in SLC12A3.2019年01月, Kidney international reports, 4(1) (1), 119 - 125, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Hypomagnesemia 1 (HOMG1) is an extremely rare disease with autosomal recessive inheritance that is caused by mutations in the transient receptor potential melastatin 6 gene (TRPM6). Here, we describe a pediatric HOMG1 case with novel compound heterozygous mutations of TRPM6 (c.1483 C > T [p.Gln495*] and c.2715del [p.Trp905*]) in a 2-month-old boy who developed refractory seizures due to hypomagnesemia with secondary hypocalcemia.2019年, Human genome variation, 6, 13 - 13, 英語, 国際誌[査読有り]
- (株)東京医学社, 2018年12月, 腎と透析, 85(6) (6), 777 - 781, 日本語
- (株)東京医学社, 2018年12月, 腎と透析, 85(6) (6), 869 - 879, 日本語
- 和歌山医学会, 2018年12月, 和歌山医学, 69(4) (4), 202 - 202, 日本語男性腎不全の家族歴からネフロン癆関連シリオパチーの診断に至った3歳男児例[査読有り]
- CD80, which regulates T cell activation, may provide a differential diagnostic marker between minimal change disease (MCD) and other renal diseases, including focal segmental glomerular sclerosis (FSGS). However, recent reports show contrasting results. Therefore, we evaluated the utility of urinary CD80 as a diagnostic biomarker. We collected 65 urine samples from 55 patients with MCD (n = 31), FSGS (n = 4), inherited nephrotic syndrome (n = 4), Alport syndrome (n = 5) and other glomerular diseases (n = 11), and control samples (n = 30). We measured urinary CD80 levels by ELISA. Urinary CD80 (ng/gCr) (median, interquartile range) levels were significantly higher in patients with MCD in relapse (91.5, 31.1-356.0), FSGS (376.2, 62.7-1916.0), and inherited nephrotic syndrome (220.1, 62.9-865.3), than in patients with MCD in remission (29.5, 21.7-52.8) (p < 0.05). Elevation of urinary CD80 was observed, even in patients with inherited nephrotic syndrome unrelated to T cell activation. Additionally, urinary CD80 was positively correlated with urinary protein levels. Our results suggest that urinary CD80 is unreliable as a differential diagnostic marker between MCD in relapse and FSGS or inherited kidney diseases. Increased urinary CD80 excretion was present in all patients with active kidney disease.2018年11月, Scientific reports, 8(1) (1), 17322 - 17322, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2018年11月, 日本小児腎臓病学会雑誌, 31(2) (2), 175 - 175, 日本語
- (一社)日本小児腎臓病学会, 2018年11月, 日本小児腎臓病学会雑誌, 31(2) (2), 176 - 176, 日本語
- BACKGROUND: Fosphenytoin (fPHT) and continuous intravenous midazolam (cMDL) had commonly been used as second-line treatments for pediatric status epilepticus (SE) in Japan. However, there is no comparative study of these two treatments. METHODS: We included consecutive children who 1) were admitted to Kobe Children's Hospital because of convulsion with fever and 2) were treated with either fPHT or cMDL as second-line treatment for convulsive SE lasting for longer than 30 min. We compared, between the fPHT and cMDL groups, the proportion of barbiturate coma therapy (BCT), incomplete recovery of consciousness, mechanical ventilation, and inotropic agents. RESULTS: The proportion of BCT was not significantly different between the two groups (48.7% [20/41] in fPHT and 35.3% [29/82] in cMDL, p = 0.17). The prevalence of incomplete recovery of consciousness, mechanical ventilation, and inotropic agents was not different between the two groups. After excluding 49 patients treated with BCT, incomplete recovery of consciousness 6 h and 12 h after onset was more frequent in the cMDL group than in the fPHT group (71.7% vs. 33.3%, p < 0.01; 56.6% vs. 14.2%, p < 0.01; respectively). Mechanical ventilation was more frequent in the cMDL group than in the fPHT group (32.0% vs. 4.7%, p = 0.01). CONCLUSIONS: Our results suggest that 1) the efficacy of fPHT and cMDL is similar, although cMDL may prevent the need for BCT compared with fPHT, and 2) fPHT is relatively safe as a second-line treatment for pediatric SE in patients who do not require BCT.2018年11月, Brain & development, 40(10) (10), 884 - 890, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Idiopathic nephrotic syndrome (INS) is the most common chronic glomerular disease in children. Approximately 80-90% of patients with childhood INS have steroid-sensitive nephrotic syndrome (SSNS), and can obtain remission with steroid therapy, while the remainder have steroid-resistant nephrotic syndrome (SRNS). Furthermore, approximately 50% of children with SSNS develop frequently-relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS). Children with FRNS/SDNS are usually treated with immunosuppressive agents such as cyclosporine, cyclophosphamide, or mizoribine in Japan. However, 10-20% of children receiving immunosuppressive agents still show frequent relapse and/or steroid dependence during or after treatment, which is defined as complicated FRNS/SDNS. Furthermore, 30% of SRNS patients who obtain remission after additional treatments such as cyclosporine also turn out to be complicated FRNS/SDNS. For such complicated FRNS/SDNS patients, rituximab (RTX) is currently used; however, recurrence after RTX treatment also remains an open issue. Because long-term use of existing immunosuppressive drugs has limitations, development of a novel treatment for maintenance therapy after RTX is desirable. Mycophenolate mofetil (MMF) is an immunosuppressive drug with fewer side effects than cyclosporine or cyclophosphamide. Importantly, recent studies have reported the efficacy of MMF in children with nephrotic syndrome. METHODS: We conduct a multicenter, double-blind, randomized, placebo-controlled trial to evaluate the efficacy and safety of MMF after RTX therapy in children with complicated FRNS/SDNS. Patients are allocated to either RTX plus MMF treatment group, or RTX plus placebo treatment group. For the former group, MMF is administered at a dose of 1000-1200 mg/m2/day (maximum 2 g/day) twice daily for 17 months after RTX treatment. The primary endpoint is time-to-treatment failure (development of frequent relapses, steroid dependence or steroid resistance). DISCUSSION: The results will provide important data on the use of MMF as maintenance therapy after RTX to prevent complicated FRNS/SDNS patients from declining into treatment failure. In future, MMF in conjunction with RTX treatment may permit increased duration of remission in 'complicated' FRNS/SDNS cases. TRIAL REGISTRATION: This trial was prospectively registered to UMIN Clinical Trials Registry on June 23, 2014 (UMIN Trial ID: UMIN000014347 ).2018年11月, BMC nephrology, 19(1) (1), 302 - 302, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Objectives: Acute kidney injury (AKI) at onset of adult systemic lupus erythematosus (SLE) is a risk factor for end stage kidney disease (ESKD). However, data on childhood-onset lupus nephritis (LN) with AKI are scarce.Methods: We retrospectively reviewed the complete files of pediatric SLE patients from 1995 to 2010. All patients underwent kidney biopsy promptly after diagnosis.Results: Thirty-six patients (10 males and 26 females) were enrolled. Mean age at diagnosis and observation period were 11.6 ± 2.4 and 8.1 ± 4.4 years, respectively. Seven patients had AKI at onset of SLE. Compared with those without AKI, patients with AKI had significantly higher proportions of pathologically proliferative LN. Only one patient with AKI progressed to ESKD without complete recovery of renal function. Overall and renal survival rates were 100and 97.2%, respectively. There was no significant difference in estimated glomerular filtration rate at the final visit (85ml/min/1.73 m2 in the AKI group vs. 103.2 ml/min/1.73 m2 in the non-AKI group; p = .11).Conclusion: Our study demonstrated favorable renal outcomes in childhood-onset LN with AKI in the near to midterm period. Inducing complete remission may be important for preserving renal function.2018年10月, Modern rheumatology, 29(6) (6), 1 - 17, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- AIM: Type IV collagen nephropathies include Alport Syndrome and thin basement membrane nephropathy (TBMN), which are caused by mutations in COL4A3/A4/A5 genes. Recently, reports of patients with heterozygous mutations in COL4A3/A4 have been increasing. The clinical course of these patients has a wide variety, and they are diagnosed as TBMN, autosomal dominant Alport syndrome (ADAS), or familial focal segmental glomerular sclerosis. However, diagnosis, frequency and clinicopathological manifestation of them remains unclear. We tested COL4A3/A4/A5 genes in patients with hereditary nephritis that was difficult to diagnose clinicopathologically, and investigated who should undergo such testing. METHODS: We performed immunostaining for α5 chain of type IV collagen [α5 (IV)] in 27 patients from 21 families who fitted the following criteria: (i) haematuria and proteinuria (± renal dysfunction); (ii) family history of haematuria, proteinuria, and/or renal dysfunction (autosomal dominant inheritance); (iii) no specific glomerulonephritis; and (iv) thinning, splitting, or lamellation of the glomerular basement membrane (GBM) on electron microscopy. Then we performed genetic testing in 19 patients from 16 families who showed normal α5 (IV) patterns. We conducted a retrospective analysis of their clinicopathological findings. RESULTS: Among 16 families, 69% were detected heterozygous mutations in COL4A3/A4, suggesting the diagnosis of TBMN/ADAS. Twenty-one percent of patients developed end stage renal disease. All patients showed thinning of GBM, which was accompanied by splitting or lamellation in seven patients. CONCLUSION: A considerable fraction of patients with hereditary nephritis that is difficult to diagnose clinicopathologically have TBMN/ADAS. It is important to recognize TBMN/ADAS and perform genetic testing in appropriate patients.2018年10月, Nephrology (Carlton, Vic.), 23(10) (10), 940 - 947, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Eighty percent of children with steroid-sensitive nephrotic syndrome (SSNS) relapse within 2 years and 40-50% patients show frequently-relapsing nephrotic syndrome (FRNS). Patients showing a relapse within 6 months after initial remission are at high risk of FRNS. Since frequent prednisolone treatment for FRNS induces severe prednisolone side effects, development of a treatment to prevent patients from shifting to FRNS is desirable. Mizoribine is an immunosuppressive drug with fewer side effects than prednisolone. Recent studies reported the efficacy of high-dose mizoribine in children with FRNS. METHODS/DESIGN: We conduct a multicenter, open, randomized controlled trial to investigate the efficacy and safety of standard prednisolone plus high-dose mizoribine therapy in children with SSNS showing a relapse within 6 months after an initial remission. Patients are allocated to either standard prednisolone alone treatment group, or standard prednisolone plus high-dose mizoribine group. For the former group, mizoribine is administered at a dose of 10 mg/kg/day once daily and continued for 2 years. The primary endpoint is the duration to frequent relapse. DISCUSSION: The results provide important data on use of high-dose mizoribine to prevent SSNS patients from shifting to FRNS. Since blood concentrations of mizoribine have not been investigated in detail until now, there is a possibility that mizoribine is underestimated in favor of other immunosuppressive drugs. In future, high-dose mizoribine therapy may lead to prevention of relapse in children at high risk of FRNS, and to decreased total dose of prednisolone. TRIAL REGISTRATION: UMIN000005103 , (Prospectively registered 1st March 2011).2018年09月, BMC nephrology, 19(1) (1), 223 - 223, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (一社)日本内分泌学会, 2018年09月, 日本内分泌学会雑誌, 94(2) (2), 700 - 700, 日本語
- 2018年09月, Case reports in nephrology and dialysis, 8(3) (3), 198 - 206[査読有り]
- Background Nephrotic syndrome is the most common cause of chronic glomerular disease in children. Most of these patients develop steroid-sensitive nephrotic syndrome (SSNS), but the loci conferring susceptibility to childhood SSNS are mainly unknown.Methods We conducted a genome-wide association study (GWAS) in the Japanese population; 224 patients with childhood SSNS and 419 adult healthy controls were genotyped using the Affymetrix Japonica Array in the discovery stage. Imputation for six HLA genes (HLA-A, -C, -B, -DRB1, -DQB1, and -DPB1) was conducted on the basis of Japanese-specific references. We performed genotyping for HLA-DRB1/-DQB1 using a sequence-specific oligonucleotide-probing method on a Luminex platform. Whole-genome imputation was conducted using a phased reference panel of 2049 healthy Japanese individuals. Replication was performed in an independent Japanese sample set including 216 patients and 719 healthy controls. We genotyped candidate single-nucleotide polymorphisms using the DigiTag2 assay.Results The most significant association was detected in the HLA-DR/DQ region and replicated (rs4642516 [minor allele G], combined Pallelic=7.84×10-23; odds ratio [OR], 0.33; 95% confidence interval [95% CI], 0.26 to 0.41; rs3134996 [minor allele A], combined Pallelic=1.72×10-25; OR, 0.29; 95% CI, 0.23 to 0.37). HLA-DRB1*08:02 (Pc=1.82×10-9; OR, 2.62; 95% CI, 1.94 to 3.54) and HLA-DQB1*06:04 (Pc=2.09×10-12; OR, 0.10; 95% CI, 0.05 to 0.21) were considered primary HLA alleles associated with childhood SSNS. HLA-DRB1*08:02-DQB1*03:02 (Pc=7.01×10-11; OR, 3.60; 95% CI, 2.46 to 5.29) was identified as the most significant genetic susceptibility factor.Conclusions The most significant association with childhood SSNS was detected in the HLA-DR/DQ region. Further HLA allele/haplotype analyses should enhance our understanding of molecular mechanisms underlying SSNS.2018年08月, Journal of the American Society of Nephrology : JASN, 29(8) (8), 2189 - 2199, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2018年08月, 日本腎臓学会誌, 60(6) (6), 735 - 735, 日本語蛋白尿出現から2年の経過で末期腎不全に至ったTRPC6遺伝子変異による遺伝性FSGSの一男児例
- (一社)日本腎臓学会, 2018年08月, 日本腎臓学会誌, 60(6) (6), 735 - 735, 日本語Charcot-Marie-Tooth病を合併しINF2遺伝子変異が同定された遺伝性FSGSの1例
- BACKGROUND: Comprehensive genetic approaches for diagnosing inherited kidney diseases using next-generation sequencing (NGS) have recently been established. However, even with these approaches, we are still failing to detect gene defects in some patients who appear to suffer from genetic diseases. One of the reasons for this is the difficulty of detecting copy number variations (CNVs) using our current approaches. For such cases, we can apply methods of array-based comparative genomic hybridization (aCGH) or multiplex ligation and probe amplification (MLPA); however, these are expensive and laborious and also often fail to identify CNVs. Here, we report seven cases with CNVs in various inherited kidney diseases screened by NGS pair analysis. METHODS: Targeted sequencing analysis for causative genes was conducted for cases with suspected inherited kidney diseases, for some of which a definitive genetic diagnosis had not been achieved. We conducted pair analysis using NGS data for those cases. When CNVs were detected by pair analysis, they were confirmed by aCGH and/or MLPA. RESULTS: In seven cases, CNVs in various causative genes of inherited kidney diseases were detected by pair analysis. With aCGH and/or MLPA, pathogenic CNV variants were confirmed: COL4A5 or HNF1B in two cases each, and EYA1, CLCNKB, or PAX2 in one each. CONCLUSION: We presented seven cases with CNVs in various genes that were screened by pair analysis. The NGS-based CNV detection method is useful for comprehensive screening of CNVs, and our results revealed that, for a certain proportion of cases, CNV analysis is necessary for accurate genetic diagnosis.2018年08月, Clinical and experimental nephrology, 22(4) (4), 881 - 888, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Children who present with seizure and/or impaired consciousness accompanied by fever without known etiology (SICF) may be diagnosed with either acute encephalopathy (AE) or febrile seizure (FS). Although approximately 5% of AE cases are fatal, it is difficult to identify fatal cases among children with SICF, which are often critical by the time of diagnosis. Thus, early prediction of outcomes for children with SICF, prior to diagnosis, may help to reduce mortality associated with AE. The aim of the present study was to identify clinical and laboratory risk factors for mortality acquired within 6 h of onset among children with SICF. METHODS: We retrospectively reviewed the medical records of children who had been admitted to Kobe Children's Hospital (Kobe, Japan) with SICF between October 2002 and September 2015. We compared clinical and laboratory characteristics acquired within 6 h of onset and outcomes between survivors and non-survivors using univariate and multivariate analyses. RESULTS: The survivor and non-survivor groups included 659 and nine patients, respectively. All patients in the non-survivor group received a final diagnosis of AE. Univariate analysis revealed significant differences between the groups with regard to seizure duration and the following laboratory parameters: aspartate transaminase (AST), alanine aminotransferase, lactate dehydrogenase, sodium, and lactate. The multivariate analysis identified AST as a significant independent factor associated with mortality. CONCLUSIONS: Elevation of AST within 6 h of onset is independently correlated with mortality in children with SICF. Our result may elucidate earlier intervention for patients with high risk of mortality.2018年08月, Brain & development, 40(7) (7), 552 - 557, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: X-linked Alport syndrome (XLAS) is a progressive hereditary nephropathy caused by mutations in the COL4A5 gene. Genotype-phenotype correlation in male XLAS is relatively well established; relative to truncating mutations, nontruncating mutations exhibit milder phenotypes. However, transcript comparison between XLAS cases with splicing abnormalities that result in a premature stop codon and those with nontruncating splicing abnormalities has not been reported, mainly because transcript analysis is not routinely conducted in patients with XLAS. METHODS: We examined transcript expression for all patients with suspected splicing abnormalities who were treated at one hospital between January of 2006 and July of 2017. Additionally, we recruited 46 males from 29 families with splicing abnormalities to examine genotype-phenotype correlation in patients with truncating (n=21, from 14 families) and nontruncating (n=25, from 15 families) mutations at the transcript level. RESULTS: We detected 41 XLAS families with abnormal splicing patterns and described novel XLAS atypical splicing patterns (n=14) other than exon skipping caused by point mutations in the splice consensus sequence. The median age for developing ESRD was 20 years (95% confidence interval, 14 to 23 years) among patients with truncating mutations and 29 years (95% confidence interval, 25 to 40 years) among patients with nontruncating mutations (P=0.001). CONCLUSIONS: We report unpredictable atypical splicing in the COL4A5 gene in male patients with XLAS and reveal that renal prognosis differs significantly for patients with truncating versus nontruncating splicing abnormalities. Our results suggest that splicing modulation should be explored as a therapy for XLAS with truncating mutations.2018年08月, Journal of the American Society of Nephrology : JASN, 29(8) (8), 2244 - 2254, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Background Nephrotic syndrome is the most common cause of chronic glomerular disease in children. Most of these patients develop steroid-sensitive nephrotic syndrome (SSNS), but the loci conferring susceptibility to childhood SSNS are mainly unknown.Methods We conducted a genome-wide association study (GWAS) in the Japanese population; 224 patients with childhood SSNS and 419 adult healthy controls were genotyped using the Affymetrix Japonica Array in the discovery stage. Imputation for six HLA genes (HLA-A, -C, -B, -DRB1, -DQB1, and -DPB1) was conducted on the basis of Japanese-specific references. We performed genotyping for HLA-DRB1/-DQB1 using a sequence-specific oligonucleotide-probing method on a Luminex platform. Whole-genome imputation was conducted using a phased reference panel of 2049 healthy Japanese individuals. Replication was performed in an independent Japanese sample set including 216 patients and 719 healthy controls. We genotyped candidate single-nucleotide polymorphisms using the DigiTag2 assay.Results The most significant association was detected in the HLA-DR/DQ region and replicated (rs4642516 [minor allele G], combined Pallelic=7.84×10-23; odds ratio [OR], 0.33; 95% confidence interval [95% CI], 0.26 to 0.41; rs3134996 [minor allele A], combined Pallelic=1.72×10-25; OR, 0.29; 95% CI, 0.23 to 0.37). HLA-DRB1*08:02 (Pc=1.82×10-9; OR, 2.62; 95% CI, 1.94 to 3.54) and HLA-DQB1*06:04 (Pc=2.09×10-12; OR, 0.10; 95% CI, 0.05 to 0.21) were considered primary HLA alleles associated with childhood SSNS. HLA-DRB1*08:02-DQB1*03:02 (Pc=7.01×10-11; OR, 3.60; 95% CI, 2.46 to 5.29) was identified as the most significant genetic susceptibility factor.Conclusions The most significant association with childhood SSNS was detected in the HLA-DR/DQ region. Further HLA allele/haplotype analyses should enhance our understanding of molecular mechanisms underlying SSNS.2018年08月, Journal of the American Society of Nephrology : JASN, 29(8) (8), 2189 - 2199, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Pierson syndrome, an autosomal recessive disorder caused by a mutation in laminin ß2 (LAMB2) gene, is characterized by congenital nephrotic syndrome and various ocular abnormalities. The ocular findings in Pierson syndrome are not well understood, because the incidence of this syndrome is very rare. We report ocular findings in a 5-month-old boy with Pierson syndrome with a novel mutation in LAMB2. We performed a pupilloplasty for his microcoria. Ophthalmic examinations after surgery revealed that he had cataract, severe retinal degeneration, and high myopia. Optical coherence tomography showed the collapse of retinal layer structures and a marked decrease of choroidal thickness. Immunohistochemistry and electron microscopy examinations revealed abnormal iris differentiation and thinning or defect of basal membranes. These results suggest that the development of the iris, lens, retina, and choroid are affected in this type of mutation.2018年08月, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 22(5) (5), 401 - 403.e1, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2018年07月, 日本小児腎不全学会雑誌, 38, 148 - 151, 日本語治療方針の決定に疾患パネル解析を用いたステロイド抵抗性ネフローゼ症候群の1例[査読有り]研究論文(学術雑誌)
- Recent advances in high-throughput sequencing for clinical genetic testing have revealed novel disease-causing genes, such as Crumbs homolog 2 (CRB2) for early-onset steroid-resistant nephrotic syndrome (SRNS). We report the long-term clinicopathologic observation of a Japanese female patient with SRNS caused by a newly identified compound heterozygous mutation of CRB2 (p.Arg628Cys and p.Gly839Trp located in the 10th and 11th epidermal growth factor-like domains, respectively). She was initially examined during a mass urinary screening for 3.5-year-old children in Japan. Although she developed long-standing SRNS without any extrarenal clinical signs thereafter, her renal function was well-preserved over the next 17 years. In total, six sequential renal biopsy specimens revealed histologic alterations ranging from minor glomerular abnormalities to advanced focal segmental glomerulosclerosis (FSGS). A genetic analysis for SRNS performed at 19 years of age revealed a newly identified compound heterozygous mutation in CRB2. Glomerular CRB2 immunoreactivity in biopsy specimens from the patient was scanty, whereas intense expression was observed in those from patients with idiopathic FSGS or in controls. To our knowledge, this is the first report regarding a long-term outcome in a case of SRNS due to an identified CRB2 mutation. Although the phenotype of CRB2 mutation-related syndrome is now expanding, we believe that this case might provide a novel clinicopathologic aspect of this syndrome.2018年07月, Nephrology (Carlton, Vic.), 23(7) (7), 697 - 702, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Pseudo-Bartter/Gitelman syndrome (p-BS/GS) encompasses a clinically heterogeneous group of inherited or acquired disorders similar to Bartter syndrome (BS) or Gitelman syndrome (GS), both renal salt-losing tubulopathies. Phenotypic overlap frequently occurs between p-BS/GS and BS/GS, which are difficult to diagnose based on their clinical presentation and require genetic tests for accurate diagnosis. In addition, p-BS/GS can occur as a result of other inherited diseases such as cystic fibrosis, autosomal dominant hypocalcemia, Dent disease, or congenital chloride diarrhea (CCD). However, the detection of the variants in genes other than known BS/GS-causing genes by conventional Sanger sequencing requires substantial time and resources. We studied 27 cases clinically diagnosed with BS/GS, but with negative genetic tests for known BS/GS genes. We conducted targeted sequencing for 22 genes including genes responsible for tubulopathies and other inherited diseases manifesting with p-BS/GS symptoms. We detected the SLC26A3 gene variants responsible for CCD in two patients. In Patient 1, we found the SLC26A3 compound heterozygous variants: c.354delC and c.1008insT. In Patient 2, we identified the compound heterozygous variants: c.877G > A, p.(Glu293Lys), and c.1008insT. Our results suggest that a comprehensive genetic screening system using targeted sequencing is useful for the diagnosis of patients with p-BS/GS with alternative genetic origins.2018年07月, Journal of human genetics, 63(8) (8), 887 - 892, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Apolipoprotein A-I amyloidosis is a rare, autosomal dominant disorder of APOA-1 gene characterized by the deposition of apolipoprotein A-I in various organs and can be classified into either hereditary or nonhereditary form in the absence of a family history. Renal disease caused by Apolipoprotein A-I amyloidosis commonly manifested as slowly progressive renal function impairment without heavy proteinuria. Apolipoprotein A-I-related amyloidosis of kidney is of pathogenetic interest because the renal failure is due to peritubular and interstitial amyloid deposits without glomerular deposits. Tubulointerstitial lesion of amyloid deposits was diagnosed in half of carriers of APOA1 gene mutation, only 13% of patients progressed to renal failure requiring hemodialysis or kidney transplantation. Recurrence of apolipoprotein A-I-related amyloidosis after kidney transplantation is very rare. We report a case of a 63-year-old Japanese female without a family history of kidney and/or liver disease who showed slowly progressive renal graft dysfunction without overt proteinuria. Graft biopsy revealed characteristic Congo red stain positive amyloid deposits localized in the renal interstitial area. No glomerular, vascular and tubular amyloid deposits were noted. Laser microdissection-liquid chromatography tandem mass spectrometry-based proteomic analysis elucidated the type of amyloidosis as apolipoprotein A-I amyloidosis. Genetic analysis of DNA sequence study revealed two novel APOA1 gene mutations of Leu202Arg and Lys262Asn. This is a first and very rare case report of the recurrence of non-familial hereditary apolipoprotein A-I amyloidosis in Japanese transplant recipient.2018年07月, Nephrology (Carlton, Vic.), 23 Suppl 2, 17 - 21, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- BACKGROUND: Two previous randomized controlled trials showed that treatment of severe childhood immunoglobulin A (IgA) nephropathy using prednisolone with azathioprine, heparin-warfarin, or dipyridamole prevented the increase of sclerosed glomeruli. Prednisolone alone, however, did not prevent further increase. These studies indicated the importance of immunosuppressants in the treatment. An additional pilot study using mizoribine instead of azathioprine enabled us to complete 2 years of combined regimen. It showed non-numerical inferior effectiveness compared with the azathioprine regimen. Further examination of the additional efficacy of warfarin and dipyridamole was required. METHODS: A randomized control trial of prednisolone and mizoribine with (group 1) or without (group 2) warfarin and dipyridamole was administered for treatment of 71 children with severe IgA nephropathy to evaluate the efficacy of additional warfarin and dipyridamole. RESULTS: Thirty of 34 patients (88.2%) in group 1, and 27 of 36 patients (75.0%) showed the disappearance of proteinuria as defined by early morning urinary protein to creatinine ratio of < 0.2 during the 2-year treatment period. The cumulative disappearance rate of proteinuria determined by the Kaplan-Meier method showed that the disappearance rate of proteinuria was significantly higher in group 1 than in group 2 (log-rank P = 0.04). There was no significant difference in pathological findings, but there was a tendency of increase of global sclerosis in group1 which might be related to warfarin. Most of the adverse effects were related to prednisolone, but fortunately transient. CONCLUSIONS: The balance between minimal benefits of warfarin/dipyridamole and potential adverse effects may be in favor of avoiding them in children with IgA nephropathy.2018年07月, Pediatric nephrology (Berlin, Germany), 33(11) (11), 2103 - 2112, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2018年07月, Journal of nephrology, 32(1) (1), 155 - 159[査読有り]
- 日本小児高血圧研究会, 2018年06月, 日本小児高血圧研究会誌, 15(1) (1), 21 - 25, 日本語高血圧を呈さず高度蛋白尿が遷延した溶連菌感染後急性糸球体腎炎の1例
- Pathogenic variants in specific complement-related genes lead to atypical hemolytic uremic syndrome (aHUS). Some reports have indicated that patients with digenic variants in these genes might present severer phenotypes. Upon detecting novel intronic variants, transcriptional analysis is necessary to prove pathogenicity; however, when intronic variants are located in intron 1 and, as a result, no transcript is produced, no appropriate method had been established to reveal the pathogenicity. Recently, the minigene assay was used to assess the pathogenicity of intronic variants. Here, we report an infantile case of aHUS caused by digenic mutations in two different complement-related genes, C3 and MCP. Targeted sequencing detected a known variant in C3 and a novel variant in the intron 1 splicing donor site of MCP. To assess the pathogenicity of this intronic variant, we conducted functional splicing assay using a minigene construct and quantitative PCR analysis of the MCP transcript, revealing the pathogenicity of the intronic variant. In conclusion, the minigene assay revealed the pathogenicity of the intron 1 splicing donor site variant for the first time. This case showed a severe phenotype of infantile-onset aHUS associated with digenic variants in two complement-related genes.2018年06月, Journal of human genetics, 63(6) (6), 755 - 759, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- No efficient treatment exists for nephrotic syndrome (NS), a frequent cause of chronic kidney disease. Here we show mutations in six different genes (MAGI2, TNS2, DLC1, CDK20, ITSN1, ITSN2) as causing NS in 17 families with partially treatment-sensitive NS (pTSNS). These proteins interact and we delineate their roles in Rho-like small GTPase (RLSG) activity, and demonstrate deficiency for mutants of pTSNS patients. We find that CDK20 regulates DLC1. Knockdown of MAGI2, DLC1, or CDK20 in cultured podocytes reduces migration rate. Treatment with dexamethasone abolishes RhoA activation by knockdown of DLC1 or CDK20 indicating that steroid treatment in patients with pTSNS and mutations in these genes is mediated by this RLSG module. Furthermore, we discover ITSN1 and ITSN2 as podocytic guanine nucleotide exchange factors for Cdc42. We generate Itsn2-L knockout mice that recapitulate the mild NS phenotype. We, thus, define a functional network of RhoA regulation, thereby revealing potential therapeutic targets.2018年05月, Nature communications, 9(1) (1), 1960 - 1960, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 日本小児体液研究会, 2018年05月, 日本小児体液研究会誌, 10, 67 - 72, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 99 - 99, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 100 - 100, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 101 - 101, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 147 - 147, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 156 - 156, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 200 - 200, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 170 - 170, 日本語
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 166 - 166, 日本語男性腎不全の家族歴からネフロン癆関連シリオパチーの診断に至った3歳男児例[査読有り]
- The pattern of X-chromosome inactivation (XCI) can affect the clinical severity of X-linked disorders in females. XCI pattern analysis has been conducted mainly by HUMARA assay, a polymerase chain reaction-based assay using a methylation-sensitive restriction enzyme. However, this assay examines the XCI ratio of the androgen receptor gene at the genomic DNA level and does not reflect the ratio of either targeted gene directly or at the mRNA level. Here, we report four females with Dent disease, and we clarified the correlation between XCI and female cases of Dent disease using not only HUMARA assay but also a novel analytical method by RNA sequencing. We constructed genetic analysis for 4 female cases showing high level of urinary low-molecular-weight proteinuria and their parents. Their XCI pattern was analyzed by both HUMARA assay and an ultra-deep targeted RNA sequencing of the CLCN5 gene using genomic DNA and mRNA extracted from both leukocytes and urine sediment. All four cases possessed pathogenic variants of the CLCN5 gene. XCI analysis revealed skewed XCI in only two cases, while the other two showed random XCI. All assay results of HUMARA and targeted RNA sequencing in both leukocytes and urinary sediment were clearly identical in all four cases. We developed a novel XCI analytical assay of ultra-deep targeted RNA sequencing and revealed that skewed XCI explains the mechanism of onset of female Dent disease in only half of such cases.2018年05月, Journal of human genetics, 63(5) (5), 589 - 595, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Nature Publishing Group, 2018年05月, Journal of Human Genetics, 63(5) (5), 647 - 656, 英語[査読有り]研究論文(学術雑誌)
- Objectives To identify clinical features that predict Group A streptococcal (GAS) pharyngitis in a Japanese paediatric primary emergency medical centre. Methods The prevalence of GAS pharyngitis according to age and body temperature (BT) was calculated among 3098 paediatric patients with pharyngitis. The numbers of GAS-positive and -negative patients for each clinical parameter, and each point increase in the McIsaac score were compared and likelihood ratios (LRs) were calculated. Results The prevalence of GAS pharyngitis was extremely low in patients aged < 1 (1.2%) and 1 year (3.9%). The GAS-positive rate was significantly higher in patients with a BT < 38.0°C compared with ≥ 38.0°C (30.0% vs. 19.8%). A BT ≥ 38.0°C was not a predictive finding for GAS pharyngitis (positive LR: 0.82). Rash was the most useful individual predictor, and a McIsaac score of 4 or 5 increased the probability; however, the positive LRs were 1.74 and 1.30, respectively. Conclusions The prevalence of GAS pharyngitis is extremely low in patients aged < 1 and 1 year, and a BT ≥ 38.0°C is not a predictive symptom. Although a rash and McIsaac score of 4 or 5 are associated with an increased probability, they cannot be used to confirm GAS infection.2018年05月, The Journal of international medical research, 46(5) (5), 1791 - 1800, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- Elsevier B.V., 2018年05月, Kidney international, 93(5) (5), 1045 - 1051, 英語[査読有り]研究論文(学術雑誌)
- 発達腎研究会, 2018年04月, 発達腎研究会誌, 26(1) (1), 8 - 10, 日本語X染色体不活化とDent病
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 336 - 336, 日本語X染色体連鎖型Alport症候群男性患者341名の臨床遺伝学的検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 337 - 337, 日本語Gitelman症候群185例における臨床的特徴に関する検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 337 - 337, 日本語次世代シークエンサー解析データを用いたpair解析により診断に至った遺伝性腎疾患例に関する検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 338 - 338, 日本語多様な表現型を示したピアソン症候群における遺伝学的・分子生物学的検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 344 - 344, 日本語ゲノムワイド関連解析による小児特発性ネフローゼ症候群のrisk haplotype同定
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 344 - 344, 日本語ステロイド抵抗性ネフローゼ症候群における網羅的遺伝子診断体制の構築
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 337 - 337, 日本語抗変異MUC1抗体によるADTKD-MUC1診断の可能性
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 421 - 421, 日本語遺伝子解析が診断に有用であったLMX1B関連腎症の1家系
- Blackwell Publishing Ltd, 2018年04月, Clinical Genetics, 93(4) (4), 931 - 933, 英語[査読有り]研究論文(学術雑誌)
- Several studies describing the diurnal occurrence of febrile seizures have reported greater seizure frequency early or late in the evening relative to midnight or early morning. However, no articles have reported on the diurnal occurrence of complex febrile seizure. Moreover, no studies have addressed the relationship between seizure severity and diurnal occurrence. We retrospectively evaluated complex febrile seizures in 462 children needing hospitalization, and investigated the relationship between severity and diurnal occurrence according to four categorized time periods (morning, afternoon, evening, and night). Our study showed that complex febrile seizures occurred most often in the evening, peaking around 18:00 (18:00-18:59), and least often at night (02:00-02:59). In addition, the frequency with which patients developed status epilepticus or needed anticonvulsant treatments was also lower during the night. However, the seizure duration and the proportion of the patients who needed anticonvulsant treatment were the same among the four time periods. Furthermore, we compared three subclasses (repeated episodes of convulsions, focal seizures, and prolonged seizures (≧15min)), two of the complex features (focal seizures and prolonged seizures), and all complex features among the four time periods. However, they were the same among the four time periods. Taken together, our data indicate that although the severity of seizures was stable over a 24-hour period, the occurrence of seizures in our cohort of pediatric patients with complex febrile seizures requiring hospitalization was highest in the evening and lowest at night.2018年03月, Epilepsy & behavior : E&B, 80, 280 - 284, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2018年, Brain and Development, 60(8) (8), 648 - 690, 英語Fosphenytoin vs. continuous midazolam for pediatric febrile status epilepticus研究論文(学術雑誌)
- BACKGROUND/AIMS: Glomerulopathy with fibronectin deposits (GFND; OMIM: 601894) is a very rare inherited kidney disease caused by pathogenic variants in the FN1 gene. Only 9 exonic pathogenic variants in FN1, 9 at the heparin-binding site, and 1 at the integrin-binding site have been reported. No intronic variants in FN1 have been detected. METHODS: We found a pathogenic intronic variant in intron 36 (c.5888-2A>G) located at the heparin-binding site. To determine whether this mutation influences splicing processes, we conducted RT-PCR analysis and an in vitro splicing assay using minigene construction. RESULTS: RT-PCR using RNA extracted from leukocytes of the proband failed because of the low expression of FN1 mRNA in leukocytes. We conducted in vitro functional splicing analysis using minigenes and found that c.5888-2A>G caused a 12 bp deletion at exon 37 by the activation of a novel splicing acceptor site within exon 37. We were able to detect the same abnormal transcript in mRNA extracted from the patient's urinary sediment and confirmed the pathogenicity of c.5888-2A>G by both RT-PCR using the patient sample and an in vitro splicing assay. CONCLUSION: Intronic variants can cause GFND. Minigene analysis is useful for determining the pathogenicity of the intronic variants and could be used for all inherited kidney diseases.2018年, Nephron, 138(2) (2), 166 - 171, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2017年12月, Environmental Health and Preventive Medicine (Web), 22(1) (1), 22:15 (WEB ONLY), 英語日本の小児一次救急医療センターにおいてロタウイルスワクチンの任意導入後の急性胃腸炎患者数変化[査読有り]研究論文(学術雑誌)
- 2017年12月, American Journal of Physiology - Renal Physiology, 313(6) (6), F1223 - F1231, 英語[査読有り]研究論文(学術雑誌)
- 2017年12月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 21(6) (6), 1003 - 1010, 英語[査読有り]研究論文(学術雑誌)
- 2017年12月, EUROPEAN JOURNAL OF MEDICAL GENETICS, 60(12) (12), 631 - 634, 英語[査読有り]研究論文(学術雑誌)
- 2017年12月, AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY, 313(6) (6), F1223 - F1231, 英語[査読有り]研究論文(学術雑誌)
- 2017年12月, BMC NEPHROLOGY, 18(1) (1), 353, 英語[査読有り]研究論文(学術雑誌)
- 2017年11月, PEDIATRIC NEPHROLOGY, 32(11) (11), 2071 - 2078, 英語[査読有り]研究論文(学術雑誌)
- Springer Verlag, 2017年11月, Pediatric Nephrology, 32(11) (11), 2071 - 2078, 英語[査読有り]研究論文(学術雑誌)
- In a case of 41-year-old man with mild nephropathy, Alport syndrome (AS) was diagnosed from the renal biopsy. However, the α5 chain of type IV collagen expressed in the glomerular basement membrane, which was the atypical staining pattern of AS. Genetic testing suggested autosomal recessive AS from heterozygous mutations at two positions in the type IV collagen α3 chain. These two gene mutations represented a new pattern of mutation and was suggested the association with an atypical α5 chain expression and mild phenotype.2017年11月, CEN case reports, 6(2) (2), 189 - 193, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- 2017年10月, Pediatrics International (Web), 59(10) (10), 1058‐1063, 英語日本人新生児におけるBiliCare経皮的ビリルビンデバイスの評価[査読有り]研究論文(学術雑誌)
- 2017年10月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 21(5) (5), 877 - 883, 英語[査読有り]研究論文(学術雑誌)
- 2017年10月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 21(5) (5), 889 - 894, 英語[査読有り]研究論文(学術雑誌)
- 2017年10月, Pediatrics international : official journal of the Japan Pediatric Society, 59(10) (10), 1058 - 1063, 英語[査読有り]研究論文(学術雑誌)
- 2017年09月, JOURNAL OF HUMAN GENETICS, 62(9) (9), 851 - 855, 英語[査読有り]研究論文(学術雑誌)
- 2017年09月, JOURNAL OF HUMAN GENETICS, 62(9) (9), 869 - 869, 英語[査読有り]
- 2017年09月, JOURNAL OF HUMAN GENETICS, 62(9) (9), 869 - 869, 英語[査読有り]
- 2017年09月, BMC NEPHROLOGY, 18(1) (1), 300, 英語[査読有り]研究論文(学術雑誌)
- Elsevier Inc, 2017年09月, Kidney International Reports, 2(5) (5), 850 - 855, 英語[査読有り]研究論文(学術雑誌)
- Springer Verlag, 2017年07月, Pediatric Nephrology, 33(9) (9), 1 - 7, 英語[査読有り]研究論文(学術雑誌)
- 2017年07月, JOURNAL OF HUMAN GENETICS, 62(7) (7), 733 - 735, 英語[査読有り]研究論文(学術雑誌)
- 2017年05月, MOLECULAR GENETICS & GENOMIC MEDICINE, 5(3) (3), 287 - 294, 英語[査読有り]研究論文(学術雑誌)
- 2017年04月, PEDIATRICS INTERNATIONAL, 59(4) (4), 501 - 503, 英語[査読有り]研究論文(学術雑誌)
- 2017年03月, PEDIATRIC NEPHROLOGY, 32(3) (3), 457 - 465, 英語[査読有り]研究論文(学術雑誌)
- 2017年02月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 21(1) (1), 136 - 142, 英語[査読有り]研究論文(学術雑誌)
- 2017年02月, JOURNAL OF HUMAN GENETICS, 62(2) (2), 335 - 337, 英語[査読有り]研究論文(学術雑誌)
- 2017年, ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE, 22(1) (1), 15, 英語[査読有り]研究論文(学術雑誌)
- The 20q11.2 microdeletion is a rare chromosomal aberration characterized by intellectual disability (ID), motor developmental delay, neonatal feeding problems, and facial dysmorphism. Here, a 2-year- and 6-month-old Japanese girl with a 1.2 Mb microdeletion of 20q11.2 showed ID, motor developmental delay, and distinctive facial features without feeding problems. The deleted region was identified by array-based comparative genomic hybridization and is the smallest reported for a 20q11.2 microdeletion.2017年, Human genome variation, 4, 17050 - 17050, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2016年12月, SCIENTIFIC REPORTS, 6, 38659, 英語[査読有り]研究論文(学術雑誌)
- 2016年12月, PEDIATRICS INTERNATIONAL, 58(12) (12), 1373 - 1374, 英語[査読有り]研究論文(学術雑誌)
- 2016年11月, TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE, 240(3) (3), 251 - 257, 英語[査読有り]研究論文(学術雑誌)
- 2016年10月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 20(5) (5), 699 - 702, 英語[査読有り]研究論文(学術雑誌)
- S. Karger AG, 2016年09月, Case Rep Nephrol Dial, 6(3) (3), 106 - 113, 英語[査読有り]研究論文(学術雑誌)
- 2016年09月, PEDIATRIC NEPHROLOGY, 31(9) (9), 1459 - 1467, 英語[査読有り]研究論文(学術雑誌)
- 2016年08月, CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 11(8) (8), 1441 - 1449, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2016年07月, 日本小児科学会雑誌, 120(7) (7), 1156 - 1156, 日本語慢性の下痢によると考えていた低K血症に成長障害を伴いBartter症候群III型の診断に至った1例[査読有り]
- 2016年07月, 日本小児腎不全学会雑誌, 36, 175 - 178, 日本語異なる経過をたどった腸管出血性大腸菌による溶血性尿毒症症候群の姉妹例[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 93 - 93, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 118 - 118, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 91 - 91, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 92 - 92, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 104 - 104, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 206 - 206, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 116 - 116, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 90 - 90, 日本語CAKUT及び原因不明の小児期発症慢性腎機能障害患者への包括的原因遺伝子解析[査読有り]
- 2016年06月, 日本小児高血圧研究会誌, 13(1号) (1号), 3 - 6, 日本語24時間自由行動下血圧測定が有用であった本態性高血圧の一例[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2016年05月, 日本腎臓学会誌, 58(3) (3), 213 - 213, 日本語小児微小変化・巣状分節性糸球体硬化症の治療戦略
- (一社)日本腎臓学会, 2016年05月, 日本腎臓学会誌, 58(3) (3), 321 - 321, 日本語半月体形成性糸状体腎炎(CGN)を呈する小児IgA腎症(IgAN)の検討
- 2016年05月, PEDIATRICS INTERNATIONAL, 58(5) (5), 429 - 430, 英語[査読有り]研究論文(学術雑誌)
- 2016年04月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 20(2) (2), 253 - 257, 英語[査読有り]研究論文(学術雑誌)
- 2016年04月, JOURNAL OF HUMAN GENETICS, 61(4) (4), 351 - 355, 英語[査読有り]研究論文(学術雑誌)
- 2016年03月, EUROPEAN JOURNAL OF HUMAN GENETICS, 24(3) (3), 387 - 391, 英語[査読有り]研究論文(学術雑誌)
- 2016年03月, BRAIN & DEVELOPMENT, 38(3) (3), 346 - 349, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2016年02月, 日本小児科学会雑誌, 120(2) (2), 240 - 240, 日本語次世代シークエンサーによる常染色体優性Alport症候群診断法の確立
- (公社)日本小児科学会, 2016年02月, 日本小児科学会雑誌, 120(2) (2), 242 - 242, 日本語腎移植後にウイルス関連の重症合併症を呈した4症例
- 2016年02月, GENETICS IN MEDICINE, 18(2) (2), 180 - 188, 英語[査読有り]研究論文(学術雑誌)
- 2016年02月, PEDIATRICS INTERNATIONAL, 58(2) (2), 152 - 155, 英語[査読有り]研究論文(学術雑誌)
- (一社)西宮市医師会, 2016年, 西宮市医師会医学雑誌, 21(21) (21), 44 - 47, 日本語[査読有り]研究論文(学術雑誌)
- 2016年, INTERNAL MEDICINE, 55(19) (19), 2843 - 2847, 英語[査読有り]研究論文(学術雑誌)
- 2015年12月, PEDIATRIC NEPHROLOGY, 30(12) (12), 2121 - 2127, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2015年11月, 日本小児腎臓病学会雑誌, 28(2) (2), 177 - 177, 日本語
- 2015年11月, BMC Pediatrics, 15, 177, 英語[査読有り]研究論文(学術雑誌)
- 2015年10月, J Pediatr Urol, 11(5) (5), 299 - 300, 英語[査読有り]研究論文(学術雑誌)
- 2015年10月, BRAIN & DEVELOPMENT, 37(9) (9), 911 - 915, 英語[査読有り]研究論文(学術雑誌)
- 2015年10月, AMERICAN JOURNAL OF HUMAN GENETICS, 97(4) (4), 555 - 566, 英語[査読有り]研究論文(学術雑誌)
- 2015年10月, JOURNAL OF PEDIATRIC UROLOGY, 11(5) (5), 299 - 300, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2015年06月, 日本小児腎臓病学会雑誌, 28(1Suppl.) (1Suppl.), 92 - 92, 日本語発症時ネフローゼ症候群を呈する小児IgA腎症(NS-IgAN)の検討
- (一社)日本小児腎臓病学会, 2015年06月, 日本小児腎臓病学会雑誌, 28(1Suppl.) (1Suppl.), 146 - 146, 日本語びまん性メサンギウム細胞増殖を呈した特発性ネフローゼ症候群の臨床病理学的検討
- (一社)日本小児腎臓病学会, 2015年06月, 日本小児腎臓病学会雑誌, 28(1Suppl.) (1Suppl.), 219 - 219, 日本語初回腎生検でIgA陽性だったが二回目に陰性化していたAlport症候群の一男児例
- 2015年06月, 日本小児高血圧研究会誌, 12(1号) (1号), 31 - 35, 日本語初診時高血圧を呈さず特発性ネフローゼ症候群との鑑別を要した腎血管性高血圧の1例[招待有り]研究論文(大学,研究機関等紀要)
- 2015年06月, PEDIATRIC NEPHROLOGY, 30(6) (6), 961 - 967, 英語[査読有り]研究論文(学術雑誌)
- Future Medicine Ltd., 2015年03月, Polycystic Kidney Disease: From Bench to Bedside, 43 - 58, 英語[査読有り]論文集(書籍)内論文
- 2015年03月, PEDIATRIC NEPHROLOGY, 30(3) (3), 445 - 450, 英語[査読有り]研究論文(学術雑誌)
- 2015年02月, PEDIATRIC NEPHROLOGY, 30(2) (2), 293 - 299, 英語[査読有り]研究論文(学術雑誌)
- 日本腎臓学会, 2015年, Nihon Jinzo Gakkai shi, 57(4) (4), 743 - 750, 日本語[Bartter syndrome and Gitelman syndrome].[査読有り]
- 2015年, Curr Pediatr Rep, 3(1) (1), 71 - 77, 英語[査読有り]研究論文(学術雑誌)
- 2015年01月, LANCET, 385(9964) (9964), 226 - 227, 英語[査読有り]研究論文(学術雑誌)
- 2015年01月, KIDNEY INTERNATIONAL, 87(1) (1), 225 - 232, 英語[査読有り]研究論文(学術雑誌)
- 2014年11月, CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 9(11) (11), 1958 - 1964, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2014年10月, 日本小児科学会雑誌, 118(10) (10), 1553 - 1553, 日本語ストレス時に増悪する低K血症で発見されたGitelman症候群の姉弟例[査読有り]
- 2014年10月, LANCET, 384(9950) (9950), 1273 - 1281, 英語[査読有り]研究論文(学術雑誌)
- 2014年10月, PEDIATRICS INTERNATIONAL, 56(5) (5), E75 - E78, 英語[査読有り]研究論文(学術雑誌)
- BACKGROUND: Autosomal recessive Alport syndrome (ARAS) is a rare hereditary disease caused by homozygous or compound heterozygous mutations in either the COL4A3 or COL4A4 genes. Failure to diagnose ARAS cases is common, even if detailed clinical and pathological examinations are carried out. As the mutation detection rate for ARAS is unsatisfactory, we sought to develop more reliable diagnostic methods and provide a better description of the clinicopathological characteristics of this disorder. METHODS: A retrospective analysis of 30 genetically diagnosed patients with ARAS in 24 pedigrees was conducted. The mutation detection strategy comprised three steps: (1) genomic DNA analysis using polymerase chain reaction (PCR) and direct sequencing; (2) mRNA analysis using reverse transcription (RT)-PCR to detect RNA processing abnormalities; (3) semi-quantitative PCR using capillary electrophoresis to detect large heterozygous deletions. RESULTS: Using the three-step analysis, we identified homozygous or compound heterozygous mutations in all patients. Interestingly, 20% of our ARAS patients showed normal expression of α5 in kidney tissue. The median age of developing end-stage renal disease was 21 years. CONCLUSIONS: The strategy described in this study improves the diagnosis for ARAS families. Although immunohistochemical analysis of α5 can provide diagnostic information, normal distribution does not exclude the diagnosis of ARAS.2014年09月, Pediatr Nephrol, 29(9) (9), 1535 - 1544, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2014年09月, PEDIATRIC NEPHROLOGY, 29(9) (9), 1535 - 1544, 英語[査読有り]研究論文(学術雑誌)
- 2014年09月, Mol Genet Genomic Med, 2(5) (5), 451 - 3, 英語[査読有り]研究論文(学術雑誌)
- 2014年06月, PEDIATRICS INTERNATIONAL, 56(3) (3), 309 - 314, 英語[査読有り]研究論文(学術雑誌)
- 2014年05月, Kidney Int, 85(5) (5), 1208 - 1213, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2014年04月, 日本小児腎臓病学会雑誌, 27(1Suppl.) (1Suppl.), 111 - 111, 日本語
- (一社)日本小児腎臓病学会, 2014年04月, 日本小児腎臓病学会雑誌, 27(1Suppl.) (1Suppl.), 224 - 224, 日本語
- 発達腎研究会, 2014年04月, 発達腎研究会誌, 22(1) (1), 27 - 29, 日本語ヒトCAKUTの原因遺伝子解析[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2014年02月, 日本小児科学会雑誌, 118(2) (2), 284 - 284, 日本語シクロスポリン投与下に再発をきたしたステロイド感受性ネフローゼ症候群の長期予後
- (公社)日本小児科学会, 2014年02月, 日本小児科学会雑誌, 118(2) (2), 286 - 286, 日本語診断時に急性腎障害を合併した小児全身性エリテマトーデス患者の腎予後に関する検討
- 2014年02月, CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 9(2) (2), 271 - 278, 英語[査読有り]研究論文(学術雑誌)
- 2014年, Human genome variation, 1, 14006[査読有り]
- 2013年10月, American Journal of Nephrology, 38(4) (4), 316 - 320, 英語[査読有り]研究論文(学術雑誌)
- 2013年06月, PEDIATRIC NEPHROLOGY, 28(6) (6), 903 - 909, 英語[査読有り]研究論文(学術雑誌)
- 2013年06月, CLINICAL NEPHROLOGY, 79(6) (6), 484 - 487, 英語[査読有り]研究論文(学術雑誌)
- 2013年01月, PEDIATRIC NEPHROLOGY, 28(1) (1), 71 - 76, 英語[査読有り]研究論文(学術雑誌)
- 2013年, Kobe Journal of Medical Sciences, 59(2) (2), E36 - E43, 英語SLC26A3 gene analysis in patients with Bartter and Gitelman syndromes and the clinical characteristics of patients with unidentified mutations[査読有り]研究論文(学術雑誌)
- 2012年12月, PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 109(52) (52), 21462 - 21467, 英語[査読有り]研究論文(学術雑誌)
- 2012年11月, PEDIATRIC TRANSPLANTATION, 16(7) (7), E286 - E290, 英語[査読有り]研究論文(学術雑誌)
- 2012年06月, PEDIATRICS, 129(6) (6), E1621 - E1625, 英語[査読有り]研究論文(学術雑誌)
- Atypical membranoproliferative glomerulonephritis (MPGN) is considered to progress to typical MPGN, and it is believed that it can be treated with corticosteroids. However, consensus that atypical MPGN is a continuum of morphologic manifestations of typical MPGN cannot be reached. Herein, we report two cases of atypical MPGN with opposite clinical course. Case 1 was a 4-year-old boy with macrohematuria and proteinuria with no prodromal symptoms. His serum C3 level had abruptly dropped, and renal biopsy confirmed a diagnosis of atypical MPGN. After performing kidney biopsy, his urinary abnormality improved and his C3 level had normalized 1 year after onset without medication. At the most recent follow-up, neither proteinuria nor hematuria was detected. Case 2 was a 7-year-old girl with microhematuria and proteinuria at her school urinary screening. Her first biopsy finding was similar to dense deposit disease, and the second biopsy showed atypical MPGN. Oral corticosteroids were started from this point, but heavy proteinuria and hypocomplementemia could not be improved sufficiently. We immediately performed third kidney biopsy and diagnosed typical MPGN. These findings suggest that the indication of therapy for atypical MPGN should be re-examined. Aggressive therapy such as steroid administration is not necessarily essential and effective for therapeutic intervention of all atypical MPGN. Moreover, atypical MPGN may involve different etiologic and pathogenetic factors, rather than a continuum of morphologic manifestations of MPGN.2012年05月, CEN case reports, 1(1) (1), 34 - 38, 英語, 国内誌[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2012年05月, 日本小児腎臓病学会雑誌, 25(1Suppl.) (1Suppl.), 191 - 191, 日本語
- (一社)日本小児腎臓病学会, 2012年05月, 日本小児腎臓病学会雑誌, 25(1Suppl.) (1Suppl.), 193 - 193, 日本語
- 2012年02月, CLINICAL NEPHROLOGY, 77(2) (2), 161 - 163, 英語[査読有り]研究論文(学術雑誌)
- 2011年10月, CLINICAL IMMUNOLOGY, 141(1) (1), 111 - 120, 英語[査読有り]研究論文(学術雑誌)
- 日本小児腎不全学会, 2011年07月, 日本小児腎不全学会雑誌, 31, 102 - 102, 日本語運動後急性腎不全とPRESの合併を反復し、GLUT9遺伝子複合ヘテロ接合体変異を同定しえた腎性低尿酸血症の1例
- 2011年06月, FASEB JOURNAL, 25(6) (6), 1844 - 1855, 英語[査読有り]研究論文(学術雑誌)
- 2011年06月, PEDIATRICS, 127(6) (6), E1621 - E1625, 英語[査読有り]研究論文(学術雑誌)
- 2011年06月, PEDIATRICS INTERNATIONAL, 53(3) (3), 406 - 408, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2011年05月, 日本腎臓学会誌, 53(3) (3), 364 - 364, 日本語血清アルブミン値と組織所見に基づいた小児紫斑病性腎炎の治療戦略
- (一社)日本小児腎臓病学会, 2011年04月, 日本小児腎臓病学会雑誌, 24(1) (1), 125 - 126, 日本語
- (一社)日本小児腎臓病学会, 2011年04月, 日本小児腎臓病学会雑誌, 24(1) (1), 133 - 133, 日本語
- 国内小児腎移植におけるミコフェノール酸モフェチル (MMF) の有効性・安全性,薬物動態を評価するために,多施設共同オープンラベル臨床試験を行った。The Japanese Society for Pediatric Nephrology, 2011年04月, 日本小児腎臓病学会雑誌, 24(1) (1), 36-46 - 46, 日本語
小児腎移植患者25例に,多剤免疫抑制薬併用下にMMF (600∼1,200mg/m2/日 分2経口投与) を1年間投与し,経過観察した。評価項目は,腎移植後6か月の拒絶反応発現割合,腎移植後1年の生着割合および生存割合,有害事象発現頻度とした。AUC0-12,Cmax,Tmaxなどの薬物動態態パラメータを算出した。
腎移植後6か月の拒絶反応発現割合は24%,腎移植後1年の生着割合は100%であった。有害事象発現頻度は68%であった。MMF投与後3か月時平均AUC0-12は,48.7±27.6μg hr/mLであった。推定AUC0-12の経時的推移は,米国小児腎移植患者と同様であった。
本試験には試験デザインと登録症例数が少ないという制限があるものの,国内小児腎移植患者における,MMFの拒絶反応抑制効果と安全性が示唆された。また国内小児腎移植患者は,国内成人患者,米国小児患者と同様の薬物動態を示すことが認められた。研究論文(学術雑誌) - 2011年04月, PEDIATRIC NEPHROLOGY, 26(4) (4), 563 - 569, 英語[査読有り]研究論文(学術雑誌)
- 2011年03月, CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 6(3) (3), 630 - 639, 英語[査読有り]研究論文(学術雑誌)
- 2011年02月, AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY, 300(2) (2), F511 - F520, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2011年02月, 日本小児科学会雑誌, 115(2) (2), 268 - 268, 日本語巣状メサンギウム増殖を示す小児IgA腎症に対するACEIの治療反応性
- 2011年02月, American Journal of Physiology - Renal Physiology, 300(2) (2), F511 - F520, 英語[査読有り]研究論文(学術雑誌)
- 2011年01月, NEPHROLOGY DIALYSIS TRANSPLANTATION, 26(1) (1), 163 - 169, 英語[査読有り]研究論文(学術雑誌)
- 2011年01月, PEDIATRIC NEPHROLOGY, 26(1) (1), 99 - 104, 英語[査読有り]研究論文(学術雑誌)
- 2011年, Nihon Jinzo Gakkai shi, 53(2) (2), 163 - 168[Bartter's syndrome].[査読有り]
- 2011年, INTERNAL MEDICINE, 50(19) (19), 2179 - 2183, 英語[査読有り]研究論文(学術雑誌)
- 13歳と10歳の兄妹で,学校検尿で発見された尿細管性蛋白尿の精査のために紹介受診した。兄妹ともに浮腫や高血圧はなく,成長・発達ともに正常で,難聴や白内障などの腎外症状も見られなかった。血液検査でも異常所見はなく,高カルシウム尿症も認めなかった。The Japanese Society for Pediatric Nephrology, 2011年, 日本小児腎臓病学会雑誌, 24(1) (1), 92 - 95, 日本語
これらの所見からDent病と診断し,病因遺伝子とされているCLCN5とOCRL1を解析したが,いずれにも変異を認めなかった。3年間,兄の尿中β2-ミクログロブリン (β2MG) は,1,000μg/L以下で著変なく,妹は当初1,000台であったものが最近は23,550μg/Lと上昇傾向である。
Dent病の約60%はCLCN5遺伝子の変異によって,また10~15%はLowe症候群の責任遺伝子であるOCRL1遺伝子の変異によって発症する。これらの遺伝子はX染色体上に位置するため,患者の90%以上が男性で,女性保因者の尿β2MGは数千μg/L程度に上昇するが軽症である。しかし,本症例では兄よりも妹のβ2MGが異常高値であることから,常染色体遺伝のDent病の存在を示唆する貴重な症例と思われた。 - 2011年, Kobe Journal of Medical Sciences, 57(1) (1), E1 - E10, 英語Molecular analysis of TSC2/PKD1 contiguous gene deletion syndrome[査読有り]研究論文(学術雑誌)
- 2010年12月, JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 95(12) (12), E511 - E518, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2010年11月, 日本小児腎臓病学会雑誌, 23(2) (2), 229 - 229, 日本語
- 血尿を特徴とする菲薄基底膜腎症 (thin basement membrane nephropathy: TBMN) は,従来は腎不全に至る率の低い予後良好な疾患と考えられてきた。しかし,TBMNの約4割は,常染色体劣性アルポート症候群 (autosomal recessive Alport syndrome: ARAS) の原因遺伝子であるCOL4A3/COL4A4のヘテロ接合体変異を有し,これら症例の一部は腎不全に進展することが明らかにされつつある。今回われわれは,術前のドナー腎生検でTBMNと診断してARAS症例への生体腎移植を実施したところ,術後にドナーのCOL4A3/COL4A4のヘテロ接合体変異が確認された2例を経験した。2例とも術前にドナーの腎機能が良好なことを確認し,術後も腎機能は安定している。ARASの生体腎移植では,保因者がドナーとなる可能性が高い。そのため,尿所見や腎機能,さらに可能な限り遺伝子異常の検索を行うなど,個々の症例で術前の十分なドナー評価と術後の慎重なフォローアップの必要性が示された。The Japanese Society for Pediatric Nephrology, 2010年11月, 日本小児腎臓病学会雑誌, 23(2) (2), 29-33 - 118, 日本語[査読有り]研究論文(学術雑誌)
- 2010年10月, PEDIATRIC NEPHROLOGY, 25(10) (10), 2165 - 2170, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2010年08月, 日本腎臓学会誌, 52(6) (6), 811 - 811, 日本語幼少時発症のFibronectin腎症でFN1遺伝子に変異のあった1例
- 2010年07月, PEDIATRIC NEPHROLOGY, 25(7) (7), 1343 - 1348, 英語[査読有り]研究論文(学術雑誌)
- 2010年06月, PEDIATRIC NEPHROLOGY, 25(6) (6), 1073 - 1079, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2010年06月, 日本小児腎臓病学会雑誌, 23(1Suppl.) (1Suppl.), 87 - 87, 日本語
- (一社)日本小児腎臓病学会, 2010年06月, 日本小児腎臓病学会雑誌, 23(1Suppl.) (1Suppl.), 123 - 123, 日本語
- 日本小児高血圧研究会, 2010年06月, 小児高血圧研究会誌, 7(1) (1), 64 - 65, 日本語運動後急性腎不全とPRES(Posterior reversible encephalopathy syndrome)の合併を反復した腎性低尿酸血症の1例
- 2010年05月, PEDIATRIC NEPHROLOGY, 25(5) (5), 953 - 955, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2010年05月, 日本腎臓学会誌, 52(3) (3), 338 - 338, 日本語X染色体連鎖型Alport症候群の臨床的検討
- Alport症候群 (AS) は感音性難聴を伴う遺伝性進行性腎疾患である。高頻度に末期腎不全に至るとされ臨床的に重要な疾患であるが,その臨床像,自然予後は十分には解明されていない。今回,分子遺伝学的特徴および近年報告された家族性良性血尿症候群との関連について,常染色体性Alport症候群を中心に概要をまとめる。The Japanese Society for Pediatric Nephrology, 2010年04月, 日本小児腎臓病学会雑誌 = Japanese journal of pediatric nephrology, 23(1) (1), 8 - 12, 日本語
- 2010年04月, PEDIATRIC NEPHROLOGY, 25(4) (4), 781 - 782, 英語[査読有り]
- 2010年03月, PEDIATRIC NEPHROLOGY, 25(3) (3), 545 - 548, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2010年02月, 日本小児科学会雑誌, 114(2) (2), 228 - 228, 日本語常染色体劣性Alport症候群女児例におけるIV型コラーゲンα1~α6鎖染色の検討
- Japanese Society for Pediatric Nephrology, 2010年, Nihon Shoni Jinzobyo Gakkai Zasshi, 23(2) (2), 172 - 178研究論文(学術雑誌)
- 2009年12月, PEDIATRIC NEPHROLOGY, 24(12) (12), 2467 - 2469, 英語[査読有り]研究論文(学術雑誌)
- 偽性低アルドステロン症I型 (PHA1) は,レニン-アルドステロン系の亢進にもかかわらず,遠位尿細管におけるナトリウムの再吸収が障害されているため,低ナトリウム血症,高カリウム血症を呈することを特徴とするまれな尿細管疾患である。常染色体優性遺伝形式をとるものと常染色体劣性遺伝形式をとるものがあり,それぞれ重症度が異なる。近年,Bartter症候群II型で新生児期にPHA1とよく似た経過をたどる症例が報告されており,注意が必要である。PHA1は新生児期に適切な脱水・電解質管理がなされれば塩分補充療法のみで成長発達も改善される予後良好な疾患である。The Japanese Society for Pediatric Nephrology, 2009年11月, 日本小児腎臓病学会雑誌 = Japanese journal of pediatric nephrology, 22(2) (2), 123 - 125, 日本語
- 腎性低尿酸血症は,human urate transporter1の異常により低尿酸血症をきたす疾患で,運動後急性腎不全の合併が多い。その発症機序について二つの仮説,すなわち「急性尿酸腎症説」および「活性酸素関与説」が提唱されているが,詳細は不明である。The Japanese Society for Pediatric Nephrology, 2009年11月, 日本小児腎臓病学会雑誌 = Japanese journal of pediatric nephrology, 22(2) (2), 147 - 151, 日本語
本論文では,腎性低尿酸血症の患者において運動後急性腎不全の合併しやすい理由を過去の文献を参考に考察するとともに,筆者らが経験した腎性低尿酸血症患児において,運動負荷の上で酸化ストレス度と抗酸化力を測定した結果を紹介した。患児は対照成人と同様,運動負荷直後から酸化ストレス度の上昇を示したが,抗酸化力は対照成人と異なり,運動負荷後,急激に低下した。すなわち対照に比して運動負荷時の酸化ストレス増大に見合う抗酸化力を有していないことが示唆された。以上より,酸化ストレス急増時の抗酸化力の相対的不足が腎性低尿酸血症における運動後急性腎不全発症に関与しているものと思われた。 - 今回われわれは,HUS発症8年後より高度蛋白尿を呈し,発症11年後の腎生検で糸球体硬化および著明な間質の線維化を認めた症例を経験したので報告する。The Japanese Society for Pediatric Nephrology, 2009年11月, 日本小児腎臓病学会雑誌 = Japanese journal of pediatric nephrology, 22(2) (2), 183 - 187, 日本語
症例は14歳女性。3歳時に溶血性尿毒症症候群 (HUS) を発症し,約1ヵ月間の腹膜透析治療を要した。透析終了後,尿蛋白は陰性化したが尿中β2MGの高値が持続したため腎生検を行ったところ,腎組織の一部に瘢痕化を認め,急性期での皮質壊死の存在が示唆された。その後,アンギオテンシン変換酵素阻害薬 (ACEI) の内服を開始し尿所見は正常化した。しかし,発症から8年後より高度尿蛋白が出現し,再度腎生検を行ったところ,糸球体硬化および著明な間質の線維化を認め今後の腎機能障害への進行が予想された。本症例のようにHUSの急性期に長期間人工透析を行い,また,尿異常が遷延する症例は,後遺症の発症率が高いと報告されているために,予後に十分な注意を払うべきである。 - 2009年11月, PEDIATRIC RESEARCH, 66(5) (5), 590 - 593, 英語[査読有り]研究論文(学術雑誌)
- 2009年11月, BMC NEPHROLOGY, 10, 37, 英語[査読有り]研究論文(学術雑誌)
- 2009年10月, HUMAN GENETICS, 126(4) (4), 533 - 538, 英語[査読有り]研究論文(学術雑誌)
- 2009年09月, PEDIATRIC NEPHROLOGY, 24(9) (9), 1773 - 1774, 英語[査読有り]
- (一社)日本腎臓学会, 2009年08月, 日本腎臓学会誌, 51(6) (6), 778 - 778, 日本語運動後急性腎不全とPRES(Posterior reversible encephalopathy syndrome)の合併を反復した腎性低尿酸血症の1例
- (一社)日本腎臓学会, 2009年08月, 日本腎臓学会誌, 51(6) (6), 794 - 794, 日本語遺伝性腎疾患におけるintron内の変異に伴う病気発症メカニズム解明のための実験系の確立
- (一社)日本腎臓学会, 2009年08月, 日本腎臓学会誌, 51(6) (6), 796 - 796, 日本語腎不全に至ったステロイド感受性微小変化型ネフローゼ症候群の1例
- 2009年07月, PEDIATRIC NEPHROLOGY, 24(7) (7), 1321 - 1328, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2009年06月, 日本小児腎臓病学会雑誌, 22(1Suppl.) (1Suppl.), 94 - 94, 日本語
- (公社)日本小児科学会, 2009年06月, 日本小児科学会雑誌, 113(6) (6), 1028 - 1028, 日本語IV型コラーゲンα5鎖の発現をモザイク状に認めたAlport症候群の1男児例
- 2009年06月, PEDIATRIC NEPHROLOGY, 24(6) (6), 1181 - 1186, 英語[査読有り]研究論文(学術雑誌)
- 2009年05月, PEDIATRIC NEPHROLOGY, 24(5) (5), 1071 - 1075, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2009年04月, 日本腎臓学会誌, 51(3) (3), 250 - 250, 日本語重症小児IgA腎症における治療後腎IgA沈着消失の臨床病理学的意義
- (一社)日本腎臓学会, 2009年04月, 日本腎臓学会誌, 51(3) (3), 290 - 290, 日本語X染色体連鎖型アルポート症候群(XLAS)の分子遺伝学的検討
- 2009年04月, PEDIATRIC NEPHROLOGY, 24(4) (4), 869 - 871, 英語[査読有り]研究論文(学術雑誌)
- 2009年03月, PEDIATRIC NEPHROLOGY, 24(3) (3), 605 - 608, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2009年02月, 日本小児科学会雑誌, 113(2) (2), 296 - 296, 日本語X染色体連鎖型アルポート症候群の分子遺伝学的検討
- 2009年02月, PEDIATRIC NEPHROLOGY, 24(2) (2), 415 - 418, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2008年11月, 日本小児腎臓病学会雑誌, 21(2) (2), 234 - 234, 日本語
- (一社)日本小児腎臓病学会, 2008年11月, 日本小児腎臓病学会雑誌, 21(2) (2), 235 - 235, 日本語
- 2008年11月, PEDIATRIC NEPHROLOGY, 23(11) (11), 2085 - 2090, 英語[査読有り]研究論文(学術雑誌)
- 2008年08月, NEPHROLOGY DIALYSIS TRANSPLANTATION, 23(8) (8), 2525 - 2530, 英語[査読有り]研究論文(学術雑誌)
- 日本小児腎不全学会, 2008年08月, 日本小児腎不全学会雑誌, 28, 151 - 153, 日本語
- 2008年08月, PEDIATRICS INTERNATIONAL, 50(4) (4), 441 - 446, 英語[査読有り]研究論文(学術雑誌)
- 2008年06月, AMERICAN JOURNAL OF KIDNEY DISEASES, 51(6) (6), 1077 - 1078, 英語[査読有り]
- 2008年06月, PEDIATRIC NEPHROLOGY, 23(6) (6), 905 - 912, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2008年05月, 日本小児腎臓病学会雑誌, 21(1Suppl.) (1Suppl.), 130 - 130, 日本語
- (一社)日本小児腎臓病学会, 2008年05月, 日本小児腎臓病学会雑誌, 21(1Suppl.) (1Suppl.), 171 - 171, 日本語
- (一社)日本小児腎臓病学会, 2008年05月, 日本小児腎臓病学会雑誌, 21(1Suppl.) (1Suppl.), 194 - 194, 日本語
- (一社)日本小児腎臓病学会, 2008年05月, 日本小児腎臓病学会雑誌, 21(1Suppl.) (1Suppl.), 197 - 197, 日本語発端者のCOL4A5遺伝子に体細胞モザイクに変異を有し、軽症の臨床症状を示したAlport症候群の2家系
- (一社)日本小児腎臓病学会, 2008年05月, 日本小児腎臓病学会雑誌, 21(1Suppl.) (1Suppl.), 197 - 197, 日本語X染色体連鎖型アルポート症候群の分子遺伝学的検討
- (一社)日本小児腎臓病学会, 2008年05月, 日本小児腎臓病学会雑誌, 21(1Suppl.) (1Suppl.), 131 - 131, 日本語
- (一社)日本腎臓学会, 2008年04月, 日本腎臓学会誌, 50(3) (3), 363 - 363, 日本語小児腎疾患におけるchymaseの発現
- (一社)日本腎臓学会, 2008年04月, 日本腎臓学会誌, 50(3) (3), 367 - 367, 日本語小手術後の一過性血漿抗利尿ホルモン分泌亢進に関する研究
- 2008年03月, PEDIATRIC NEPHROLOGY, 23(3) (3), 481 - 485, 英語[査読有り]研究論文(学術雑誌)
- 2008年03月, JOURNAL OF MEDICAL GENETICS, 45(3) (3), 182 - 186, 英語研究論文(学術雑誌)
- (公社)日本小児科学会, 2008年01月, 日本小児科学会雑誌, 112(1) (1), 80 - 80, 日本語LDL吸着療法(LDL-A)が有効であった巣状分節性糸球体硬化症(FSGS)の1例
- 2007年12月, BIOLOGICAL & PHARMACEUTICAL BULLETIN, 30(12) (12), 2371 - 2375, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2007年11月, 日本小児腎臓病学会雑誌, 20(2) (2), 164 - 167, 日本語
- (一社)日本小児腎臓病学会, 2007年11月, 日本小児腎臓病学会雑誌, 20(2) (2), 152 - 158, 日本語日本人3型Bartter症候群患者5例における遺伝子型および表現型に関する研究[査読有り]
- (一社)日本小児腎臓病学会, 2007年11月, 日本小児腎臓病学会雑誌, 20(2) (2), 235 - 235, 日本語日本人3型Bartter症候群患者5例における遺伝子型および表現型に関する研究[査読有り]
- 2007年11月, PEDIATRIC NEPHROLOGY, 22(11) (11), 1957 - 1961, 英語[査読有り]研究論文(学術雑誌)
- 2007年09月, PEDIATRIC RESEARCH, 62(3) (3), 364 - 369, 英語[査読有り]研究論文(学術雑誌)
- 2007年08月, PEDIATRIC NEPHROLOGY, 22(8) (8), 1219 - 1223, 英語[査読有り]研究論文(学術雑誌)
- 2007年08月, 日本小児腎不全学会雑誌, 27巻, , pp. 60-62, 日本語常染色体劣性多発性嚢胞腎(ARPKD)の2例の臨床経過の検討[査読有り]研究論文(学術雑誌)
- 2007年07月, PEDIATRIC NEPHROLOGY, 22(7) (7), 975 - 980, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2007年06月, 日本小児腎臓病学会雑誌, 20(1Suppl.) (1Suppl.), 93 - 93, 日本語ベロ毒素産生型腸管出血性大腸菌性溶血性尿毒症症候群におけるMDR1遺伝子多型の関与
- (一社)日本小児腎臓病学会, 2007年06月, 日本小児腎臓病学会雑誌, 20(1Suppl.) (1Suppl.), 112 - 112, 日本語小手術後の一過性血漿抗利尿ホルモン分泌亢進に関する研究 医原性低ナトリウム血症および術後嘔気嘔吐症発症機序に関する考察
- (一社)日本小児腎臓病学会, 2007年06月, 日本小児腎臓病学会雑誌, 20(1Suppl.) (1Suppl.), 114 - 114, 日本語日本人3型Bartter症候群患者5例における遺伝子型および表現型に関する研究[査読有り]
- (一社)日本腎臓学会, 2007年04月, 日本腎臓学会誌, 49(3) (3), 244 - 244, 日本語血管性紫斑病における腎炎発症とintercellular adhesion molecule-1(ICAM-1)遺伝子多型K469Eの関与
- 2007年04月, PEDIATRICS INTERNATIONAL, 49(2) (2), 196 - 201, 英語[査読有り]研究論文(学術雑誌)
- 2007年04月, PEDIATRIC RESEARCH, 61(4) (4), 502 - 505, 英語[査読有り]研究論文(学術雑誌)
- 2006年12月, PEDIATRIC NEPHROLOGY, 21(12) (12), 1824 - 1829, 英語[査読有り]研究論文(学術雑誌)
- 2006年11月, NEPHROLOGY DIALYSIS TRANSPLANTATION, 21(11) (11), 3133 - 3138, 英語[査読有り]研究論文(学術雑誌)
- 2006年10月, NEPHROLOGY DIALYSIS TRANSPLANTATION, 21(10) (10), 2959 - 2962, 英語[査読有り]研究論文(学術雑誌)
- 2006年08月, 日本小児腎不全学会雑誌, 26巻, , pp. 175-177, 175 - 177, 日本語ハプロタイプ解析と直接シークエンス法にて新たなPKHD1遺伝子変異を同定したARPKDの1例[査読有り]研究論文(学術雑誌)
- 2006年08月, 日本小児腎不全学会雑誌, 26巻, , pp. 262-264, 262 - 264, 日本語Rituximabの投与がFSGSの移植後再発に対し有効であったと考えられた1例 ネフローゼ症候群に対するBリンパ球活性化の関与に関する考察[査読有り]研究論文(学術雑誌)
- Generally, idiopathic membranous glomerulonephritis (MGN) is a global glomerular disease that affects the whole of the glomerulus. However, idiopathic segmental MGN (SMGN) that shows IgG deposits in a portion of the glomerulus is encountered often. For clarification of whether SMGN is the same entity as idiopathic global MGN (GMGN), the two diseases were compared. From 1978 to 2004, 38 children (11 with SMGN and 27 with GMGN) received a diagnosis of idiopathic MGN. Immunofluorescence microscopy showed segmental granular IgG staining along the capillary loops in SMGN, whereas GMGN showed global staining. On light microscopy, SMGN showed segmental thickening of the glomerular basement membrane, with spike formation, whereas GMGN showed global lesions. The frequency of C1q deposits in SMGN was significantly higher than that in GMGN (91 versus 41%; P < 0.01). On electron microscopy, mesangial electron-dense deposits were detected in 10 (91%) cases of SMGN and also were found in the subepithelial and intramembranous area, whereas only six (22%) cases of GMGN had mesangial electron-dense deposits (P < 0.001). There were no significant differences in clinical features between the groups. Two children with SMGN underwent a repeat biopsy 3 yr after the first biopsy, and both patients again showed SMGN. At the final observation (mean observation time 7.5 yr in SMGN and 12.4 yr in GMGN), all children of both groups had a good outcome. In conclusion, these findings as a whole suggest that SMGN may be another glomerular disease entity with child predominance that is distinctive from GMGN.2006年07月, Clinical journal of the American Society of Nephrology : CJASN, 1(4) (4), 723 - 729, 英語, 国際誌[査読有り]研究論文(学術雑誌)
- 2006年07月, CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 1(4) (4), 723 - 729, 英語[査読有り]研究論文(学術雑誌)
- 2006年04月, PEDIATRIC NEPHROLOGY, 21(4) (4), 475 - 481, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2006年04月, 日本腎臓学会誌, 48(3) (3), 201 - 201, 日本語全国調査における典型的HUSの重症化因子の検討
- (一社)日本腎臓学会, 2006年04月, 日本腎臓学会誌, 48(3) (3), 236 - 236, 日本語小児IgA腎症におけるTransforming Growth Factor(TGF)-β1遺伝子多型(C-509T,T869C)の関与
- 2006年04月, PEDIATRICS INTERNATIONAL, 48(2) (2), 152 - 157, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2006年02月, 日本小児科学会雑誌, 110巻, 2号, pp.233-233(2) (2), 233 - 233, 日本語Alport症候群に対する抗アルドステロン薬の効果についての検討研究論文(国際会議プロシーディングス)
- 一般社団法人 日本泌尿器科学会, 2006年, 日本泌尿器科学会雑誌, 97(2) (2), 413 - 413, 日本語
- 2006年, JOURNAL OF HUMAN GENETICS, 51(11) (11), 969 - 976, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2005年12月, 日本小児科学会雑誌, 109(12) (12), 1474 - 1474, 日本語膜性腎症を伴ったslowly progressive IDDMの男性の1例
- 2005年12月, 日本小児科学会雑誌, 109巻, 12号, pp.1478-1478, 日本語尿中落下細胞を用いた解析で遺伝子変異を証明できたGitelman症候群の1例研究論文(国際会議プロシーディングス)
- (公社)日本小児科学会, 2005年12月, 日本小児科学会雑誌, 109巻, 12号, pp.1472-1473(12) (12), 1472 - 1473, 日本語マイコプラズマ感染を契機に発症したEVANS症候群の1例研究論文(国際会議プロシーディングス)
- 小児期に発症し,各種免疫抑制剤の投与でも完全寛解に至らず,成人期にキャリーオーバーした難治性ネフローゼ症候群に対し,ミコフェノール酸モフェチルを投与し良好な経過を得た2例について報告する。2例とも幼少期にネフローゼ症候群を発症し,頻回に再発を繰り返したためシクロスポリン,シクロフォスファミド,ミゾリビンなどの各種免疫抑制剤を投与されていた。いずれも成人期にキャリーオーバーし,シクロスポリンの腎毒性,シクロフォスファミドの投与量限界などから既存の免疫抑制剤による寛解は困難と判断し,ミコフェノール酸モフェチルの投与を開始した。症例1は投与開始直後と12カ月後にそれぞれ再発を認めたものの尿蛋白は速やかに消失し,症例2は投与開始後10カ月間再発を認めておらず,いずれも良好な臨床経過である。ミコフェノール酸モフェチルは副作用も少なく,難治性ネフローゼ症候群に対する効果が期待されており,今後長期に経過を観察し効果を見極める必要があると思われた。The Japanese Society for Pediatric Nephrology, 2005年11月, 日本小児腎臓病学会雑誌, 18巻, 2号, pp.131-135(2) (2), 131 - 135, 日本語[査読有り]研究論文(学術雑誌)
- 2005年11月, PEDIATRIC NEPHROLOGY, 20(11) (11), 1660 - 1663, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本移植学会, 2005年10月, 移植, 40(総会臨時) (総会臨時), 209 - 209, 日本語
- 2005年08月, 日本小児腎不全学会雑誌, 25巻, pp.138-140, 138 - 140, 日本語腎機能が保たれている時期に腹膜透析を導入した難治性ネフローゼ症候群の1例[査読有り]研究論文(学術雑誌)
- (一社)日本腎臓学会, 2005年05月, 日本腎臓学会誌, 47巻, 3号, pp.353-353(3) (3), 353 - 353, 日本語当院における溶血性尿毒症症候群の臨床的検討研究論文(国際会議プロシーディングス)
- (一社)日本透析医学会, 2005年05月, 日本透析医学会雑誌, 38巻, Suppl.1, pp.1227-1227(Suppl.1) (Suppl.1), 1227 - 1227, 日本語維持血液透析を施行している小児末期腎不全の1症例研究論文(国際会議プロシーディングス)
- (一社)日本小児腎臓病学会, 2005年04月, 日本小児腎臓病学会雑誌, 18巻, 1Suppl., pp.180-180(1Suppl.) (1Suppl.), 180 - 180, 日本語膜性増殖性糸球体腎炎(MPGN)24例の長期予後に関する検討研究論文(国際会議プロシーディングス)
- (一社)日本小児腎臓病学会, 2005年04月, 日本小児腎臓病学会雑誌, 18巻, 1Suppl., pp.184-184(1Suppl.) (1Suppl.), 184 - 184, 日本語全国調査における典型的溶血性尿毒症症候群の治療の検討研究論文(国際会議プロシーディングス)
- 2005年04月, 日本小児腎臓病学会雑誌, 18巻, 1Suppl., pp.144-144, 日本語Gene Scanを用いることで遺伝子異常を発見できた3型バーター症候群の1例研究論文(国際会議プロシーディングス)
- (公社)日本薬剤学会, 2005年03月, 薬剤学, 65巻, Suppl., pp. 122-122(Suppl.) (Suppl.), 122 - 122, 日本語小児腎疾患患者におけるCsA体内動態に及ぼす併用薬・腎機能の影響研究論文(国際会議プロシーディングス)
- (公社)日本小児科学会, 2005年02月, 日本小児科学会雑誌, 109巻, 2号, pp. 239-239(2) (2), 239 - 239, 日本語当院における溶血性尿毒症症候群(HUS)の臨床的検討研究論文(国際会議プロシーディングス)
- (公社)日本小児科学会, 2005年02月, 日本小児科学会雑誌, 109巻, 2号, pp. 149-149(2) (2), 149 - 149, 日本語全国調査における典型的溶血性尿毒症候群の重症化因子の検討研究論文(国際会議プロシーディングス)
- 2004年12月, 日本小児科学会雑誌, 108巻, 12号, pp. 1515-1515, 日本語腹膜透析を導入した頻回再発型ネフローゼ症候群の1例研究論文(国際会議プロシーディングス)
- 2004年12月, 日本小児科学会雑誌, 108巻, 12号, pp. 1513-1513, 日本語治療抵抗性で腎不全へと至り,移植後再発のため再び腎不全へと至った,微小変化型ネフローゼの1例研究論文(国際会議プロシーディングス)
- (公社)日本小児科学会, 2004年12月, 日本小児科学会雑誌, 108巻, 12号, pp. 1522-1522(12) (12), 1522 - 1522, 日本語タクロリムスが有効であった難治性ネフローゼ症候群の2例研究論文(国際会議プロシーディングス)
- MPO-ANCA (myeloperoxidase anti-neutrophil cytoplasmic autoantibody) が陽性のANCA関連血管炎症候群の2症例について報告する。The Japanese Society for Pediatric Nephrology, 2004年11月, 日本小児腎臓病学会雑誌, 17巻, 2号, pp. 95-101(2) (2), 95 - 101, 日本語
症例1は7歳の女児。間質性肺炎と軽度の腎機能障害で発症した。ステロイドパルス療法の後, 多剤併用療法を行ったが, 徐々に腎機能は悪化し発症4年後に腹膜透析導入となった。現在は原疾患の再燃もなく腹膜透析継続中である。
症例2は6歳の女児。肺出血と高度の腎機能障害で発症し, 入院当日より腹膜透析を導入した。またステロイドパルス療法を行い肺出血はいったん改善したがすぐに再出血し人工呼吸管理を要した。2度目のステロイドパルス療法は効果がなく, 血漿交換療法を行ったところ劇的に呼吸状態は改善し一命を取りとめた。しかし腎機能は改善せず現在も腹膜透析を継続している。
2症例はどちらも末期腎不全へと移行し腎予後が不良であった。またステロイドパルス療法が無効例の呼吸器症状に対しては血漿交換療法も考慮すべきと考えられた。[査読有り]研究論文(学術雑誌) - 2004年08月, PEDIATRIC NEPHROLOGY, 19(8) (8), 844 - 852, 英語[査読有り]研究論文(学術雑誌)
- 2004年08月, 日本小児腎不全学会雑誌, 24巻, , pp. 98-100, 日本語頻回の嘔吐に伴い一過性の急性腎不全を繰り返した1例[査読有り]研究論文(学術雑誌)
- (一社)日本臨床薬理学会, 2004年08月, 臨床薬理, 35巻, Suppl., pp. S151-S151(Suppl.) (Suppl.), S151 - S151, 日本語小児患者におけるCyclosporineの体内動態とMDR1遺伝子多型の関連性研究論文(国際会議プロシーディングス)
- 2004年08月, 日本小児腎不全学会雑誌, 24巻, , pp. 149-152, 149 - 152, 日本語Blood accessの確保に難渋し,維持血液透析を余儀なくされた2歳女児例[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2004年06月, 日本小児腎臓病学会雑誌, 17(1Suppl.) (1Suppl.), 102 - 102, 日本語Rituximabの投与が,FSGSの移植後再発に対し有効であったと考えられた1例 FSGSとBリンパ球活性化の関与に関する考察
- (一社)日本小児腎臓病学会, 2004年06月, 日本小児腎臓病学会雑誌, 17(1Suppl.) (1Suppl.), 131 - 131, 日本語
- (一社)日本小児腎臓病学会, 2004年06月, 日本小児腎臓病学会雑誌, 17(1Suppl.) (1Suppl.), 190 - 190, 日本語巣状膜性糸球体腎炎(FMGN) びまん性膜性糸球体腎炎(DMGN)との比較検討
- (一社)日本小児腎臓病学会, 2004年06月, 日本小児腎臓病学会雑誌, 17巻, 1Suppl., pp. 158-158(1Suppl.) (1Suppl.), 158 - 158, 日本語当院で経験したANCA関連血管炎症候群の2例の検討研究論文(国際会議プロシーディングス)
- (一社)日本小児腎臓病学会, 2004年06月, 日本小児腎臓病学会雑誌, 17巻, 1Suppl., pp. 141-141(1Suppl.) (1Suppl.), 141 - 141, 日本語Bartter症候群8例における遺伝子解析研究論文(国際会議プロシーディングス)
- (一社)日本腎臓学会, 2004年04月, 日本腎臓学会誌, 46(3) (3), 220 - 220, 日本語日本人家族性巣状分節性糸球体硬化症におけるαアクチニン4遺伝子とポドシン遺伝子変異の検索
- (一社)日本腎臓学会, 2004年04月, 日本腎臓学会誌, 46巻, 3号, pp. 234-234(3) (3), 234 - 234, 日本語当院における典型的MPGN及びAtypical MPGNの臨床的検討研究論文(国際会議プロシーディングス)
- 2004年02月, PEDIATRIC NEPHROLOGY, 19(2) (2), 144 - 147, 英語[査読有り]研究論文(学術雑誌)
- (公社)日本小児科学会, 2004年02月, 日本小児科学会雑誌, 108巻, 2号, pp. 323-323(2) (2), 323 - 323, 日本語非典型的膜性増殖性糸球体腎炎(Atypical MPGN)の臨床的検討研究論文(国際会議プロシーディングス)
- 2004年, 日本小児腎不全学会雑誌, 24巻, pp. 142-145, 142 - 145, 日本語キャンピロバクター腸炎後に溶血性尿毒症症候群を発症し末期腎不全へと至った7歳女児例研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2003年06月, 日本小児腎臓病学会雑誌, 16(1Suppl.) (1Suppl.), 174 - 174, 日本語巣状分節性糸球体硬化症(FSGS)は微小変化に改善しうる
- (一社)日本小児腎臓病学会, 2003年06月, 日本小児腎臓病学会雑誌, 16(1Suppl.) (1Suppl.), 177 - 177, 日本語急性腎不全を合併した小児ネフローゼ症候群12例の臨床病理学的検討
- (一社)日本小児腎臓病学会, 2003年06月, 日本小児腎臓病学会雑誌, 16(1Suppl.) (1Suppl.), 186 - 186, 日本語非典型的な経過をとり腎生検を施行した溶血性尿毒症症候群についての検討
- 2003年06月, 日本小児腎臓病学会雑誌, 16巻, Suppl.1, pp. 132-132, 日本語小児におけるネオーラル薬物動態に関する研究研究論文(国際会議プロシーディングス)
- (一社)日本腎臓学会, 2003年04月, 日本腎臓学会誌, 45巻, 3号, pp. 251-251(3) (3), 251 - 251, 日本語小児におけるネオーラル薬物動態に関する研究研究論文(国際会議プロシーディングス)
- 2002年12月, Clinical and Laboratory Haematology, 24(6) (6), 347 - 351, 英語[査読有り]研究論文(学術雑誌)
- (一社)日本小児腎臓病学会, 2002年06月, 日本小児腎臓病学会雑誌, 15(1Suppl.) (1Suppl.), 142 - 142, 日本語小児期ネオーラル内服患者におけるシクロスポリン血中濃度モニタリングの検討
- 2002年05月, KIDNEY INTERNATIONAL, 61(5) (5), 1801 - 1805, 英語[査読有り]研究論文(学術雑誌)
- 日本小児腎不全学会, 2001年08月, 日本小児腎不全学会雑誌, 21, 140 - 140, 日本語ACE阻害剤及びアンギオテンシンI受容体拮抗薬を投与したアルポート症候群の5例
- (株)メディカルレビュー社, 2000年09月, Pharma Medica, 18(9) (9), 187 - 187, 日本語ACE阻害剤及びアンギオテンシンI受容体拮抗薬を投与したアルポート症候群の5例
- Alport SyndromeCLINICAL CHARACTERISTICS: Alport syndrome is characterized by kidney manifestations, sensorineural hearing loss (SNHL), and ocular manifestations. In the absence of treatment, kidney disease progresses from microhematuria to proteinuria, progressive kidney insufficiency, and end-stage kidney disease (ESKD) in most males with X-linked Alport syndrome (XLAS), and in most males and females with autosomal recessive Alport syndrome (ARAS). Progressive SNHL is usually present by late childhood or early adolescence. Ocular findings include anterior lenticonus (which is virtually pathognomonic), maculopathy (whitish or yellowish flecks or granulations in the perimacular region), corneal endothelial vesicles (posterior polymorphous dystrophy), and recurrent corneal erosion. In females with XLAS and individuals with autosomal dominant Alport syndrome (ADAS), ESKD is frequently delayed until later adulthood, SNHL is relatively late in onset, and ocular involvement is rare. DIAGNOSIS/TESTING: The molecular diagnosis of Alport syndrome is established in a proband with suggestive findings and a pathogenic variant(s) in COL4A3, COL4A4, or COL4A5 identified by molecular genetic testing. Kidney biopsy, skin biopsy (in some individuals with XLAS), or clinical diagnostic criteria may be used to establish the diagnosis in those without access to genetic testing or those with uninformative results. MANAGEMENT: Treatment of manifestations: Angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to delay onset of ESKD; standard treatment of hypertension; kidney transplantation for ESKD. Potential living related donors must be evaluated carefully to avoid nephrectomy in an affected individual. Hearing aids as needed for SNHL; cataract removal as needed; in those with deletions of COL4A5 extending into intron 2 of COL4A6, surgical intervention for symptomatic leiomyomas as needed. Surveillance: Evaluation by a nephrologist including urinalysis, assessment of kidney function, and blood pressure every six to 12 months; monthly monitoring of at-risk transplant recipients for development of anti-glomerular basement membrane antibody-mediated glomerulonephritis for the first year post transplant; audiologic evaluation every one to two years beginning at age six to seven years; ophthalmology evaluation for ocular abnormalities every one to two years beginning in adolescence in males with a COL4A5 truncating pathogenic variant and in persons with ARAS. Agents/circumstances to avoid: Drink adequate fluids as dehydration may accelerate the progression of nephropathy. Protection of corneas from minor trauma in those with recurrent corneal erosions. Minimize exposure to loud noise. Evaluation of relatives at risk: Evaluate at-risk family members in order to identify as early as possible those who would benefit from initiation of treatment either by molecular genetic testing if the pathogenic variant(s) in the family are known or urinalysis and blood pressure if the pathogenic variant(s) in the family are not known. GENETIC COUNSELING: COL4A5-related Alport syndrome is inherited in an X-linked manner (XLAS). COL4A3- and COL4A4-related Alport syndrome are inherited in an autosomal dominant (ADAS) or autosomal recessive (ARAS) manner. Digenic Alport syndrome is caused by pathogenic variants in more than one Alport syndrome-related gene: typically pathogenic variants in both COL4A3 and COL4A4 (in cis or in trans) or, more rarely, a pathogenic variant in COL4A5 in addition to a pathogenic variant in COL4A3 or COL4A4. XLAS: The risk to sibs of a male proband depends on the genetic status of the mother: if the mother of the proband has a COL4A5 pathogenic variant, the chance of transmitting it in each pregnancy is 50%. The risk to the sibs of a female proband depends on the genetic status of the parents: if the mother of the proband has a COL4A5 pathogenic variant, the chance of transmitting it in each pregnancy is 50%; if the father of the proband has a COL4A5 pathogenic variant, he will transmit it to all of his daughters and none of his sons. Males and females who inherit the pathogenic variant will be affected. ARAS: If both parents are known to be heterozygous for a COL4A3 or COL4A4 pathogenic variant, each sib of an affected individual has at conception a 25% chance of inheriting biallelic pathogenic variants (and having ARAS), a 50% chance of being heterozygous (and at risk for ADAS), and a 25% chance of inheriting neither of the familial pathogenic variants. ADAS: If a parent of the proband is affected and/or is known to have the COL4A3 or COL4A4 pathogenic variant identified in the proband, the risk to sibs of inheriting the pathogenic variant is 50%. The severity of clinical manifestations may vary greatly among heterozygous family members; some heterozygotes may be asymptomatic and some may develop ESKD. Digenic Alport syndrome: The risk to sibs depends on the involved genes, the location of the pathogenic variants (i.e., in cis or in trans) in families segregating pathogenic variants in COL4A3 and COL4A4, and the sex of the proband (in families segregating pathogenic variants in COL4A5 and COL4A3 or COL4A4). Once the Alport syndrome-related pathogenic variant(s) have been identified in an affected family member, prenatal and preimplantation genetic testing are possible.University of Washington, Seattle, 1993年, 英語
- 2024年, 近畿小児科学会プログラム・抄録集, 37th副腎皮質腫瘍を合併したBeckwith-Wiedemann症候群の一例
- 2024年, 近畿小児科学会プログラム・抄録集, 37th劇症型経過をたどり外科的治療を要した小児潰瘍性大腸炎の2例
- 2023年, 日本小児腎臓病学会雑誌(Web), 36Alport症候群原因遺伝子COL4A5の各種exon欠損がIV型コラーゲン三量体分泌に与える影響
- 2023年, 日本整形外科学会雑誌, 97(9) (9)Frontometaphyseal dysplasia type1の遺伝学的診断と遺伝カウンセリング
- 2023年, 日本先天代謝異常学会雑誌, 39当院で経験した希少先天性グリコシル化異常症(CDG)の2女児例
- 2023年, 日本小児遺伝学会学術集会プログラム・抄録集, 46thこどもたちへの遺伝カウンセリング後に診断を確定したOptic atrophy plus症候群の親子例
- (公社)日本小児科学会, 2022年02月, 日本小児科学会雑誌, 126(2) (2), 215 - 215, 日本語電解質異常から発見する小児遺伝性腎疾患 バーター症候群・ギッテルマン症候群
- 2022年, 小児内科, 54(1) (1)生後早期のアルドステロン測定により診断にいたった早産児のI型偽性低アルドステロン症の1例
- 2022年, 日本人類遺伝学会大会プログラム・抄録集, 67th (CD-ROM)Genetic autopsyで17q12欠失症候群と診断したPotter sequenceの1男児例
- 2022年, 日本人類遺伝学会大会プログラム・抄録集, 67th (CD-ROM)周期的な不機嫌を呈したBosch-Boonstra-Schoaf optic atrophy syndromeの1例
- 2022年, 日本遺伝カウンセリング学会誌, 43(1) (1)Marfan症候群とX連鎖性高IgM症候群を合併した兄弟とその家族への遺伝カウンセリング
- (株)東京医学社, 2021年12月, 小児内科, 53(増刊) (増刊), 484 - 490, 日本語【小児疾患診療のための病態生理2 改訂第6版】腎・泌尿器疾患 繊毛病
- (株)診断と治療社, 2021年11月, 小児科診療, 84(11) (11), 1436 - 1440, 日本語
- (株)東京医学社, 2021年11月, 腎と透析, 91(5) (5), 837 - 843, 日本語
- (株)医学書院, 2021年09月, Medicina, 58(10) (10), 1651 - 1654, 日本語
- (有)科学評論社, 2021年09月, 腎臓内科, 14(3) (3), 329 - 335, 日本語
- (株)東京医学社, 2021年08月, 腎と透析, 91(増刊) (増刊), 76 - 80, 日本語【腎疾患治療薬update】(第1章)腎疾患患者への薬の使い方 小児難治性ネフローゼ症候群 リツキシマブ
- (株)東京医学社, 2021年08月, 腎と透析, 91(増刊) (増刊), 808 - 811, 日本語【腎疾患治療薬update】(第5章)期待される薬剤 アルポート症候群の治療 RAS系阻害薬、バルドキソロンメチル、核酸医薬
- (株)東京医学社, 2021年07月, 腎と透析, 91(1) (1), 89 - 93, 日本語
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 392 - 392, 日本語遺伝性腎疾患研究最前線:国内で行われている最先端の研究に触れる OCRL異常によるLowe症候群およびDent disease-2の発症メカニズム
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 392 - 392, 日本語遺伝性腎疾患研究最前線:国内で行われている最先端の研究に触れる アルポート症候群に対する治療法の開発
- (一社)日本腎臓学会, 2021年06月, 日本腎臓学会誌, 63(4) (4), 395 - 395, 日本語嚢胞性腎疾患:現在の課題を認識し未来におけるより良い診療を創造するためのシンポジウム 遺伝学的解析が嚢胞性腎疾患診療に与えてきたインパクトと課題
- (株)文光堂, 2021年05月, Medical Practice, 38(5) (5), 727 - 733, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 67 - 67, 日本語
- (一社)日本小児腎臓病学会, 2021年05月, 日本小児腎臓病学会雑誌, 34(1Suppl.) (1Suppl.), 68 - 68, 日本語
- (株)診断と治療社, 2021年04月, 小児科診療, 84(増刊) (増刊), 306 - 309, 日本語
- 金原出版(株), 2021年02月, 小児科, 62(2) (2), 130 - 135, 日本語
- (公社)日本小児科学会, 2021年02月, 日本小児科学会雑誌, 125(2) (2), 173 - 173, 日本語明日から使える輸液療法の考え方 小児の維持輸液は低張液? それとも等張液?
- (公社)日本小児科学会, 2021年02月, 日本小児科学会雑誌, 125(2) (2), 260 - 260, 日本語当科で経験した寡巨大糸球体症(Oligomeganephronia)の臨床病理学的検討
- (公社)日本小児科学会, 2021年02月, 日本小児科学会雑誌, 125(2) (2), 261 - 261, 日本語Oxford分類を用いた小児IgA腎症・紫斑病性腎炎の臨床病理学的所見の比較
- (公社)日本小児科学会, 2021年02月, 日本小児科学会雑誌, 125(2) (2), 284 - 284, 日本語Lowe症候群とDent disease-2における分子生物学的発症機序の解明
- (公社)日本小児科学会, 2021年02月, 日本小児科学会雑誌, 125(2) (2), 285 - 285, 日本語異なる臨床像を呈したSLC4A1遺伝子による常染色体優性遠位尿細管性アシドーシスの姉弟例
- 2021年, 日本腎臓学会誌(Web), 63(4) (4)CLCN5遺伝子を含むX染色体微細欠失により発症したDent disease-1女性の2例
- 2021年, 日本人類遺伝学会大会プログラム・抄録集, 66th (CD-ROM)嚢胞性腎疾患の包括的遺伝子解析
- 2021年, 日本小児腎臓病学会雑誌(Web), 34(1) (1)免疫複合体関連腎炎との鑑別を要したFrasier症候群の女児例
- 2021年, 日本小児腎臓病学会雑誌(Web), 34(2) (2)発症8年後に再生検を行ったフィブロネクチン腎症の一例
- 2021年, 日本小児遺伝学会学術集会プログラム・抄録集, 44th (CD-ROM)MLPA法で診断したTSC2-PKD1隣接遺伝子欠失症候群7例の検討
- (株)メディカルドゥ, 2021年01月, 遺伝子医学, 11(1) (1), 108 - 115, 日本語遺伝性疾患(遺伝病)を学ぶ Alport症候群
- (有)科学評論社, 2021年01月, 腎臓内科, 13(1) (1), 105 - 112, 日本語遺伝性腎疾患における遺伝学的検査方法の進歩
- (株)メディカルドゥ, 2021年01月, 遺伝子医学, 11(1) (1), 108 - 115, 日本語遺伝性疾患(遺伝病)を学ぶ Alport症候群
- 日本小児臨床薬理学会, 2020年12月, 日本小児臨床薬理学会雑誌, 33(1) (1), 143 - 143, 日本語小児AMR対策事業に協力する前の小児初期救急施設における内服抗菌薬処方割合と処方医師プロファイルとの関係
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 43 - 43, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 46 - 46, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 76 - 76, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 77 - 77, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 81 - 81, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 82 - 82, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 85 - 85, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 86 - 86, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 87 - 87, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 88 - 88, 英語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 88 - 88, 英語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 107 - 107, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 109 - 109, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 109 - 109, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 123 - 123, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 133 - 133, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 138 - 138, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 145 - 145, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 147 - 147, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 148 - 148, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 150 - 150, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 158 - 158, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 160 - 160, 日本語
- (一社)日本小児腎臓病学会, 2020年12月, 日本小児腎臓病学会雑誌, 33(1Suppl.) (1Suppl.), 176 - 176, 日本語
- (株)東京医学社, 2020年11月, 腎と透析, 89(5) (5), 846 - 849, 日本語
- (有)科学評論社, 2020年11月, 腎臓内科, 12(5) (5), 467 - 473, 日本語【腎臓内科医が知っておくべき遺伝性腎疾患】Alport症候群
- (一社)日本透析医学会, 2020年10月, 日本透析医学会雑誌, 53(Suppl.1) (Suppl.1), 388 - 388, 日本語家族性巣状分節性糸球体硬化症を疑われるもAlport症候群と判明し透析導入となった一例
- Springer, 2020年08月01日, Clinical and Experimental Nephrology, 24(8) (8), 651 - 656, 英語書評論文,書評,文献紹介等
- (一社)日本小児腎臓病学会, 2020年04月, 日本小児腎臓病学会雑誌, 33(1) (1), 86 - 87, 日本語
- (一社)日本小児腎臓病学会, 2020年04月, 日本小児腎臓病学会雑誌, 33(1) (1), 105 - 105, 日本語
- 日本逆流性腎症フォーラム, 2020年02月, 日本逆流性腎症フォーラムプログラム・抄録集, 28回, 14 - 14, 日本語RNを科学する-ともに考えようRNの管理- VURと遺伝子異常
- 東京 : 日本小児腎不全学会, 2020年, 日本小児腎不全学会雑誌 = Journal of Japanese Society for Pediatric Renal Failure, 40, 191 - 194, 日本語Dent病に合併した薬剤性の急性尿細管間質性腎炎の1例
- 2020年, 日本小児科学会雑誌, 124(6) (6)アルドステロン高値により診断に至った早産児の偽性低アルドステロン症1型の1例
- 2020年, 滋賀医学, 42遺伝子検査で診断に至ったX連鎖型Alport症候群の1例
- 2020年, 日本小児腎臓病学会雑誌(Web), 33(1) (1)Dent disease-2の女児例に関する初めての報告およびその発症機序の解明
- (株)東京医学社, 2019年12月, 周産期医学, 49(12) (12), 1675 - 1678, 日本語第2子に偽性低アルドステロン症を認め、第1子にも高レニン・高アルドステロン血症を認めた二絨毛膜二羊膜双胎例
- (一社)日本小児腎臓病学会, 2019年11月, 日本小児腎臓病学会雑誌, 32(2) (2), 138 - 138, 日本語Alport症候群モデルマウスにおけるエクソンスキッピング療法の有効性の検討
- 臨床体液研究会, 2019年09月, 臨床体液, 46, 3 - 3, 日本語種々の病態における水電解質異常 診断に苦慮し、遺伝子検査にて確定診断に至った低K血症の1例
- (株)日本小児医事出版社, 2019年08月, 小児科臨床, 72(8) (8), 1030 - 1034, 日本語出生後初回の採血で著明な高K血症を呈した尿路奇形を伴わない続発性偽性低アルドステロン症の1新生児例
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 90 - 90, 日本語Alport症候群モデルマウスにおけるエクソンスキッピング療法の有効性の検討
- (一社)日本小児腎臓病学会, 2019年05月, 日本小児腎臓病学会雑誌, 32(1Suppl.) (1Suppl.), 182 - 182, 日本語WT1遺伝子KTS変異による免疫複合体腎炎の発症機序の検討
- 科学評論社, 2019年05月, 腎臓内科・泌尿器科 = Nephrology & urology, 9(5) (5), 425 - 429, 日本語腎泌尿器の遺伝性疾患 (特集 腎泌尿器の遺伝性疾患・難病医療)
- (公社)日本小児科学会, 2019年02月, 日本小児科学会雑誌, 123(2) (2), 283 - 283, 日本語6つのネフローゼ遺伝子変異が描く治療可能な病態パスウェイ
- (公社)日本小児科学会, 2019年02月, 日本小児科学会雑誌, 123(2) (2), 283 - 283, 日本語6つのネフローゼ遺伝子変異が描く治療可能な病態パスウェイ
- 2019年, 日本小児内分泌学会学術集会プログラム・抄録集, 53rd頭痛・全身倦怠感を主訴に診断されたGitelman症候群の姉弟例
- 2019年, 臨床体液(Web), 46診断に苦慮し,遺伝子検査にて確定診断に至った低K血症の1例
- (株)診断と治療社, 2018年12月, 小児科診療, 81(12) (12), 1723 - 1729, 日本語【難しくない 小児腎領域の難病診療】 小児腎領域の小児慢性特定疾病・指定難病 バーター(Bartter)症候群・ギッテルマン(Gitelman)症候群
- (株)日本医事新報社, 2018年10月, 日本医事新報, (4930) (4930), 61 - 62, 日本語尿細管性アシドーシス1、2型の鑑別はどのように行われるか? 現在は負荷試験なしで遺伝子診断をオーダーすることが多い
- (株)東京医学社, 2018年10月, 腎と透析, 85(4) (4), 568 - 572, 日本語【腎移植-最新の知見】 原因疾患に応じた治療戦略 WT1関連腎炎の術前・術後管理
- 金原出版(株), 2018年09月, 小児科, 59(10) (10), 1409 - 1417, 日本語【小児腎・泌尿器疾患update】 遺伝性尿細管機能異常症
- 2018年07月31日, 日本小児腎不全学会雑誌, 38, 7‐10, 日本語Alport症候群における分子生物学的治療法開発の現状
- (公社)日本小児科学会, 2018年07月, 日本小児科学会雑誌, 122(7) (7), 1256 - 1257, 日本語COQ6遺伝子の複合ヘテロ接合体変異を同定した乳児ネフローゼ症候群の1例
- 日本小児腎不全学会, 2018年07月, 日本小児腎不全学会雑誌, 38, 178 - 181, 日本語片腎摘なしでネフローゼ期の管理を行っているフィンランド型先天性ネフローゼ症候群の男児例
- 金原出版(株), 2018年07月, 小児科, 59(8) (8), 1197 - 1202, 日本語ゲノム情報を臨床へ 遺伝性腎疾患へのアプローチ バイオサイエンスデータベースを使った解析手法
- (公社)日本小児科学会, 2018年07月, 日本小児科学会雑誌, 122(7) (7), 1256 - 1257, 日本語COQ6遺伝子の複合ヘテロ接合体変異を同定した乳児ネフローゼ症候群の1例
- 2018年07月01日, 小児科, 59(8) (8), 1197‐1202, 日本語
- 日本小児高血圧研究会, 2018年06月, 日本小児高血圧研究会誌, 15(1) (1), 21 - 25, 日本語高血圧を呈さず高度蛋白尿が遷延した溶連菌感染後急性糸球体腎炎の1例
- 2018年05月30日, 腎と透析, 84, 358‐360, 日本語遺伝学的検査 2.単一遺伝子疾患 2)Alport症候群
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 102 - 102, 日本語COQ6遺伝子の複合ヘテロ接合体変異を同定した乳児ネフローゼ症候群の一例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 155 - 155, 日本語
- (株)東京医学社, 2018年05月, 腎と透析, 84(増刊) (増刊), 358 - 360, 日本語【腎と透析ベッドサイド検査事典】 (第12章)遺伝学的検査 単一遺伝子疾患 Alport症候群
- (公社)日本小児科学会, 2018年05月, 日本小児科学会雑誌, 122(5) (5), 896 - 902, 日本語3歳児検尿での軽微な蛋白尿を契機に診断した常染色体優性遠位尿細管性アシドーシス
- 日本小児体液研究会, 2018年05月, 日本小児体液研究会誌, 10, 67 - 72, 日本語低身長を契機に診断に至ったGitelman症候群の2例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 73 - 73, 日本語ネフローゼ症候群の病因と病態 ネフローゼ症候群の病因としての遺伝子異常
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 99 - 99, 日本語In vitro実験系を用いたCOL4A5 intron変異の病原性の検討
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 100 - 100, 日本語次世代シークエンサーによるネフロン癆関連シリオパチーの包括的遺伝子解析
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 101 - 101, 日本語Copy Number Variations解析により遺伝学的診断が臨床診断と異なる結果を得た4症例の検討
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 102 - 102, 日本語COQ6遺伝子の複合ヘテロ接合体変異を同定した乳児ネフローゼ症候群の一例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 123 - 123, 日本語NPHP1ホモ全欠失を合併した原発性アルドステロン血症の一例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 147 - 147, 日本語In vitro splicing assayを用いたFrasier症候群の臨床遺伝学的検討
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 154 - 154, 日本語8歳でステロイド抵抗性ネフローゼ症候群を発症し後にNPHS1複合ヘテロ接合体変異が判明した女児例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 154 - 154, 日本語無症候性蛋白尿を契機に診断されたステロイド抵抗性ネフローゼ症候群の原因遺伝子症例の検討
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 155 - 155, 日本語ゲノムワイド関連解析による小児特発性ネフローゼ症候群のrisk haplotype同定
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 156 - 156, 日本語尿中CD80の腎疾患診断マーカーとしての有用性の検討
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 157 - 157, 日本語無症候性蛋白尿を契機に発見されたTRPC6遺伝子変異による巣状糸球体硬化症の女児例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 166 - 166, 日本語男性腎不全の家族歴からネフロン癆関連シリオパチーの診断に至った3歳男児例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 168 - 168, 日本語遺伝学的検査により確定診断され、次子の出生前診断が検討された遺伝性腎疾患の2家系
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 170 - 170, 日本語小児silent lupus nephritisに関する臨床病理学的検討
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 184 - 184, 日本語常染色体劣性型が疑われたが、遺伝子解析の結果X連鎖型Alport症候群と診断された1例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 186 - 186, 日本語溶連菌感染後急性糸球体腎炎罹患後に急速に腎機能障害が進行し末期腎不全に至ったAlport症候群の高校生男児
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 199 - 199, 日本語SLC4A1遺伝子による遠位尿細管性アシドーシスの姉妹例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 200 - 200, 日本語成長ホルモン補充療法中に、低K血症、手足の痺れからGitelman症候群と診断された一例
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 200 - 200, 日本語Gitelman症候群185例における臨床的特徴に関する検討
- (一社)日本小児腎臓病学会, 2018年05月, 日本小児腎臓病学会雑誌, 31(1Suppl.) (1Suppl.), 209 - 209, 日本語不完全型Denys-Drash症候群が疑われる新規遺伝子変異を示した1例
- (一社)日本透析医学会, 2018年05月, 日本透析医学会雑誌, 51(Suppl.1) (Suppl.1), 699 - 699, 日本語慢性硬膜下血腫を契機にGitelman症候群と診断された一例
- 日本遺伝カウンセリング学会, 2018年04月, 日本遺伝カウンセリング学会誌, 39(1) (1), 31 - 36, 日本語未診断疾患における網羅的ゲノム解析時代の遺伝カウンセリング 小児慢性腎臓病(CKD)の原因遺伝子解析と遺伝カウンセリング
- (公社)日本小児科学会, 2018年04月, 日本小児科学会雑誌, 122(4) (4), 814 - 814, 日本語OFD1ヘミ接合性変異を認めたネフロン癆関連シリオパチーの1男児例
- (公社)日本小児科学会, 2018年04月, 日本小児科学会雑誌, 122(4) (4), 814 - 815, 日本語治療方針の決定に疾患パネル解析を用いたステロイド抵抗性ネフローゼ症候群の1例
- (株)診断と治療社, 2018年04月, 小児科診療, 81(増刊) (増刊), 777 - 779, 日本語【小児の治療指針】 腎・尿路 Alport症候群
- (一社)日本内分泌学会, 2018年04月, 日本内分泌学会雑誌, 94(1) (1), 433 - 433, 日本語矮小陰茎、停留精巣、高度蛋白尿を契機に不全型Denys-Drash症候群が疑われた1例
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 285 - 285, 日本語腎臓病領域における希少疾患と指定難病 小児希少疾患の遺伝子解析の意義
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 336 - 336, 日本語X染色体連鎖型Alport症候群男性患者341名の臨床遺伝学的検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 337 - 337, 日本語Gitelman症候群185例における臨床的特徴に関する検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 337 - 337, 日本語次世代シークエンサー解析データを用いたpair解析により診断に至った遺伝性腎疾患例に関する検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 337 - 337, 日本語抗変異MUC1抗体によるADTKD-MUC1診断の可能性
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 338 - 338, 日本語多様な表現型を示したピアソン症候群における遺伝学的・分子生物学的検討
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 344 - 344, 日本語ゲノムワイド関連解析による小児特発性ネフローゼ症候群のrisk haplotype同定
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 344 - 344, 日本語ステロイド抵抗性ネフローゼ症候群における網羅的遺伝子診断体制の構築
- (一社)日本腎臓学会, 2018年04月, 日本腎臓学会誌, 60(3) (3), 421 - 421, 日本語遺伝子解析が診断に有用であったLMX1B関連腎症の1家系
- 日本遺伝カウンセリング学会, 2018年04月, 日本遺伝カウンセリング学会誌, 39(1) (1), 31 - 36, 日本語未診断疾患における網羅的ゲノム解析時代の遺伝カウンセリング 小児慢性腎臓病(CKD)の原因遺伝子解析と遺伝カウンセリング
- 発達腎研究会, 2018年04月, 発達腎研究会誌, 26(1) (1), 8 - 10, 日本語X染色体不活化とDent病
- (有)科学評論社, 2018年02月, 腎臓内科・泌尿器科, 7(2) (2), 148 - 153, 日本語【腎泌尿器領域における個別化医療・精密医療】 ゲノム医療で変わる小児腎領域
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 256 - 256, 日本語次世代シークエンサーを用いたAlport症候群の網羅的診断法の確立
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 257 - 257, 日本語Gitelman症候群の臨床的特徴に関する検討
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 285 - 285, 日本語尿中CD80の腎疾患診断マーカーとしての有用性の検討
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 307 - 307, 日本語小児IgA腎症における蛋白尿再燃因子の検討
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 395 - 395, 英語成長ホルモン補充療法中に診断に至ったGitelman症候群の一例(A case of Gitelman syndrome complicated with growth hormone deficiency)
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 396 - 396, 日本語急速に末期腎不全に至ったACTN4新規遺伝子変異を伴うFSGSの13歳男子
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 396 - 396, 日本語NUP107の複合ヘテロ変異を認めた無症候性蛋白尿の3歳女児
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 397 - 397, 日本語TTC21B遺伝子の複合ヘテロ接合性変異を認めた多発性嚢胞腎の一例
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 445 - 445, 日本語腎動脈ではなく腎末梢動脈狭窄による腎血管性高血圧症と診断し得たもやもや病の1例
- (公社)日本小児科学会, 2018年02月, 日本小児科学会雑誌, 122(2) (2), 446 - 446, 日本語くる病症状、低身長を呈した常染色体優性遠位尿細管性アシドーシスの一例
- 2018年, 日本臨床腎移植学会プログラム・抄録集, 51st, 145, 日本語ドナー選定を考慮した遺伝子診断でBOR症候群と診断された一例
- 2018年, 日本臨床腎移植学会プログラム・抄録集, 51st, 247, 日本語遺伝子検査で原発性オキサローシスを除外した1例
- (株)日本メディカルセンター, 2018年01月, 腎と骨代謝, 31(1) (1), 37 - 43, 日本語
- (公社)日本小児科学会, 2017年12月, 日本小児科学会雑誌, 121(12) (12), 2026 - 2026, 日本語低身長を主訴に発見されたGitelman症候群の姉妹例
- (株)日本医事新報社, 2017年11月, 日本医事新報, (4880) (4880), 38 - 44, 日本語【知っておきたい「子どもの脱水と輸液管理」】 正しい輸液療法のあり方
- (公社)日本小児科学会, 2017年11月, 日本小児科学会雑誌, 121(11) (11), 1898 - 1898, 日本語3型Bartter症候群(3型BS)の2例とGitelman症候群(GS)の2例:臨床診断の限界について
- (株)東京医学社, 2017年11月, 小児内科, 49(増刊) (増刊), 256 - 258, 日本語【小児臨床検査のポイント2017】 腎機能検査 尿細管機能検査 遠位尿細管・集合管機能検査 尿濃縮能、TTKG、フロセミド負荷試験、塩化アンモニウム負荷試験
- (一社)日本小児腎臓病学会, 2017年11月, 日本小児腎臓病学会雑誌, 30(2) (2), 179 - 179, 日本語エクソンスキッピング療法によるアルポート症候群特異的治療法の開発
- (一社)日本小児腎臓病学会, 2017年11月, 日本小児腎臓病学会雑誌, 30(2) (2), 181 - 181, 日本語
- (一社)日本小児腎臓病学会, 2017年11月, 日本小児腎臓病学会雑誌, 30(2) (2), 187 - 188, 日本語
- (一社)日本小児腎臓病学会, 2017年11月, 日本小児腎臓病学会雑誌, 30(2) (2), 200 - 200, 日本語PLCE1遺伝子変異を認めた巣状分節性糸球体硬化症の1歳児例
- (一社)日本小児腎臓病学会, 2017年11月, 日本小児腎臓病学会雑誌, 30(2) (2), 201 - 201, 日本語X連鎖型女性Alport症候群の2例
- (公社)日本小児科学会, 2017年10月, 日本小児科学会雑誌, 121(10) (10), 1739 - 1739, 日本語健診で偶然発見されたGitelman症候群の5歳女児例
- (公社)日本小児科学会, 2017年10月, 日本小児科学会雑誌, 121(10) (10), 1772 - 1772, 日本語CRB2変異によるステロイド抵抗性ネフローゼ症候群(SRNS)の1例
- (一社)日本内分泌学会, 2017年10月, 日本内分泌学会雑誌, 93(2) (2), 592 - 592, 日本語遺伝子診断し得たGitelman症候群の一例
- 日本小児PD・HD研究会, 2017年10月, 日本小児PD・HD研究会雑誌, 29, 31 - 31, 日本語無症候性蛋白尿で発見された末期腎不全に移行した、INF2遺伝子変異によるFSGSの男児例
- 2017年09月, PEDIATRIC NEPHROLOGY, 32(9) (9), 1747 - 1747, 英語NEW COMBINATION THERAPY WITH PREDNISOLONE (PSL), MIZORIBINE AND LISINOPRIL FOR SEVERE CHILDHOOD IGA NEPHROPATHY (IGAN)研究発表ペーパー・要旨(国際会議)
- 2017年09月, PEDIATRIC NEPHROLOGY, 32(9) (9), 1756 - 1756, 英語A VARIETY OF PHENOTYPES REFLECTED BY GENOTYPES AND LAMININ beta 2 EXPRESSION ON GLOMERULUS IN PIERSON SYNDROME研究発表ペーパー・要旨(国際会議)
- 2017年09月, PEDIATRIC NEPHROLOGY, 32(9) (9), 1754 - 1754, 英語IN VITRO SPLICING ASSAYS TO DETECT INTRONIC PATHOGENIC VARIANTS IN INHERITED KIDNEY DISEASES研究発表ペーパー・要旨(国際会議)
- (有)科学評論社, 2017年09月, 腎臓内科・泌尿器科, 6(3) (3), 245 - 248, 日本語各種疾患の移行医療 現状と課題 ネフローゼ症候群と移行医療
- (一社)日本腎臓学会, 2017年09月, 日本腎臓学会誌, 59(6) (6), 723 - 723, 日本語EYA1遺伝子欠損による鰓弓耳腎症候群の1例
- (一社)日本腎臓学会, 2017年09月, 日本腎臓学会誌, 59(6) (6), 857 - 857, 日本語遺伝性腎疾患における遺伝子診断の現状とこれからの課題
- (一社)日本腎臓学会, 2017年09月, 日本腎臓学会誌, 59(6) (6), 871 - 871, 日本語TGFBI関連眼腎症候群の1例 顆粒状角膜ジストロフィII型と腎症の合併例
- (一社)日本腎臓学会, 2017年09月, 日本腎臓学会誌, 59(6) (6), 875 - 875, 日本語シクロスポリンの効果は一時的であったACTN4新規遺伝子変異を伴うFSGS男児例
- (一社)日本腎臓学会, 2017年09月, 日本腎臓学会誌, 59(6) (6), 906 - 906, 日本語糖尿病合併のないA3243G変異ミトコンドリア病によるFSGSの一例
- (一社)日本腎臓学会, 2017年09月, 日本腎臓学会誌, 59(6) (6), 928 - 928, 日本語腎病理所見にて髄質嚢胞腎(MCKD)の特徴を認めた2例
- 日本小児高血圧研究会, 2017年06月, 日本小児高血圧研究会誌, 14(1) (1), 32 - 36, 日本語蛋白尿、高血圧を認め24時間自由行動下血圧測定を施行した極低出生体重の1例
- (有)科学評論社, 2017年06月, 腎臓内科・泌尿器科, 5(6) (6), 570 - 573, 日本語【腎再生医療】 遺伝性腎疾患と分子生物学的治療
- (公社)日本小児科学会, 2017年05月, 日本小児科学会雑誌, 121(5) (5), 903 - 903, 日本語ナットクラッカー現象を合併した起立性蛋白尿の1例
- (公社)日本小児科学会, 2017年05月, 日本小児科学会雑誌, 121(5) (5), 908 - 908, 日本語成長障害の経過観察中に四肢麻痺をきたし診断に至った尿細管性アシドーシスの1例
- (公社)日本小児科学会, 2017年05月, 日本小児科学会雑誌, 121(5) (5), 913 - 913, 日本語24時間自由行動下血圧測定が高血圧診療に有用であった1例
- 日本遺伝カウンセリング学会, 2017年05月, 日本遺伝カウンセリング学会誌, 38(2) (2), 55 - 55, 日本語未診断疾患における網羅的ゲノム解析時代の遺伝カウンセリング 小児CKD(慢性腎臓病)の原因遺伝子解析と遺伝カウンセリング
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 63 - 63, 日本語ゲノム情報を臨床へ 遺伝性腎疾患へのアプローチ バイオサイエンスデータベースを使った解析手法
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 102 - 102, 日本語エクソンスキッピング療法によるアルポート症候群特異的治療法の開発
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 106 - 106, 日本語
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 153 - 153, 日本語
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 174 - 174, 日本語Lowe症候群およびDent2の分子生物学的検討
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 181 - 181, 日本語先天性ネフローゼ症候群/乳児ネフローゼ症候群およびステロイド抵抗性ネフローゼ症候群における網羅的遺伝子診断体制の構築
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 186 - 186, 日本語In vivoおよびin vitroの解析によりsplicing異常による疾患発症を証明したフィブロネクチン腎症の一例
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 187 - 187, 日本語無症候性蛋白尿を呈し次世代シークエンサーにてNPHS1遺伝子異常を同定した女児例
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 210 - 210, 日本語C1qの沈着を伴った常染色体優性Alport症候群の1例
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 211 - 211, 日本語Alport症候群9家系の臨床的検討
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 211 - 211, 日本語minigeneを用いた遺伝性腎疾患におけるpathogenic splicing variantの同定
- (一社)日本小児腎臓病学会, 2017年05月, 日本小児腎臓病学会雑誌, 30(1Suppl.) (1Suppl.), 212 - 212, 日本語NGSターゲット遺伝子シークエンスパネルによるCAKUTおよびNPHの包括的原因遺伝子解析
- (株)診断と治療社, 2017年04月, 小児科診療, 80(増刊) (増刊), 334 - 337, 日本語【小児科ケースカンファレンス】 腎・泌尿器疾患、生殖器疾患 Gitelman症候群
- 発達腎研究会, 2017年04月, 発達腎研究会誌, 25(1) (1), 34 - 36, 日本語マイクロRNAによる多発性嚢胞腎疾患特異的治療の検討
- (公社)日本小児科学会, 2017年04月, 日本小児科学会雑誌, 121(4) (4), 780 - 780, 日本語偶然見つかったGitelman症候群の2例
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 185 - 185, 日本語Alport症候群の臨床遺伝学的研究
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 205 - 205, 日本語難治性腎疾患における新規治療標的分子 遺伝性疾患におけるエクソンスキッピング療法の現状と腎疾患への応用の可能性
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 218 - 218, 日本語NPH・MCKDの遺伝子診断と病型
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 251 - 251, 日本語小児IgA腎症における糸球体毛細管係蹄(cap)IgA沈着の臨床病理学的検討
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 252 - 252, 日本語医師主導治験でリツキシマブの投与を行った小児期発症難治性ネフローゼ症候群患者の長期予後
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 257 - 257, 日本語女性Dent病における遺伝学的背景
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 314 - 314, 日本語次世代シークエンサーを用いたAlport症候群の網羅的診断法の確立
- (一社)日本腎臓学会, 2017年04月, 日本腎臓学会誌, 59(3) (3), 314 - 314, 日本語NGSターゲット遺伝子シークエンスパネルによるCAKUTおよびNPHの包括的原因遺伝子解析
- (一社)日本小児腎臓病学会, 2017年04月, 日本小児腎臓病学会雑誌, 30(1) (1), 54 - 59, 日本語
- 2017年04月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 21(2) (2), 193 - 202, 英語[査読有り]書評論文,書評,文献紹介等
- (株)東京医学社, 2017年03月, 腎と透析, 82(3) (3), 383 - 388, 日本語【腎臓医が知っておきたい分子遺伝学の進歩】 疾患編 Alport症候群
- (公社)日本小児科学会, 2017年02月, 日本小児科学会雑誌, 121(2) (2), 187 - 187, 日本語若い先生に「リサーチマインドを」 明日の小児科を築くPhysician scientistを 遺伝性腎疾患の研究から学んだ大切なこと 研究の楽しさと臨床へのフィードバック
- (公社)日本小児科学会, 2017年02月, 日本小児科学会雑誌, 121(2) (2), 235 - 235, 日本語下痢関連溶血性尿毒症症候群(D+HUS)の急性期経過と予後
- (公社)日本小児科学会, 2017年02月, 日本小児科学会雑誌, 121(2) (2), 236 - 236, 日本語小児期にCKDに至ったX染色体連鎖型Alport症候群の女児例
- (公社)日本小児科学会, 2017年02月, 日本小児科学会雑誌, 121(2) (2), 420 - 420, 日本語腎外症状を呈さないCRB2変異によるステロイド抵抗性ネフローゼ症候群(SRNS)の1例
- (一社)日本内分泌学会, 2016年12月, 日本内分泌学会雑誌, 92(S.Branc) (S.Branc), 355 - 355, 日本語NCCT機能異常を伴う偽性副甲状腺機能低下症の一例
- (株)文光堂, 2016年12月, 病理と臨床, 34(12号) (12号), 1317 - 1325, 日本語【腎生検病理診断の実際と新たな展開】 遺伝性腎疾患の最近の進歩[査読有り]記事・総説・解説・論説等(学術雑誌)
- (一社)日本小児腎臓病学会, 2016年11月, 日本小児腎臓病学会雑誌, 29(2) (2), 137 - 141, 日本語
- (一社)日本小児腎臓病学会, 2016年11月, 日本小児腎臓病学会雑誌, 29(2) (2), 180 - 180, 日本語
- (一社)日本小児腎臓病学会, 2016年11月, 日本小児腎臓病学会雑誌, 29(2) (2), 182 - 182, 日本語女性のDent病患者2例における発症機序に関する考察
- (一社)日本小児腎臓病学会, 2016年11月, 日本小児腎臓病学会雑誌, 29(2号) (2号), 109 - 113, 日本語[査読有り]記事・総説・解説・論説等(学術雑誌)
- 2016年10月, PEDIATRIC NEPHROLOGY, 31(10) (10), 1819 - 1819, 英語Crescentic IgA Nephropathy in children.研究発表ペーパー・要旨(国際会議)
- 2016年10月, PEDIATRIC NEPHROLOGY, 31(10) (10), 1751 - 1751, 英語Genetic and clinical characteristics of female X-linked Alport syndrome: 267 cases study研究発表ペーパー・要旨(国際会議)
- 2016年10月, PEDIATRIC NEPHROLOGY, 31(10) (10), 1870 - 1870, 英語Clinical characteristics and long term outcome of diarrhea associated hemolytic uremic syndrome研究発表ペーパー・要旨(国際会議)
- 2016年10月, PEDIATRIC NEPHROLOGY, 31(10) (10), 1831 - 1832, 英語Genetic approach to the siblings with congenital/infantile nephrotic syndrome by targeted resequencing研究発表ペーパー・要旨(国際会議)
- (株)東京医学社, 2016年10月, 小児内科, 48(10号) (10号), 1618 - 1620, 日本語【慢性疾患児の一生を診る】 腎尿路疾患 Bartter症候群・Gitelman症候群[査読有り][招待有り]記事・総説・解説・論説等(学術雑誌)
- 日本小児腎不全学会, 2016年07月, 日本小児腎不全学会雑誌, 36, 331 - 334, 日本語遺伝子解析により早期診断に至ったGitelman症候群の2例
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 174 - 174, 日本語
- (一社)日本小児腎臓病学会, 2016年06月, 日本小児腎臓病学会雑誌, 29(1Suppl.) (1Suppl.), 95 - 95, 日本語平滑筋腫を合併したアルポート症候群の臨床像と遺伝学的検討
- 2016年06月, 腎と透析, 80(増刊) (増刊), 272 - 276, 日本語【腎と透析診療指針2016】 (第8章)その他の糸球体疾患 Alport症候群[査読有り]記事・総説・解説・論説等(学術雑誌)
- 発達腎研究会, 2016年04月, 発達腎研究会誌, 24(1) (1), 13 - 15, 日本語次世代シークエンサーを用いた先天性腎尿路奇形(CAKUT)の原因遺伝子解析[査読有り]記事・総説・解説・論説等(学術雑誌)
- 2016年04月, 小児科診療, 79(増刊) (増刊), 300, 日本語【小児の症候群】 腎・泌尿器 Gitelman症候群[査読有り]記事・総説・解説・論説等(学術雑誌)
- 2016年04月, 小児科診療, 79(増刊) (増刊), 294, 日本語【小児の症候群】 腎・泌尿器 Bartter症候群[査読有り][招待有り]記事・総説・解説・論説等(学術雑誌)
- 2016年, 日本小児腎不全学会学術集会プログラム・抄録集, 38th常染色体劣性型か常染色体優性型かの判別に苦慮したAlport症候群の一女児例
- (一社)日本内分泌学会, 2015年12月, 日本内分泌学会雑誌, 91(Suppl.Branch) (Suppl.Branch), 119 - 119, 日本語腰部脊柱管狭窄症により顕性化し、負荷試験と遺伝子検査で確定診断できた高齢者Gitelman症候群の1例
- 2015年09月, PEDIATRIC NEPHROLOGY, 30(9) (9), 1669 - 1669, 英語GENETIC, PATHOLOGICAL AND CLINICAL BACKGROUNDS IN AUTOSOMAL DOMINANT ALPORT SYNDROME研究発表ペーパー・要旨(国際会議)
- (一社)日本小児腎臓病学会, 2015年06月, 日本小児腎臓病学会雑誌, 28(1Suppl.) (1Suppl.), 152 - 152, 日本語Branchio-oto-renal(BOR)症候群の原因遺伝子と腎症状に関する検討
- (一社)日本小児腎臓病学会, 2015年06月, 日本小児腎臓病学会雑誌, 28(1Suppl.) (1Suppl.), 90 - 90, 日本語cpkマウスにおける嚢胞形成に対するsmad3ノックアウトの効果
- 2015年06月, 内科, 115(6号) (6号), 1036, 日本語【内科疾患の診断基準・病型分類・重症度】(第3章)腎臓 診断メモ 先天性ネフローゼ/乳児ネフローゼ症候群記事・総説・解説・論説等(学術雑誌)
- 2015年06月, 内科, 115(6号) (6号), 1039, 日本語【内科疾患の診断基準・病型分類・重症度】(第3章)腎臓 診断メモ Bartter症候群・Gitelman症候群 遺伝性塩類喪失性尿細管機能異常症記事・総説・解説・論説等(学術雑誌)
- 2015年06月, 内科, 115(6号) (6号), 1037, 日本語【内科疾患の診断基準・病型分類・重症度】(第3章)腎臓 診断メモ Alport症候群記事・総説・解説・論説等(学術雑誌)
- (一社)日本小児腎臓病学会, 2015年06月, 日本小児腎臓病学会雑誌, 28(1Suppl.) (1Suppl.), 124 - 124, 日本語RAAS blockの開始時期により腎機能の経過が異なった常染色体劣性Alport症候群の3姉弟例
- (一社)日本腎臓学会, 2015年04月, 日本腎臓学会誌, 57(3) (3), 458 - 458, 日本語Branchio-oto-renal(BOR)症候群の原因遺伝子と腎症状に関する検討
- 発達腎研究会, 2015年04月, 発達腎研究会誌, 23(1) (1), 15 - 18, 日本語cpkマウスにおける嚢胞形成に対するsmad3ノックアウトの効果
- 2015年04月, Medical Practice, 32(臨増) (臨増), 114 - 116, 日本語【病態生理と症例から学ぶ輸液ガイド】 (第2章)身につけておきたい水・電解質輸液の基本手技 経口補水療法の行いかた記事・総説・解説・論説等(学術雑誌)
- 発達腎研究会, 2015年04月, 発達腎研究会誌, 23(1) (1), 19 - 22, 日本語ヒトCAKUTの原因遺伝子解析記事・総説・解説・論説等(学術雑誌)
- (一社)日本内分泌学会, 2015年04月, 日本内分泌学会雑誌, 91(1) (1), 296 - 296, 日本語妊娠中の低カリウム性筋症出現を契機に診断されたGitelman症候群の1例
- (一社)日本内分泌学会, 2015年04月, 日本内分泌学会雑誌, 91(1) (1), 332 - 332, 日本語甲状腺中毒性周期性四肢麻痺を契機にGitelman症候群と診断された一例
- (公社)日本小児科学会, 2015年03月01日, 日本小児科学会雑誌, 119(3) (3), 635 - 635, 日本語トピラマート開始後著明な尿細管性アシドーシスと低身長の増悪を認めた1例
- 2015年01月, Annual Review腎臓, 2015, 75 - 79, 日本語Basic nephrology 分子生物学 Alport症候群の軽症亜型記事・総説・解説・論説等(学術雑誌)
- 2014年12月, PEDIATRIC NEPHROLOGY, 29(12) (12), 2443 - 2443, 英語Differential diagnosis of Bartter/Gitelman syndrome and pseudo-disorder based on clinical characteristics研究発表ペーパー・要旨(国際会議)
- 2014年09月, PEDIATRIC NEPHROLOGY, 29(9) (9), 1683 - 1683, 英語X-linked Alport syndrome patients caused by atypical splicing mutations in COL4A5研究発表ペーパー・要旨(国際会議)
- 2014年09月, PEDIATRIC NEPHROLOGY, 29(9) (9), 1684 - 1685, 英語The comprehensive genetic analysis of CAKUT in Japan研究発表ペーパー・要旨(国際会議)
- 2014年08月, 腎と透析, 77(2号) (2号), 207 - 209, 日本語【腎のたまり病】 アミロイド以外の蛋白由来物質が蓄積する疾患 フィブロネクチン関連腎症の診断と治療[査読有り]記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2014年07月, 小児科学レクチャー, 4(3号) (3号), 539 - 547, 日本語【わかる輸液-体液の生理を知り、正しい輸液オーダーができる!-】 基礎知識編 維持輸液の役割記事・総説・解説・論説等(学術雑誌)
- 診断と治療社, 2014年06月, 小児科診療, 77(6号) (6号), 743 - 748, 日本語【日常診療で遭遇する小児腎泌尿器疾患とトピックス】 尿細管疾患・嚢胞性腎疾患 Bartter症候群・Gitelman症候群の診断アプローチおよび偽性Bartter症候群・偽性Gitelman症候群の診断のポイント[査読有り]記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2014年06月, 内科, 113(6号) (6号), 1172 - 1173, 日本語【内科疾患 最新の治療 明日への指針】(第3章)腎臓 Alport症候群[査読有り]記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- (公社)日本小児科学会, 2014年05月, 日本小児科学会雑誌, 118(5) (5), 876 - 876, 日本語マイコプラズマ肺炎を契機に診断されたGitelman症候群の1例
- 発達腎研究会, 2014年04月, 発達腎研究会誌, 22(1) (1), 15 - 17, 日本語cpkマウスにおける病的Smad3リン酸化
- (一社)日本小児腎臓病学会, 2014年04月, 日本小児腎臓病学会雑誌, 27(1Suppl.) (1Suppl.), 127 - 127, 日本語
- 2014年04月, 小児科診療, 77(増刊) (増刊), 754 - 756, 日本語【小児の治療指針】 腎・尿路 Alport症候群[査読有り]記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2013年09月, 小児内科, 45(9号) (9号), 1704 - 1708, 日本語【クローズアップ 症例でみる水電解質異常】 低マグネシウム血症 遺伝性低マグネシウム血症記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2013年09月, 小児内科, 45(9号) (9号), 1612 - 1616, 日本語【クローズアップ 症例でみる水電解質異常】 低カリウム血症 Bartter症候群、Gitelman症候群記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2013年07月, 腎と骨代謝, 26(3号) (3号), 237 - 244, 日本語【尿細管トランスポーターの機能制御と疾患治療-トピックス】 Bartter症候群・Gitelman症候群 遺伝性塩類喪失性尿細管機能異常症(salt-losing tubulopathy)[査読有り]記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2013年05月, 小児内科, 45(5号) (5号), 940 - 941, 日本語【クローズアップ 負荷試験の実際2013】 腎機能検査 フロセミド負荷試験(尿酸性化能)記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- (一社)日本小児腎臓病学会, 2013年05月, 日本小児腎臓病学会雑誌, 26(1Suppl.) (1Suppl.), 196 - 196, 日本語記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2013年04月, 腎と透析, 74(増刊) (増刊), 280 - 282, 日本語【腎疾患治療薬マニュアル2013-14】 腎疾患に対する薬剤の使用方法 Bartter症候群、Gitelman症候群記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2013年01月, Annual Review腎臓, 2013, 193 - 203, 日本語Clinical nephrology 尿細管・間質障害 先天性尿細管チャネル・輸送体異常の新たな分子機構記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- 2012年01月, 日本臨床, (別冊腎臓症候群(上)) (別冊腎臓症候群(上)), 773 - 779, 日本語【腎臓症候群(第2版)上-その他の腎臓疾患を含めて-】 尿細管輸送異常症 Bartter症候群・Gitelman症候群(遺伝性塩類喪失性尿細管機能異常症)記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)
- (公社)日本小児科学会, 2011年10月, 日本小児科学会雑誌, 115(10) (10), 1596 - 1596, 日本語低カリウム(K)血性横紋筋融解症をきたしたGitelman症候群(GS)の女子
- 2011年05月, PEDIATRIC NEPHROLOGY, 26(5) (5), 827 - 827, 英語A family with benign familial hematuria of X-linked dominant inheritance研究発表ペーパー・要旨(国際会議)
- 2011年05月, PEDIATRIC NEPHROLOGY, 26(5) (5), 828 - 828, 英語Clinical and immunohistochemical analyses of Japanese families with autosomal alport syndrome研究発表ペーパー・要旨(国際会議)
- (公社)日本小児科学会, 2011年03月, 日本小児科学会雑誌, 115(3) (3), 665 - 665, 日本語検尿異常を契機に発見された腎盂内結石を伴う腎性低尿酸血症の1女児例
- 2010年12月, PEDIATRIC NEPHROLOGY, 25(12) (12), 2556 - 2556, 英語A MALE X-LINKED ALPORT SYNDROME WITH A DELETION OF COL4A5 GENE, EXPRESSING NORMAL PATTERN OF TYPE IV COLLAGEN ALPHA 5 CHAINS IN GBM研究発表ペーパー・要旨(国際会議)
- 国立病院総合医学会, 2010年11月, 国立病院総合医学会講演抄録集, 64回, 368 - 368, 日本語当科におけるアルポート症候群の臨床病理学的検討
- 2010年09月, PEDIATRIC NEPHROLOGY, 25(9) (9), 1824 - 1824, 英語Clinical Characteristics of Genetically-Proven Gitelman's Syndrome研究発表ペーパー・要旨(国際会議)
- 2010年09月, PEDIATRIC NEPHROLOGY, 25(9) (9), 1879 - 1879, 英語Treatment Strategy and Outcome for Henoch-Schonlein Purpura Nephritis研究発表ペーパー・要旨(国際会議)
- 2010年09月, PEDIATRIC NEPHROLOGY, 25(9) (9), 1796 - 1796, 英語Natural Remission Rate and Prognostic Factors in Childhood IgA Nephropathy with Minimal Change or Focal Mesangial Proliferation研究発表ペーパー・要旨(国際会議)
- 2010年08月31日, 日本小児腎不全学会雑誌 : 小児腎不全研究会記事, 30, 145 - 146, 日本語運動後急性腎不全とPRES (Posterior reversible encephalopathy syndrome) の合併を反復した腎性低尿酸血症の1例
- 2010年08月31日, 日本小児腎不全学会雑誌 : 小児腎不全研究会記事, 30, 32 - 33, 日本語腎移植後の巣状分節性糸球体硬化症 (FSGS) 再発
- 日本小児腎不全学会, 2010年08月, 日本小児腎不全学会雑誌, 30(0) (0), 178 - 180, 日本語集学的治療により救命しえたPotter sequenceの1例
- 日本小児腎不全学会, 2010年08月, 日本小児腎不全学会雑誌, 30, 29 - 31, 日本語多くの困難を抱えた小児腎移植の検討 FSGSの二次生体腎移植 症例提示
- 発達腎研究会, 2010年07月, 発達腎研究会誌, 18(1) (1), 10 - 13, 日本語
- (公社)日本小児科学会, 2010年07月, 日本小児科学会雑誌, 114(7) (7), 1096 - 1096, 日本語低カリウム(K)血性横紋筋融解症をきたしたGitelman症候群(GS)の女子
- (一社)日本小児腎臓病学会, 2010年06月, 日本小児腎臓病学会雑誌, 23(1Suppl.) (1Suppl.), 135 - 135, 日本語
- (一社)日本腎臓学会, 2010年05月, 日本腎臓学会誌, 52(3) (3), 383 - 383, 日本語ヒトARPKDと相同遺伝子変異を有するPCK ratにおける上皮間葉移行
- (一社)日本腎臓学会, 2010年05月, 日本腎臓学会誌, 52(3) (3), 302 - 302, 日本語平滑筋腫合併アルポート症候群(DL-AS)の遺伝学的検討
- 2010年04月, Pediatric Research, 67(4) (4), 444 - 445, 英語速報,短報,研究ノート等(学術雑誌)
- (公社)日本小児科学会, 2010年02月, 日本小児科学会雑誌, 114(2) (2), 230 - 230, 日本語Gitelman症候群の小児にみられた低カリウム血性横紋筋融解症
- 2009年11月15日, 日本小児腎臓病学会雑誌 = Japanese journal of pediatric nephrology, 22(2) (2), 219 - 219, 日本語腎性低尿酸血症における運動後急性腎不全の病因に関する検討 : 運動負荷時の酸化ストレス度と抗酸化力の不均衡
- 一般社団法人 日本小児腎臓病学会, 2009年11月15日, 日本小児腎臓病学会雑誌 = Japanese journal of pediatric nephrology, 22(2) (2), 131 - 135, 日本語IPEX症候群と腎疾患
- (一社)日本小児腎臓病学会, 2009年11月, 日本小児腎臓病学会雑誌, 22(2) (2), 226 - 228, 日本語1998〜2005年末までの期間に発生した15歳未満の末期腎不全症例の2007年末の状態に関する追跡調査 集計結果の報告その他
- 2009年08月31日, 日本小児腎不全学会雑誌 : 小児腎不全研究会記事, 29, 120 - 121, 日本語運動後急性腎不全 (ALPE) を呈しPRES (Posterior Reversible Encephalopathy Syndrome) を合併した腎性低尿酸血症の1例
- 2009年08月31日, 日本小児腎不全学会雑誌 : 小児腎不全研究会記事, 29, 198 - 200, 日本語当院にて2007年以降に経験した小児献腎移植の4例
- 日本小児腎不全学会, 2009年08月, 日本小児腎不全学会雑誌, 29, 179 - 182, 日本語多重リスクに対し検討を重ね二次生体腎移植に成功した巣状分節性糸球体硬化症の1小児例
- 2009年07月01日, 日本小児科学会雑誌, 113(7) (7), 1177 - 1178, 日本語急性膵炎を契機に発見されたGitelman症候群の1例
- 金原出版, 2009年06月, 小児科, 50(7) (7), 1017 - 1021, 日本語Alport症候群 (特集 小児疾患における臨床遺伝学の進歩) -- (話題の疾患遺伝子)
- (一社)日本小児腎臓病学会, 2009年06月01日, 日本小児腎臓病学会雑誌, 22(1) (1), 138 - 138, 日本語遺伝性腎疾患におけるintron内の変異に伴う病気発症メカニズム解明のためのin vivoおよびin vitroの実験系の確立
- (一社)日本小児腎臓病学会, 2009年06月01日, 日本小児腎臓病学会雑誌, 22(1) (1), 98 - 98, 日本語IPEX症候群に微小変化型ネフローゼ症候群を合併した1症例
- (一社)日本小児腎臓病学会, 2009年06月, 日本小児腎臓病学会雑誌, 22(1Suppl.) (1Suppl.), 138 - 138, 日本語
- (一社)日本小児腎臓病学会, 2009年06月, 日本小児腎臓病学会雑誌, 22(1Suppl.) (1Suppl.), 104 - 104, 日本語腎移植後巣状分節性糸球体硬化症(FSGS)再発高リスク小児例に対する腎移植前予防的治療の試み
- 日本小児医事出版社, 2009年06月, 小児科臨床, 62巻, 6号, pp. 1039-1044(6) (6), 1037 - 1071, 日本語【腎・泌尿器疾患の診断・治療Update】 腎疾患の遺伝子診断 どこまで明らかにされたか?Alport症候群を中心に記事・総説・解説・論説等(学術雑誌)
- (一社)日本腎臓学会, 2009年04月, 日本腎臓学会誌, 51(3) (3), 272 - 272, 日本語ヒトARPKD相同遺伝子ラットモデルにおける尿細管部位特異的嚢胞形成
- 2009年04月, 小児科診療, 72巻, 増刊, pp. 377-377, 日本語【小児の症候群】 腎・泌尿器 Gitelman症候群記事・総説・解説・論説等(学術雑誌)
- 診断と治療社, 2009年04月, 小児科診療, 72巻, 増刊, pp. 370-370, 367 - 395, 日本語【小児の症候群】 腎・泌尿器 Bartter症候群記事・総説・解説・論説等(学術雑誌)
- (一社)日本小児腎臓病学会, 2009年04月, 日本小児腎臓病学会雑誌, 22巻, 1号, pp. 24-28(1) (1), 24 - 28, 日本語記事・総説・解説・論説等(学術雑誌)
- 2009年02月, 小児内科, 41巻, 2号, pp. 213-220, 日本語【小児腎疾患の診断・治療戦略】 腎疾患の診断における遺伝子解析の有用性記事・総説・解説・論説等(学術雑誌)
- 2008年11月, 小児内科, 40巻, 増刊, pp. 923-927, 日本語【小児疾患診療のための病態生理】 腎・泌尿器疾患 Bartter症候群とGitelman症候群記事・総説・解説・論説等(学術雑誌)
- (一社)日本移植学会, 2008年09月, 移植, 43(総会臨時) (総会臨時), 346 - 346, 日本語多重リスクに対し検討を重ね二次生体腎移植を行った巣状分節性糸球体硬化症の1小児例
- 2008年09月, 病理と臨床, 26巻, 9号, pp. 898-903, 日本語【小児病理 最近のトピックス】 小児腎疾患の遺伝子異常と病理 Alport症候群とWT1関連腎症を例として記事・総説・解説・論説等(学術雑誌)
- 日本小児腎不全学会, 2008年08月, 日本小児腎不全学会雑誌, 28, 205 - 207, 日本語
- 日本小児科学会, 2008年07月, 日本小児科学会雑誌, 112巻, 7号, pp. 1059-1067(7) (7), 1059 - 1067, 日本語Bartter症候群の病因病態 遺伝子解析から見えてきたもの[査読有り]記事・総説・解説・論説等(学術雑誌)
- 2008年05月, 腎と透析, 64巻, 5号, pp. 796-798, 日本語【透析トラブルQ&A】 透析患者の保育園、幼稚園、学校生活での注意点を教えてください記事・総説・解説・論説等(学術雑誌)
- (一社)日本インターベンショナルラジオロジー学会, 2008年04月, IVR: Interventional Radiology, 23(2) (2), 217 - 217, 日本語ゼラチンスポンジによる塞栓を行った腎生検後の仮性動脈瘤の1例
- 診断と治療社, 2008年02月, 小児科診療, 71(2) (2), 305 - 310, 日本語Bartter症候群,Gitelman症候群 (特集 腎・尿路疾患--ABCと新たな展開) -- (尿細管疾患の病態と治療)
- 2008年02月, CLINICAL AND EXPERIMENTAL NEPHROLOGY, 12(1) (1), 16 - 19, 英語[査読有り]書評論文,書評,文献紹介等
- (一社)日本内分泌学会, 2007年12月, 日本内分泌学会雑誌, 83(3) (3), 792 - 792, 日本語スプライシング異常が確認できたGitelman症候群の一例
- 2007年09月, PEDIATRIC NEPHROLOGY, 22(9) (9), 1492 - 1492, 英語Identification of 6 novel mutations in the COL4A5 gene of Japanese patients with X-linked alport syndrome研究発表ペーパー・要旨(国際会議)
- 2007年09月, PEDIATRIC NEPHROLOGY, 22(9) (9), 1524 - 1524, 英語Transient elevation of plasma antidiuretic hormone level after kidney biopsy associated with iatrogenic hyponatremia or postoperative nausea and vomit研究発表ペーパー・要旨(国際会議)
- 2007年09月, PEDIATRIC NEPHROLOGY, 22(9) (9), 1488 - 1488, 英語Molecular analysis of 5 Japanese patients with type III bartter syndrome研究発表ペーパー・要旨(国際会議)
- 2007年09月, 腎と透析, 63巻, 3号, pp. 407-414, 日本語Bartter症候群、Gitelman症候群の遺伝子解析からみえてきたこと記事・総説・解説・論説等(学術雑誌)
- 2007年05月, PEDIATRIC TRANSPLANTATION, 11, 85 - 85, 英語Long-term outcome of focal segmental glomerulosclerosis after living-related pediatric renal transplantation.研究発表ペーパー・要旨(国際会議)
- 2007年04月, 日本小児腎臓病学会雑誌, 20巻, 1号, pp. 21-25, 日本語記事・総説・解説・論説等(学術雑誌)
- (株)東京医学社, 2006年12月, 腎と透析, 61巻, 6号, pp. 835-840(6) (6), 819 - 821, 日本語【腎・泌尿器疾患領域における遺伝子解析】 Bartter症候群記事・総説・解説・論説等(学術雑誌)
- (一社)日本TDM学会, 2006年04月, TDM研究, 23(2) (2), 89 - 90, 日本語
- (公社)日本小児科学会, 2006年04月01日, 日本小児科学会雑誌, 110(4) (4), 583 - 584, 日本語巣状分節状糸球体硬化症のフォロー中に発症したBasedow病の1例
- 2006年02月, PEDIATRIC NEPHROLOGY, 21(2) (2), 194 - 200, 英語記事・総説・解説・論説等(学術雑誌)
- 2006年01月, Annual Review腎臓, 2006巻, pp.180-189, 日本語小児領域 Bartter症候群の表現型,遺伝子型の相関記事・総説・解説・論説等(学術雑誌)
- 2005年12月, 腎と透析, 59巻, 増刊, pp. 72-76, 日本語【ネフローゼ症候群のすべて】 基礎 実験モデル 糸球体透過性因子の最近の動向記事・総説・解説・論説等(学術雑誌)
- 2005年07月, PEDIATRIC NEPHROLOGY, 20(7) (7), 910 - 913, 英語[査読有り]記事・総説・解説・論説等(学術雑誌)
- 金原出版, 2005年06月, 小児科, 46巻, 7号, pp.1179-1184(7) (7), 1179 - 1184, 日本語非典型的膜性増殖性糸球体腎炎の治療と予後記事・総説・解説・論説等(学術雑誌)
- Background: The angiotensin converting enzyme (ACE) gene carries insertion (I)and deletion (D) polymorphism within its intron 16. The presence of D-allele in theACE gene has been reported as a probable genetic risk factor for idiopathic nephroticsyndrome神戸大学医学部, 2005年, The Kobe Journal Of Medical Sciences, Vol. 51, No. 3-4, pp. 41-47(3) (3), 41 - 47, 英語[査読有り]記事・総説・解説・論説等(学術雑誌)
- 南江堂, 2004年05月, 内科, 93巻, 5号, pp. 960-963(5) (5), 959 - 963, 日本語目でみる症例 小児IgA腎症記事・総説・解説・論説等(学術雑誌)
- 2004年02月, 小児内科, 36巻, 2号, pp. 330-333, 日本語【腎炎・ネフローゼ:そこが知りたい】 cyclosporineはトラフ値の測定がこれまで重要とされてましたが,最近はいかがですか?記事・総説・解説・論説等(学術雑誌)
- 2003年11月, JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 14, 103A - 103A, 英語Genetic linkage analysis of candidate loci in Japanese families with steroid resistant nephrotic syndrome.研究発表ペーパー・要旨(国際会議)
- 日本医療薬学会, 2003年09月01日, 日本医療薬学会年会講演要旨集, 13, 152 - 152, 日本語28-04-03 小児患者におけるシクロスポリン C2 モニタリングに関する検討
- 2003年, 日本小児腎不全学会雑誌, 23巻, 8, pp. 200-203, 日本語移植後リンパ球増殖性疾患(PTLD)の再発時にrituximabを投与し著効した1例記事・総説・解説・論説等(学術雑誌)
- 2002年09月, JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 13, 305A - 305A, 英語A new mutation of Na-K-2Cl cotransportor gene (NKCC2) in antenatal Bartter syndrome with renal failure.研究発表ペーパー・要旨(国際会議)
- 2002年09月, JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 13, 631A - 631A, 英語Pharmacokineties of neutral in pediatric patients.研究発表ペーパー・要旨(国際会議)
- 金原出版, 2002年08月, 小児科, 43(8) (8), 1014 - 1021, 日本語小児急性腎不全における静脈栄養 (特集 小児期急性腎不全の治療)
- 第47回日本腎臓学会東部学術集会, 2017年10月, 日本語, 日本腎臓学会, 横浜, 国内会議遺伝性腎疾患における遺伝子診断の現状とこれからの課題口頭発表(招待・特別)
- 第47回日本腎臓学会東部学術集会, 2017年10月, 日本語, 日本腎臓学会, 横浜, 国内会議シクロスポリンの効果は一時的であったACTN4新規遺伝子変異を伴うFSGS男児例[招待有り]口頭発表(一般)
- ASN Kidney Week 2017, 2017年10月, 英語, American Society of Nephrology, New Orleans, USA, 国際会議The comprehensive gene screening for congenital, infantile, and steroid resistant nephrotic syndrome in Japan[招待有り]ポスター発表
- 第47回日本腎臓学会東部学術集会, 2017年10月, 日本語, 日本腎臓学会, 横浜, 国内会議TGFBI関連眼腎症候群の1例:顆粒状角膜ジストロフィII型と腎症の合併例[招待有り]口頭発表(一般)
- ・第38回日本小児腎不全学会, 2017年09月, 日本語, 日本小児腎不全学会, 淡路, 国内会議治療方針の決定に疾患パネル解析を用いたステロイド抵抗性ネフローゼ症候群の1例[招待有り]口頭発表(一般)
- ・第38回日本小児腎不全学会, 2017年09月, 日本語, 日本小児腎不全学会, 淡路, 国内会議Alport症候群の病態生理と軽症化の試み[招待有り]口頭発表(招待・特別)
- 第60回日本腎臓学会学術集会 サテライトシンポジウム, 2017年07月, 日本語, 日本腎臓学会, 北海道, 国内会議Alport症候群の病理解析と治療法の開発[招待有り]口頭発表(招待・特別)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議臨床および病理学的にAlport症候群と診断した一例における分子生物学的検討[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議先天性ネフローゼ症候群/乳児ネフローゼ症候群およびステロイド抵抗性ネフローゼ症候群における網羅的遺伝子診断体制の構築[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議ゲノム情報を臨床へ―遺伝性腎疾患へのアプローチ―バイオサイエンスデータベースを使った解析手法[招待有り]口頭発表(招待・特別)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議エクソンスキッピング療法によるアルポート症候群特異的療法治療法の開発[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議NGSターゲット遺伝子シークエンスパネルによるCAKUTおよびNPHの包括的原因遺伝子解析[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議minigeneを用いた遺伝性腎疾患におけるpathogenic splicing variantの同定[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議Lowe症候群およびDent2の分子生物学的検討[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議lgA腎症候群における降圧薬治療不応例に関する臨床病理学的検討[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議In vivoおよび in vitroの解析によりsplicing異常による疾患発症を証明したフィブロネクチン腎症の一例[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議Establishment of a comprehensive diagnostic method using next generation sequencer for the Alport syndrome[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議C1qの沈着を伴った常染色体優性Alport症候群の一例[招待有り]口頭発表(一般)
- 第52回日本小児腎臓病学会, 2017年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議Alport症候群9家計の臨床的検討[招待有り]口頭発表(一般)
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議小児lgA腎症における糸球体毛細管係蹄(cap)lgA沈着の臨床病理学的検討[招待有り]口頭発表(一般)
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議女性Dent病における遺伝学的背景[招待有り]口頭発表(一般)
- 日本小児科学会兵庫県地方会, 2017年05月, 日本語, 日本小児科学会, 神戸, 国内会議治療方針決定の一助に疾患パネル解析を用いたステロイド抵抗性ネフローゼ症候群の1例[招待有り]口頭発表(一般)
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議次世代シークエンサーを用いたAlport症候群の網羅的診断法の確立[招待有り]口頭発表(一般)
- 第120回 日本小児科学会学術集会, 2017年05月, 日本語, 日本小児科学会, 東京, 国内会議下痢関連溶血性尿毒症症候群(D+HUS)の急性期経過と予後[招待有り]口頭発表(招待・特別)
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議医師主導治験でリツキシマブ投与を行った小児期発症難治性ネフローゼ症候群患者の長期予後[招待有り]口頭発表(一般)
- 第120回 日本小児科学会学術集会, 2017年05月, 日本語, 日本小児科学会, 東京, 国内会議遺伝性腎疾患の研究から学んだ大切なこと-研究の楽しさと臨床へのフィードバック-[招待有り]口頭発表(招待・特別)
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議遺伝性疾患におけるエクソンスキッピング療法の現状と腎疾患への応用の可能性[招待有り]口頭発表(招待・特別)
- Asian Congress of Pediatric Nephrology 2017 & 39th Malaysian Pediatric Association Annual Congress,, 2017年05月, 英語, Kuala Lumpur, Malaysia., 国際会議The utility of urinary CD80 as a diagnostic maker in patients with renal disease[招待有り]口頭発表(一般)
- 日本小児科学会兵庫県地方会, 2017年05月, 日本語, 日本小児科学会, 神戸, 国内会議OFD1ヘミ接合性変異を認めたネフロン癆関連シリオパチーの1男児例[招待有り]口頭発表(一般)
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議NPH・MCKDの遺伝子診断と病型[招待有り]口頭発表(招待・特別)
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議NGSターゲット遺伝子シークエンスパネルによるCAKUTおよびNPHの包括的原因遺伝子解析[招待有り]口頭発表(一般)
- 50th Anniversary Meeting of the European Society for Pediatric Nephrology, 2017年05月, 英語, The International Pediatric Nephrology Association, Glasgou, Scotland, 国際会議In vitro splicing assays to detecy intronic pathogenic variants in inherited kidney disease[招待有り]ポスター発表
- ASN Kidney Week 2017 Annual Meeting, 2017年05月, 英語, American Society of Nephrology, New Orleans, USA, 国際会議Functional splicing analysis in an infantile case of atypical hemolytic uremic syndrome caused by digenic mutations in C3 and MCP genes.[招待有り]ポスター発表
- 50th Anniversary Meeting of the European Society for Pediatric Nephrology, 2017年05月, 英語, The International Pediatric Nephrology Association, Glasgou, Scotland, 国際会議A variety of phenotypes reflected by genotypes and laminin β2 sxpression on glomerulus in Pierson syndrome[招待有り]ポスター発表
- 第60回日本腎臓学会, 2017年05月, 日本語, 日本腎臓学会, 仙台, 国内会議Alport症候群の臨床遺伝学的研究[招待有り]口頭発表(招待・特別)
- Asian Congress of Pediatric Nephrology 2017 & 39th Malaysian Pediatric Association Annual Congress,, 2017年05月, 英語, Kuala Lumpur, Malaysia., 国際会議A comprehensive diagnosis by targeted sequencing for clinically suspectsd alport syndrome patients in Japan[招待有り]ポスター発表
- The15th Japan-Korea-China Pediatrics Nephrology Seminar 2017, 2017年04月, 英語, International Pediatric Nephrology Association, Tokyo, Japan, 国際会議Genetic approach for the nephrotic syndrome[招待有り]口頭発表(招待・特別)
- The15th Japan-Korea-China Pediatrics Nephrology Seminar 2017, 2017年04月, 英語, International Pediatric Nephrology Association, Tokyo, Japan, 国際会議Diagnostic strategy for inherited hypomagnesemia[招待有り]口頭発表(一般)
- ISN Frontiers Meeting 2018, 2017年02月, 英語, 国際腎臓学会, 東京, 国際会議Clinical characteristics in Gitelman syndrome[招待有り]ポスター発表
- ISN Frontiers Meetings 2018, 2017年01月, 英語, 国際腎臓学会, 東京, 国際会議The comprehensive gene screening for congenital, infantile, and steroid resistant nephrotic syndrome in Japan[招待有り]ポスター発表
- Kidney Week of the American Society of Nephrology 2016, 2016年11月, 英語, Kidney Week of the American Society of Nephrology, Chicago, USA, 国際会議Characteristics of genetic and biomolecular backgrounds in patients with LAMB2 related nephropathy[招待有り]口頭発表(一般)
- 第38回日本小児腎不全学会学術集会, 2016年10月, 日本語, 日本小児腎不全学会, 岐阜, 国内会議当院における小児腎移植の現状と課題[招待有り]口頭発表(一般)
- 17thCongress of the International Pediatric Nephrology Association, 2016年09月, 英語, Congress of the International Pediatric Nephrology Association, Iguazu, Brazil, 国際会議Genetic and clinical characteristics of female X-linked Alport Syndrome: 267case study[招待有り]口頭発表(一般)
- 第 269 回 日本小児科学会兵庫県地方会, 2016年09月, 日本語, 日本小児科学会兵庫県地方会, 姫路, 国内会議24時間自由行動下血圧測定が高血圧診療に有用であった1例[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議平滑筋腫を合併したアルポート症候群の臨床像と遺伝子学的検討[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議直腸カルチノイドと頭蓋咽頭腫を認めたアルポート症候群の一例[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議腎炎の急性期治療 ACE-I,ARBの使用の可否 血清アルブミン値と病理組織所見に基づいた紫斑病性腎炎の治療戦略[招待有り]口頭発表(招待・特別)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議小児早期発症ステロイド抵抗性ネフローゼ症候群におけるNUP107変異の同定[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議女性のDent病患者者2例における発症機序に関する考察[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議次世代シークエンサーにて診断に至ったSDCCAG8変異によるネフロン癆の女児例[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議下痢関連溶血性尿毒症症候群(D+HUS)の急性期経過と予後[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議ネフローゼ症候群と遺伝子-どこまで分かっているか、どのような場合遺伝子診断が必要か-[招待有り]口頭発表(招待・特別)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議ターゲットシークエンス法による常染色体優性Alport症候群診断法の確立および遺伝学的背景、臨床的、病理学的検討[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議エビデンスから見たネフローゼ‐Evidence-based treatment for nephrotic syndrome up to date-[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 愛知, 国内会議X染色体連鎖型Alport症候群女性267例の遺伝学的・臨床的検討[招待有り]口頭発表(一般)
- 第51回日本小児腎臓病学会学術集会, 2016年07月, 日本語, 日本小児腎臓病学会, 名古屋, 国内会議CAKUT及び原因不明の小児期発症慢性腎機能障害患者への包括的原因遺伝子解析[招待有り]口頭発表(一般)
- 第59回日本腎臓学会学術総会, 2016年06月, 日本語, 日本腎臓学会, 横浜, 国内会議当院の染色体優位性アルポート症候群の臨床病理学的特徴[招待有り]口頭発表(一般)
- 第59回日本腎臓学会学術総会, 2016年06月, 日本語, 日本腎臓学会, 横浜, 国内会議男女共同参画委員会企画:遺伝性腎疾患[招待有り]口頭発表(招待・特別)
- 第59回日本腎臓学会学術総会, 2016年06月, 日本語, 日本腎臓学会, 横浜, 国内会議小児微少変化・巣状分節性糸球体硬化症の治療戦略[招待有り]口頭発表(招待・特別)
- 第59回日本腎臓学会学術総会, 2016年06月, 日本語, 日本腎臓学会, 横浜, 国内会議小児早期発症ステロイド抵抗性ネフローゼ症候群におけるNUP107変異の同定[招待有り]口頭発表(一般)
- 第59回日本腎臓学会学術総会, 2016年06月, 日本語, 日本腎臓学会, 横浜, 国内会議次世代シークエンサー(NGS)による染色体優性Alport症候群診断法の確立および臨床的、病理学的検討[招待有り]口頭発表(一般)
- 第119回日本小児科学会学術集会, 2016年05月, 日本語, 日本小児科学会, 札幌, 国内会議両アレル性NUP107変異は早期小児発症ステロイド抵抗性ネフローゼ症候群を引き起こ す[招待有り]口頭発表(一般)
- 第119回日本小児科学会学術集会, 2016年05月, 日本語, 日本小児科学会, 札幌, 国内会議直腸カルチノイドと頭蓋咽頭腫を認めたアルポート症候群の一例[招待有り]口頭発表(一般)
- 第268回日本小児科学会兵庫県地方会, 2016年05月, 日本語, 日本小児科学会兵庫県地方会, 神戸, 国内会議成長障害の経過観察中に四肢麻痺をきたし診断に至った尿細管性アシドーシスの1例[招待有り]口頭発表(一般)
- 第119回日本小児科学会学術集会, 2016年05月, 日本語, 日本小児科学会, 札幌, 国内会議腎移植後にウイルス関連の重症合併症を呈した4症例[招待有り]口頭発表(一般)
- 第119回日本小児科学会学術集会, 2016年05月, 日本語, 日本小児科学会, 札幌, 国内会議次世代シークエンサーによる染色体優性Alport症候群診断法の確立[招待有り]口頭発表(一般)
- 第119回日本小児科学会学術集会, 2016年05月, 日本語, 日本小児科学会, 札幌, 国内会議胃腸炎に伴う低K血症から診断に至ったGitelman症候群の兄妹例[招待有り]ポスター発表
- The 14th China-Japan-Korea Pediatric Nephrology Seminar 2016, 2016年05月, 英語, China-Japan-Korea Pediatric Nephrology Seminar, Beijing,, China, 国際会議Pathological and genetic aspects of the siblings with congenital/infantile nephrotic syndrome[招待有り]口頭発表(一般)
- 第13回国際人類遺伝学会, 2016年04月, 英語, 第13回国際人類遺伝学会国内組織委員会、日本学術会議, 京都, 国際会議The comprehensive genetic analysis of congenital anomalies of the kidney and urinary tract (CAKUT) in Japan.[招待有り]口頭発表(一般)
- Pediatric Academic Societies (PAS) Annual Meeting 2016, 2016年04月, 英語, Pediatric Academic Societies, Baltimore, USA, 国際会議Gene targeting therapy for Alport syndrome.[招待有り]口頭発表(招待・特別)
- 第37回日本小児腎不全学会学術集会, 2015年11月, 日本語, 日本小児腎不全学会, 石川, 国内会議腎移植後にウイルス関連の重症合併症を呈した4症例口頭発表(一般)
- 第37回日本小児腎不全学会学術集会, 2015年11月, 日本語, 日本小児腎不全学会, 石川, 国内会議小児腎疾患診療における遺伝学的アプローチ公開講演,セミナー,チュートリアル,講習,講義等
- 第37回日本小児腎不全学会学術集会, 2015年11月, 日本語, 日本小児腎不全学会, 石川, 国内会議遺伝子解析により早期診断に至ったGitelman症候群の2例[招待有り]ポスター発表
- 第37回日本小児腎不全学会学術集会, 2015年11月, 日本語, 日本小児腎不全学会, 石川, 国内会議異なる経過をたどった腸管出血性大腸菌による溶血性尿毒症症候群の姉妹例口頭発表(一般)
- Kidney Week 2015, 2015年11月, 英語, American Society of Nephrology, San Diego, アメリカ, 国際会議Somatic Mosaicism and Variant Frequency Detected by Next Generation Sequencing in X Linked Alport Syndrome.[招待有り]ポスター発表
- Kidney Week 2015, 2015年11月, 英語, American Society of Nephrology, San Diego, アメリカ, 国際会議Comprehensive Approach to Understand Human Renal Development Based on the Identification of Responsible Genes for CAKUT.[招待有り]口頭発表(一般)
- 第45回日本腎臓学会西部学術大会, 2015年10月, 日本語, 日本腎臓学会, 金沢, 国内会議腎炎・ネフローゼ症候群の治療トピックス 難治性ネフローゼ症候群に対するリツキシマブ治療シンポジウム・ワークショップパネル(公募)
- 日本人類遺伝学会 第60回大会, 2015年10月, 日本語, 日本人類遺伝学会, 東京, 国内会議Target gene sequencing panel を用いた先天性腎尿路奇形症候群(CAKUT)の網羅的遺伝子解析[招待有り]口頭発表(一般)
- 第266 回 日本小児科学会兵庫県地方会, 2015年09月, 日本語, 日本小児科学会兵庫県地方会, 姫路, 国内会議重度の神経学的後遺症を残した腸管出血性大腸菌による溶血性尿毒症症候群の1 女児例口頭発表(一般)
- 48th Annual Scientific Meeting of the European Society for Pediatric Nephrology, 2015年09月, 英語, ESPN, Brussels, ベルギー, 国際会議Genetic, pathological and clinical backgrounds in autosomal dominant Alport syndrome.[招待有り]ポスター発表
- 日本小児腎臓病学会学術集会 第50回記念大会, 2015年06月, 日本語, 日本小児腎臓病学会, 神戸, 国内会議低カリウム血症、代謝性アルカローシスを呈した常染色体優性低カルシウム血症の一例口頭発表(一般)
- 第58回日本腎臓学会学術総会, 2015年06月, 日本語, 日本腎臓学会, 名古屋, 国内会議常染色体優性Alport症候群の遺伝学的背景と臨床像口頭発表(一般)
- 日本小児腎臓病学会学術集会 第50回記念大会, 2015年06月, 日本語, 日本小児腎臓病学会, 神戸, 国内会議常染色体優性Alport症候群における遺伝学的背景および臨床的、病理学的検討口頭発表(一般)
- 第58回日本腎臓学会学術総会, 2015年06月, 日本語, 日本腎臓学会, 名古屋, 国内会議小児特発性膜性腎症とPLA2Rの関連[招待有り]ポスター発表
- 日本小児腎臓病学会学術集会 第50回記念大会, 2015年06月, 日本語, 日本小児腎臓病学会, 神戸, 国内会議びまん性メサンギウム細胞増殖を呈した特発性ネフローゼ症候群の臨床病理学的検討口頭発表(一般)
- 第58回日本腎臓学会学術総会, 2015年06月, 日本語, 日本腎臓学会, 名古屋, 国内会議Branchio-oto-renal (BOR) 症候群の原因遺伝子と腎症状に関する検討[招待有り]口頭発表(一般)
- 日本小児腎臓病学会学術集会 第50回記念大会, 2015年06月, 日本語, 日本小児腎臓病学会, 神戸, 国内会議Branchio-oto-renal(BOR)症候群の原因遺伝子と腎症状に関する検討[招待有り]口頭発表(一般)
- 日本小児腎臓病学会学術集会 第50回記念大会, 2015年06月, 日本語, 日本小児腎臓病学会, 神戸, 国内会議Bartter症候群と臨床診断された先天性クロール下痢症の2例口頭発表(一般)
- 第265 回 日本小児科学会兵庫県地方会, 2015年05月, 日本語, 日本小児科学会兵庫県地方会, 神戸, 国内会議全身性エリテマトーデス様所見を呈したヒトパルボウイルスB19 感染症の1 例口頭発表(一般)
- The 13th Korea-China-Japan Pediatric Nephrology Seminar 2015, 2015年05月, 英語, 日韓 中小児腎臓セミナー事務局 小児腎臓セミナー事務局 小児腎臓セミナー事務局 小児腎臓セミナー事務局 小児腎臓セミナー事務局 小児腎臓セミナー事務局, 韓国, 韓国, 国際会議Pathogenesis for hypokalemia in case with autosomal dominant hypocalcemia.口頭発表(一般)
- The 11th Asian Society for Pediatric Research, 2015年04月, 英語, Asian Society for Pediatric Research, 大阪, 国際会議Evidence-based treatment for Nephrotic syndrome[招待有り]口頭発表(招待・特別)
- Ⅻ Asian Congress of Pediatric Nephrology, 2014年12月, 英語, IPNA, New Delhi, India, 国際会議Effectiveness of diagnostic algorithm for inherited hypomagnesemia.[招待有り]ポスター発表
- Ⅻ Asian Congress of Pediatric Nephrology, 2014年12月, 英語, IPNA, New Delhi, India, 国際会議Differential diagnosis of Bartter/Gitelman syndrome and pseudo-disorder based on clinical characteristics.[招待有り]口頭発表(一般)
- 第59回日本人類遺伝学会, 2014年11月, 日本語, 日本人類遺伝学会, 東京, 国内会議染色体構造異常によるsyndromic CAKUT の原因遺伝子についての検討[招待有り]口頭発表(一般)
- American Society of Nephrology Kidney Week 2014, 2014年11月, 英語, ASN, Philadelphia, USA, 国際会議Smad3 Gene Deletion Ameliorates Cyst Formation and Interstitial Fibrosis in cpk Mouce, a Model of ARPKD.[招待有り]ポスター発表
- American Society of Nephrology Kidney Week 2014, 2014年11月, 英語, ASN, Philadelphia, USA, 国際会議Autosomal Dominant Alport Syndrome: Molecular Analysis of the COL4A3/COL4A4 Genes and Clinical Outcome.[招待有り]ポスター発表
- 第36回日本小児腎不全学会学術集会, 2014年10月, 日本語, 日本小児腎不全学会, 松江, 国内会議ステロイド及びシクロスポリンで完全寛解に至った巣状分節性糸球体硬化症collapsing variantの1例[招待有り]口頭発表(一般)
- The American Society of Human Genetics, 2014年10月, 英語, ASHG, San Diego, USA, 国際会議The comprehensive genetic analysis of congenital anomalies of kidney and urinary tract (CAKUT) in Japan.[招待有り]ポスター発表
- 第263回日本小児科学会兵庫県地方会, 2014年09月, 日本語, 日本小児科学会兵庫県地方会, 姫路, 国内会議トピラマート開始後著明な尿細管性アシドーシスと低身長の増悪を認めた一例口頭発表(一般)
- 47th Annual Scientific Meeting of the European Society for Pediatric Nephrology, 2014年09月, 英語, ESPN, PORTO, Portugal, 国際会議X-linked Alport syndrome patients caused by atypical splicing mutations in COL4A5.[招待有り]口頭発表(一般)
- 47th Annual Scientific Meeting of the European Society for Pediatric Nephrology, 2014年09月, 英語, ESPN, PORTO, Portugal, 国際会議The comprehensive genetic analysis of CAKUT in Japan.[招待有り]口頭発表(一般)
- 第57回日本腎臓学会学術総会, 2014年07月, 日本語, 日本腎臓学会, 横浜, 国内会議本邦におけるCAKUT包括的原因遺伝子解析システムの構築[招待有り]口頭発表(一般)
- 第57回日本腎臓学会学術総会, 2014年07月, 日本語, 日本腎臓学会, 横浜, 国内会議遺伝性塩類喪失性尿細管機能異常症とその偽性症例の臨床的差異に関する検討[招待有り]口頭発表(一般)
- 第57回日本腎臓学会学術総会, 2014年07月, 日本語, 日本腎臓学会, 横浜, 国内会議フィブロネクチン腎症におけるFN1遺伝子変異の同定およびその機能解析に関する研究[招待有り]口頭発表(一般)
- 第57回日本腎臓学会学術総会, 2014年07月, 日本語, 日本腎臓学会, 横浜, 国内会議BartterおよびGitelman症候群に関する全国疫学調査[招待有り]口頭発表(一般)
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議cpkマウスARPKDモデルにおける病的Smad3リン酸化[招待有り]口頭発表(一般)
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議微少蛋白尿を呈する小児IgA腎症の長期予後[招待有り]口頭発表(一般)
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議低カリウム血性横紋筋融解症を合併したGitelman症候群の男児例[招待有り]口頭発表(一般)
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議初診時高血圧を呈さず特発性ネフローゼ症候群との鑑別を要した腎血管性高血圧の1例[招待有り]口頭発表(一般)
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議遺伝性塩類喪失性尿細管機能異常症とその偽性症例の臨床的差異に関する検討[招待有り]口頭発表(一般)
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議フィブロネクチン腎症(FN)におけるFN1遺伝子変異の同定およびその機能解析に関する研究[招待有り]口頭発表(一般)
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議アルポート症候群―重症・軽症を規定する因子に関する再考―[招待有り]口頭発表(招待・特別)
- 15th European Congress of Paediatric Surgery, 2014年06月, 英語, European Paediatric Surgeons' Association, Dublin, Ireland, 国際会議Effective application of fibrin glue to prevent pericatheter leakage in peritoneal dialysis: a preliminary trial[招待有り]ポスター発表
- 第49回日本小児腎臓病学会学術集会, 2014年06月, 日本語, 日本小児腎臓病学会, 秋田, 国内会議ACE阻害剤の投与により急性腎障害を認めたBartter症候群3型の1例[招待有り]口頭発表(一般)
- 第51回日本小児外科学会学術集会, 2014年05月, 日本語, 日本小児外科学会, 大阪, 国内会議小児腹膜透析カテーテル留置後に生じた外科的合併症の検討[招待有り]ポスター発表
- 第262回日本小児科学会兵庫県地方会, 2014年05月, 日本語, 日本小児科学会兵庫県地方会, 神戸, 国内会議学校検尿で発見され、緩徐な経過を辿った特発性ネフローゼ症候群の1例口頭発表(一般)
- 第117回日本小児科学会学術集会, 2014年04月, 日本語, 日本小児科学会, 名古屋, 国内会議シクロスポリン投与下に再発をきたしたステロイド感受性ネフローゼ症候群の長期予後[招待有り]口頭発表(一般)
- 第261回日本小児科学会兵庫県地方会, 2014年02月, 日本語, 日本小児科学会兵庫県地方会, 西宮, 国内会議再発直後に肺炎球菌による敗血症を合併したネフローゼ症候群の一例口頭発表(一般)
- American Society of Nephrology KIDNEY WEEK, 2013年11月, 英語, American Society of Nephrology, Atlanta, USA, 国際会議Natural History and Protein Expression Pattern in Autosomal Recessive Alport Syndrome Based on the Comprehensive Strategy for Genetic Analysis.[招待有り]ポスター発表
- American Society of Nephrology KIDNEY WEEK, 2013年11月, 英語, American Society of Nephrology, Atlanta, USA, 国際会議Investigation of Principal Mechanism for Renal Sodium Retention in Children with Idiopathic Nephrotic Syndrome.[招待有り]ポスター発表
- 第35回日本小児腎不全学会学術集会, 2013年10月, 日本語, 小児腎不全学会, 福島, 国内会議腹膜透析中に急性虫垂炎を発症した3歳女児例[招待有り]口頭発表(一般)
- The American Society of Human Genetics, 2013年10月, 英語, The American Society of Human Genetics, Boston, USA, 国際会議Heterozygous microdeletion of 16q covering SALL1 and RPGRIP1L could be a novel contiguous gene syndrome with renal impairment.[招待有り]ポスター発表
- 第260回日本小児科学会兵庫県地方会, 2013年09月, 日本語, 日本小児科学会兵庫県地方会, 姫路, 国内会議発症後20年以上を経て再熱した紫斑病性腎炎の1例口頭発表(一般)
- The Sixteenth Congress of the International Pediatric Nephrology Association, 2013年08月, 英語, International Pediatric Nephrology Association, Shanghai, China, 国際会議Multicenter, Double-Blind, Placebo-Controlled, Randomized Trial of Rituximab for the Treatment of Childhood-Onset Refractory nephrotic syndrome.[招待有り]ポスター発表
- 第48回日本小児腎臓病学会学術集会, 2013年06月, 日本語, 日本小児腎臓病学会, 徳島, 国内会議常染色体優性多発性嚢胞腎(ADPKD)の間質線維化における上皮間葉系形質転換(EMT)の関与に関する研究[招待有り]口頭発表(一般)
- 第48回日本小児腎臓病学会学術集会, 2013年06月, 日本語, 日本小児腎臓病学会, 徳島, 国内会議ネフローゼ症候群を呈したX染色体連鎖型Alport症候群の2例[招待有り]ポスター発表
- 第259回日本小児科学会兵庫県地方会, 2013年05月, 日本語, 日本小児科学会兵庫県地方会, 神戸, 国内会議長期の寛解維持後に突然再発を繰り返したステロイド抵抗性ネフローゼ症候群の1例口頭発表(一般)
- European Renal Association-European Dialysis and Transplant Association, 2013年05月, 英語, ERA-EDTA, Istanbul, Turkey, 国際会議The relation between steroid responsiveness and immunofluorescence findings in infant idiopathic nephrotic syndrome.[招待有り]ポスター発表
- American Society of Nephrology, 2012 Kidney Week, 2012年10月, 英語, San Diego, 国際会議Genetical and clinical aspects of X-linked Alport syndrome in males with positive staining of the α5 (IV) chain.[招待有り]口頭発表(一般)
- American Society of Nephrology, 2012 Kidney Week, 2012年10月, 英語, San Diego, 国際会議Clinical characteristics and mutational pattern of genetically-proven Gitelman's syndrome.[招待有り]ポスター発表
- 第47回日本小児腎臓病学会学術集会, 2012年06月, 日本語, 東京, 国内会議尿中落下細胞の遺伝子解析と尿細管疾患の診断の実際-salt-losing tubulopathy を例に-[招待有り]口頭発表(招待・特別)
- 第47回日本小児腎臓病学会学術集会, 2012年06月, 日本語, 東京, 国内会議一過性に高度蛋白尿を呈し診断に苦慮したThin basement membrane diseaseの一例[招待有り]ポスター発表
- 第47回日本小児腎臓病学会学術集会, 2012年06月, 日本語, 東京, 国内会議X染色体連鎖型Alport症候群男性患者の腎重症度は、腎組織のα5染色パターンで予測可能である[招待有り]ポスター発表
- 第55回日本腎臓学会学術総会, 2012年06月, 日本語, 横浜, 国内会議Gitelman症候群と偽性Gitelman症候群の臨床的差異に関する検討[招待有り]ポスター発表
- 第55回日本腎臓学会学術総会, 2012年06月, 日本語, 横浜, 国内会議2q36-q37領域における部分母親性イソダイソミーによる常染色体劣性Alport症候群の1男性例[招待有り]ポスター発表
- 第47回日本小児腎臓病学会学術集会, 2012年06月, 日本語, 東京, 国内会議2q36-q37領域における部分母親性イソダイソミーによる常染色体劣性Alport症候群の1男性例[招待有り]口頭発表(一般)
- 第114回日本小児科学会学術集会, 2011年08月, 日本語, 日本小児科学会, 東京, 国内会議巣状メキサンギウム増殖を示す小児IgA腎症に対するACEIの治療反応性[招待有り]その他
- 第54回日本腎臓学会学術総会, 2011年06月, 日本語, 日本腎臓学会, 横浜, 国内会議小児IgA腎症におけるオックスフォード分類の有用性[招待有り]その他
- 第54回日本腎臓学会学術総会, 2011年06月, 日本語, 日本腎臓学会, 横浜, 国内会議血清アルブミン値と組織所見に基づいた小児紫斑病性腎炎の治療戦略[招待有り]その他
- ERA-EDTA Congress, 2011年06月, 英語, プラハ, チェコ, 国際会議Investigation of molecular background for patients with exercise-idcuced acute renal failure[招待有り]その他
- The 11th Asian Congress of Pediatric Nephrology, 2011年06月, 英語, アジア小児腎臓学会, 福岡, 国際会議Genotype-phenotype correlation of Japanese X-linked Alport syndrome.[招待有り]その他
- The 11th Asian Congress of Pediatric Nephrology, 2011年06月, 英語, アジア小児腎臓学会, 福岡, 国際会議Deep intronic mutations in COL4A5 causes X-linked Alport syndrome.[招待有り]その他
- The 11th Asian Congress of Pediatric Nephrology, 2011年06月, 英語, アジア小児腎臓学会, 福岡, 国際会議Compound heterozygous mutations in COL4A3 or COL4A4 may correlate with a better prognosis in autosomal-recessive Alport syndrome.[招待有り]その他
- ERA-EDTA Congress, 2011年06月, 英語, プラハ, チェコ, 国際会議Clinical distinction between genetically-proven gitelman's and pseudo-gitelman's syndrome[招待有り]その他
- Pediatric Academic Societies' 2011Annual Meeting, 2011年04月, 英語, Pediatric Academic Societies, デンバー, アメリカ, 国際会議Recurrent exercise-induced acute renal failure and PRES with severe renal hypouricemia by compound-heterozygous SLC2A9 mutation.[招待有り]ポスター発表
- Pediatric Academic Societies' 2011Annual Meeting, 2011年04月, 英語, Pediatric Academic Societies, デンバー, アメリカ, 国際会議Alport syndrome associated with hemophilia A-molecular mechanism of phenotypic divergence between siblings.[招待有り]ポスター発表
- Renal Week 2010, 2010年11月, 英語, American Society of Nephrology 2010 Annual Meeting, デンバー, アメリカ, 国際会議The Relationship between Arginine Vasopressin Levels and Hyponatremia in Children Receiving Hypotonic or Isotonic Intravenous Fluids Following a Percutaneous Renal Biopsy[招待有り]ポスター発表
- Renal Week 2010, 2010年11月, 英語, American Society of Nephrology 2010 Annual Meeting, デンバー, アメリカ, 国際会議Prognostic Factors in Childhood IgA Nephropathy with Focal Mesangial Proliferation Treated with Angiotensin Converting Enzyme Inhibitors[招待有り]ポスター発表
- Renal Week 2010, 2010年11月, 英語, American Society of Nephrology 2010 Annual Meeting, デンバー, アメリカ, 国際会議Epithelial-to-Mesenchymal Transition (EMT) in cpk Mouse, a Model of ARPKD[招待有り]ポスター発表
- Renal Week 2010, 2010年11月, 英語, American Society of Nephrology 2010 Annual Meeting, デンバー, アメリカ, 国際会議Clinical and Immunohistochemical Analyses of Japanese Families with Genetically-Defined Autosomal-Recessive Alport Syndrome[招待有り]ポスター発表
- 第40回日本腎臓学会西部学術大会, 2010年10月, 日本語, 日本腎臓学会, 広島, アメリカ, 国内会議幼少期発症のFibronectin腎症でFN1遺伝子に変異のあった1例[招待有り]口頭発表(一般)
- the 15th Congress of the International Pediatric Nephrology Association, 2010年08月, 英語, The International Pediatric Nephrology Association, ニューヨーク, アメリカ, 国際会議Treatment Strategy and Outcome for Henoch-Schonlein Purpura Nephritis[招待有り]ポスター発表
- the 15th Congress of the International Pediatric Nephrology Association, 2010年08月, 英語, The International Pediatric Nephrology Association, ニューヨーク, アメリカ, 国際会議Natural Remission Rate and Prognostic Factors in Childhood IgANephropathy with Minimal Change or Focal Mesangial Proliferation[招待有り]口頭発表(一般)
- the 15th Congress of the International Pediatric Nephrology Association, 2010年08月, 英語, The International Pediatric Nephrology Association, ニューヨーク, アメリカ, 国際会議Clinical Characteristics of Genetically-Proven Gitelman's Syndrome[招待有り]ポスター発表
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議微小変化・巣状メサンギウム増殖を示す小児IgA 腎症における自然寛解率とその予測因子[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議伴性優性遺伝の家族性良性血尿の1家系[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議多嚢胞性異形成腎(MCDK)の兄弟例におけるHNF-1β 遺伝子変異[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議常染色体劣性多発性嚢胞腎(ARPKD)モデルcpk マウスの尿細管上皮細胞における上皮間葉移行(EMT)[招待有り]ポスター発表
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議常染色体性Alport 症候群の臨床および分子生物学的検討[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議運動後急性腎不全とPRESの合併を反復し、GLUT9遺伝子複合へテロ接合体変異を同定しえた腎性低尿酸血症の一例[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議遺伝子解析で確定診断しえたGitelman 症候群31例の臨床的検討[招待有り]ポスター発表
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議シクロスポリンにてネフローゼ症候群と食物アレルギー性腸炎の寛解維持が可能となったIPEX症候群の一例[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議X染色体連鎖型Alport症候群と血友病Aを合併した一男児例―同胞男児間における表現型の差異についての分子遺伝学的検討―[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議LINE-1 レトロトランスポゾンの置換によるEYA1 遺伝子変異をともなったbranchio-oto-renal症候群の1女児例[招待有り]口頭発表(一般)
- 第45回日本小児腎臓病学会学術集会, 2010年07月, 日本語, 日本小児腎臓病学会, 大阪, 国内会議COL4A3/COL4A4 のヘテロ変異を有する菲薄基底膜症候群のドナーから腎移植を実施した2例[招待有り]口頭発表(一般)
- 第53回日本腎臓学会学術総会, 2010年06月, 日本語, 日本腎臓学会, 神戸, 国内会議平滑筋腫合併アルポート症候群(DL-AS)の遺伝学的検討[招待有り]口頭発表(一般)
- 第53回日本腎臓学会学術総会, 2010年06月, 日本語, 日本腎臓学会, 神戸, 国内会議常染色体劣性遺伝を呈したAlport症候群の一例[招待有り]口頭発表(一般)
- 第53回日本腎臓学会学術総会, 2010年06月, 日本語, 日本腎臓学会, 神戸, 国内会議ヒトARPKDと相同遺伝子変異を有するPCK ratにおける上皮間葉移行[招待有り]ポスター発表
- 第53回日本腎臓学会学術総会, 2010年06月, 日本語, 日本腎臓学会, 神戸, 国内会議X染色体連鎖型Alport症候群の臨床的検討[招待有り]口頭発表(一般)
- 第113回日本小児科学会学術集会, 2010年04月, 日本語, 日本小児科学会, 盛岡, 国内会議常染色体劣性Alport症候群女児例におけるIV型コラーゲンα1~α6鎖染色の検討[招待有り]口頭発表(一般)
- 第113回日本小児科学会学術集会, 2010年04月, 日本語, 日本小児科学会, 盛岡, 国内会議レシピエント選定基準改定後に経験した小児献腎移植の5例[招待有り]口頭発表(一般)
- 第113回日本小児科学会学術集会, 2010年04月, 日本語, 日本小児科学会, 盛岡, 国内会議3歳健診から血尿と蛋白尿が持続し,Alport症候群の孤発例と考えられた女児例[招待有り]ポスター発表
- 第43回日本臨床腎移植学会, 2010年01月, 日本語, 日本臨床腎移植学会, 高知, 国内会議リツキシマブが著効した腎移植後重症EBウィルス感染症の一例[招待有り]口頭発表(一般)
- 第39回日本腎臓学会西部学術大会, 2009年10月, 日本語, 日本腎臓学会, 和歌山, 国内会議腎不全に至ったステロイド感受性微小変化型ネフローゼ症候群の1例[招待有り]口頭発表(一般)
- 第39回日本腎臓学会西部学術大会, 2009年10月, 日本語, 日本腎臓学会, 和歌山, 国内会議運動後急性腎不全とPRES(Posterior reversible encephalopathy syndrome)の合併を反復した腎性低尿酸血症の1例[招待有り]口頭発表(一般)
- 第39回日本腎臓学会西部学術大会, 2009年10月, 日本語, 日本腎臓学会, 和歌山, 国内会議遺伝性腎疾患におけるintron内の変異に伴う病気発症メカニズム解明のための実験系の確立[招待有り]口頭発表(一般)
- 第60回日本皮膚科学会中部支部学術大会, 2009年10月, 日本語, 日本皮膚科学会中部支部, 京都, 国内会議マイコプラズマ肺炎が関与したと考えられるアセトアミノフェンによる中毒性表皮壊死症の一例[招待有り]ポスター発表
- American Society of Nephrology 2009 Annual Meeting, 2009年10月, 英語, American Society of Nephrology, サンディエゴ, アメリカ, 国際会議Snail1 Is Involved in Epithelial-to-Mesenchymal Transition (EMT) in Cyst-Lining Epithelial Cells in PCK Rat[招待有り]ポスター発表
- American Society of Nephrology 2009 Annual Meeting, 2009年10月, 英語, American Society of Nephrology, サンディエゴ, アメリカ, 国際会議Investigation of Molecular Background for Patients with Exercise-Induced Acute Renal Failure[招待有り]ポスター発表
- American Society of Nephrology 2009 Annual Meeting, 2009年10月, 英語, American Society of Nephrology, サンディエゴ, アメリカ, 国際会議A Deep Intronic Mutation in the SLC12A3 Gene Leads to Gitelman Syndrome[招待有り]ポスター発表
- 第52回日本腎臓学会学術総会, 2009年06月, 日本語, 日本腎臓学会, 横浜, 国内会議等張性輸液は手術後の低ナトリウム(Na)血症を防止する[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議小児ネフローゼ症候群患者におけるリツキシマブ血中濃度と投与後再発についての検討[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議重症小児IgA 腎症における治療反応性規定因子[招待有り]口頭発表(一般)
- 第52回日本腎臓学会学術総会, 2009年06月, 日本語, 日本腎臓学会, 横浜, 国内会議重症小児IgA腎症における治療後腎IgA沈着消失の臨床病理学的意義[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議遺伝性腎疾患におけるintron 内の変異に伴う病気発症メカニズム解明のためのin vivoおよびin vitro の実験系の確立[招待有り]口頭発表(一般)
- 第52回日本腎臓学会学術総会, 2009年06月, 日本語, 日本腎臓学会, 横浜, 国内会議ヒトARPKD相同遺伝子ラットモデルにおける尿細管部位特異的嚢胞形成[招待有り]口頭発表(一般)
- 第52回日本腎臓学会学術総会, 2009年06月, 日本語, 日本腎臓学会, 横浜, 国内会議X染色体連鎖型アルポート症候群(XLAS)の分子遺伝学的検討[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 英語, 日本小児腎臓病学会, 東京, 国内会議X 染色体連鎖型アルポート症候群の男性患者における糸球体基底膜4型コラーゲンα5鎖陽性例の検討[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議NR3C2遺伝子変異に伴いmRNA にsplicing 異常を認めたにも関わらず軽症であった偽性低アルドステロン症1型の親子例[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議IPEX 症候群に微小変化型ネフローゼ症候群を合併した1症例[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議COL4A5遺伝子に9塩基の欠失を有し、GBM に4型コラーゲンα5鎖の正常の発現を認めたX 染色体連鎖型アルポート症候群男児例[招待有り]口頭発表(一般)
- 第44回日本小児腎臓病学会学術集会, 2009年06月, 日本語, 日本小児腎臓病学会, 東京, 国内会議ARPKD 相同遺伝子ラットモデルの尿細管上皮細胞における上皮間葉移行(EMT)[招待有り]口頭発表(一般)
- 第112回日本小児科学会学術集会, 2009年04月, 日本語, 日本小児科学会, 奈良, 国内会議X染色体連鎖型アルポート症候群の分子遺伝学的検討[招待有り]口頭発表(一般)
- 第29回日本アフェレシス学会学術大会, 2008年11月, 日本語, 日本アフェレーシス学会, 広島, 国内会議リポソーバLA-15を用いた血漿吸着療法(LA-15PA)の検討-体重19kgの小児に対するLDL-Aを経験して[招待有り]ポスター発表
- American Society of Nephrology 2008 Annual Meeting, 2008年11月, 英語, tThai Pediatric Nephrology Association, フィラデルフィア, アメリカ, 国際会議Treatment of Refractory Steroid-Dependent Nephrotic Syndrome with a Single Dose of Rituximab, a Multicenter Prospective Study.[招待有り]ポスター発表
- American Society of Nephrology 2008 Annual Meeting, 2008年11月, 英語, tThai Pediatric Nephrology Association, フィラデルフィア, アメリカ, 国際会議The First Case of Minimal Change Nephrotic Syndrome Associated with Immunodysregulation, Polyendocrinopathy, Enteropathy, X-Linked (IPEX) Syndrome.[招待有り]その他
- 41th American Society of Pediatric Nephrology, 2008年11月, 英語, 41th American Society of Pediatric Nephrology, フィラデルフィア, アメリカ, 国際会議The first case of minimal change nephrotic syndrome associated with immunodysregulation, polyendocrinopathy, enteropathy, X-linked(IPEX) syndrome.[招待有り]口頭発表(一般)
- American Society of Nephrology 2008 Annual Meeting, 2008年11月, 英語, tThai Pediatric Nephrology Association, フィラデルフィア, アメリカ, 国際会議TCF2 Mutation in Patients with Congenital Anomalies of the Kidney and Urinary Tract (CAKUT).[招待有り]ポスター発表
- American Society of Nephrology 2008 Annual Meeting, 2008年11月, 英語, tThai Pediatric Nephrology Association, フィラデルフィア, アメリカ, 国際会議Somatic Mosaicism for a Mutation of the COL4A5 Gene in Three Sporadic X-Linked Alport Syndrome Cases.[招待有り]ポスター発表
- 41th American Society of Pediatric Nephrology, 2008年11月, 英語, 41th American Society of Pediatric Nephrology, フィラデルフィア, アメリカ, 国際会議Somatic mosaicism for a mutation of the COL4A5 gene in three sporadic X-linked alport syndrome cases.[招待有り]ポスター発表
- American Society of Nephrology 2008 Annual Meeting, 2008年11月, 英語, tThai Pediatric Nephrology Association, フィラデルフィア, アメリカ, 国際会議Epithelial-to-Mesenchymal Transition in Cyst-Lining Epithelial Cells in PCK Rat.[招待有り]ポスター発表
- American Society of Nephrology 2008 Annual Meeting, 2008年11月, 英語, tThai Pediatric Nephrology Association, フィラデルフィア, アメリカ, 国際会議Elevated AVP Levels and Hyponatremia Following Percutaneous Renal Biopsies in Children.[招待有り]ポスター発表
- American Society of Nephrology 2008 Annual Meeting, 2008年11月, 英語, tThai Pediatric Nephrology Association, フィラデルフィア, アメリカ, 国際会議Disappearance of Glomerular IgA Deposits in Severe Childhood IgA Nephropathy after 2-yr Combination/Prednisolone Therapy.[招待有り]その他
- 第30回日本小児腎不全学会, 2008年10月, 日本語, 日本小児腎不全学会, 栃木, 国内会議当院にて昨年1年間に経験した小児献腎移植の3例[招待有り]口頭発表(一般)
- 2008 the Korean Society of Pediatric Nephrology, 2008年10月, 英語, Korean Society of Pediatric Nephrology, ソウル, 韓国, 国際会議Molecular and clinical investigation for the X-linked alport syndrome.[招待有り]口頭発表(一般)
- 第44回日本移植学会, 2008年09月, 日本語, 日本移植学会, 大阪, 国内会議アルポート症候群を原疾患とする慢性腎不全に対して施行された生体腎移植7例の検討[招待有り]口頭発表(一般)
- 第43回日本小児腎臓病学会学術集会, 2008年06月, 日本語, 日本小児腎臓学会, 福岡, 国内会議III型Bartter症候群患者における利尿剤負荷試験~Gitelman症候群との類似性の機序に関する研究~[招待有り]口頭発表(一般)
- 第43回日本小児腎臓病学会学術集会, 2008年06月, 日本語, 日本小児腎臓学会, 福岡, 国内会議Bartter症候群、Gitelman症候群の病型と臨床症状、遺伝学的背景に関する最近の知見[招待有り]口頭発表(一般)
- 第51回日本腎臓学会学術総会, 2008年05月, 日本語, 日本腎臓学会, 福岡, 国内会議小手術後の一過性血漿抗利尿ホルモン分泌亢進に関する研究[招待有り]口頭発表(一般)
- Pediatric Academic Societies' 2008 Annual Meeting, 2008年05月, 英語, Pediatric Academic Societies, ハワイ, アメリカ, 国際会議Transient elevations of plasma antidiuretic hormone levels in children with post-operative nausea and vomiting after kidney biopsy.[招待有り]ポスター発表
- 第244回日本小児科会兵庫県地方会, 2008年02月, 日本語, 日本小児科会兵庫県地方会, 西宮, 国内会議難治性全身性エリテマトーデス(SLE)に対してリツキシマブ(RTX)を投与した2症例口頭発表(一般)
- 第41回日本小児内分泌学会学術集会, 2007年11月, 日本語, 日本小児内分泌学会, 横浜, 国内会議全身性エリテマトーデスを合併した緩徐進行型1型糖尿病の1例[招待有り]ポスター発表
- 第41回小児内分泌学会学術集会, 2007年11月, 日本語, 日本小児内分泌学会, 横浜, 国内会議全身性エリテマトーデスを合併した緩徐進行型1型糖尿病の1例[招待有り]ポスター発表
- TheAmericanSocietyofNephrologyRenalWeek2007, 2007年10月, 英語, American Society of Nephrology, Calfornia, アメリカ, 国際会議Molecular analysis of digenic inheritance in type IV Bartter syndrome phenotype .[招待有り]ポスター発表
- TheAmericanSocietyofNephrologyRenalWeek2007, 2007年10月, 英語, American Society of Nephrology, Calfornia, アメリカ, 国際会議Genetic backgrounds in patients with exercise-induced acute renal failure.[招待有り]ポスター発表
- 第29回日本小児腎不全学会総会・学術集会, 2007年09月, 日本語, 日本小児腎不全学会, 松江, 国内会議末期腎不全に至り腎移植を行った小児ネフローゼ症候群4例の検討[招待有り]口頭発表(一般)
- 第29回日本小児腎不全学会総会・学術集会, 2007年09月, 日本語, 日本小児腎不全学会, 松江, 国内会議腎性低尿酸血症を伴わなかった運動後急性腎不全(ALPE)の1例[招待有り]口頭発表(一般)
- 第243回日本小児科学会兵庫県地方会, 2007年09月, 日本語, 日本小児科学会兵庫県地方会, 姫路, 国内会議LDL吸着療法(LDL-A)が有効であった巣状分節性糸球体硬化症(FSGS)の一例[招待有り]口頭発表(一般)
- 14thCongressoftheInternationalPediatricNephrologyAssociation, 2007年08月, 英語, International Pediatric Nephrology Association, Budapest, ハンガリー, 国際会議Transient elevation of plasma antidiuretic hormone level arter kindney biopsy associated with iatrogenic hyponatremia or postoperative nausea and vomit.[招待有り]ポスター発表
- 14thCongressoftheInternationalPediatricNephrologyAssociation, 2007年08月, 英語, International Pediatric Nephrology Association, Budapest, ハンガリー, 国際会議Molecular analysis of 5 Japanese patients with type III bartter syndrome.[招待有り]ポスター発表
- 14thCongressoftheInternationalPediatricNephrologyAssociation, 2007年08月, 英語, International Pediatric Nephrology Association, Budapest, ハンガリー, 国際会議Identification of 6 novel mutations in the COL4A5 gene of Japanese patients with X-linked alport syndrome.[招待有り]ポスター発表
- 第42回日本小児腎臓病学会学術集会, 2007年06月, 日本語, 日本小児腎臓病学会, 横浜, 国内会議日本人3型Bartter症候群患者5例における遺伝子型および表現型に関する研究[招待有り]口頭発表(一般)
- 第42回日本小児腎臓病学会学術集会, 2007年06月, 日本語, 日本小児腎臓病学会, 横浜, 国内会議小手術後の一過性血漿抗利尿ホルモン分泌亢進に関する研究―医原性低ナトリウム血症および術後嘔気嘔吐症発症機序に関する考察―[招待有り]口頭発表(一般)
- 第42回日本小児腎臓病学会学術集会, 2007年06月, 日本語, 日本小児腎臓病学会, 横浜, 国内会議血清尿酸値の軽度低下を伴った運動後急性腎不全(ALPE)の2例―臨床的および遺伝学的検討―[招待有り]口頭発表(一般)
- 第50回日本腎臓学会学術総会, 2007年05月, 日本語, 日本腎臓学会, 浜松, 国内会議血管性紫斑病における腎炎発症とintercellular adhesion molecule-1 (ICAM-1)遺伝子多型K469Eの関与[招待有り]ポスター発表
- 第50回日本腎臓学会学術総会, 2007年05月, 日本語, 日本腎臓学会, 浜松, 国内会議運動後急性腎不全とURAT1遺伝子変異との関連についての検討[招待有り]ポスター発表
- 第110回日本小児科学会学術集会, 2007年04月, 日本語, 日本小児科学会, 京都, 国内会議運動後急性腎不全とURAT1遺伝子変異との関連についての検討[招待有り]口頭発表(一般)
- 第109回日本小児科学会学術集会, 2006年04月, 日本語, 日本小児科学会学術集会事務局, 石川, 国内会議Alport症侯群に対する抗アルドステロン薬の効果についての検討[招待有り]口頭発表(一般)
- 第238回 日本小児科学会兵庫県地方会, 2006年02月, 日本語, 神戸大学 小児科, 兵庫, 国内会議学校検尿で発見され、腎生検にてループス腎炎と診断された1例[招待有り]口頭発表(一般)
- 第238回 日本小児科学会兵庫県地方会, 2006年02月, 日本語, 神戸大学 小児科, 兵庫, 国内会議ステロイドパルス療法を要する重度の腹部症状を認めたHenoch-Schonlein紫斑病(HSP)の1例[招待有り]口頭発表(一般)
- American Society of Nephrology 38th Annual Renal Week Meeting, 2005年11月, 英語, American Society of Nephrology, Philadelphia, 国際会議The national survey of typical hemolytic uremic syndrome in Japan: the analysis of the risk factors predicated the induction of dialysis and the development of central nervous system disorders[招待有り]ポスター発表
- American Society of Nephrology 38th Annual Renal Week Meeting, 2005年11月, 英語, American Society of Nephrology, Philadelphia, 国際会議EYA1 and SIX1 gene mutations in Japanese patients with Branchio-Oto-Renal (BOR) syndrome and related diseases[招待有り]ポスター発表
- 第39回日本小児内分泌学会, 2005年10月, 日本語, 日本小児内分泌学会, 東京, 国内会議巣状分節性糸球体硬化症のフォロー中に発症したBasedow病の一例[招待有り]ポスター発表
- 第277回日本小児腎不全学会, 2005年09月, 日本語, 日本小児腎不全学会, 横浜, 国内会議Rituximabの投与がFSGSの移植後再発に対し有効であったと考えられた1例[招待有り]口頭発表(一般)
- 医療薬学フォーラム2005, 2005年07月, 日本語, 日本薬学会, 鹿児島, 国内会議小児難治性ネフローゼ患者におけるシクロスポリンの腎毒性発現因子の解明[招待有り]ポスター発表
- 医療薬学フォーラム2005/第13回クリニカルファーマシーシンポジウム, 2005年07月, 日本語, 日本薬学会医療薬学部会, 鹿児島, 国内会議小児難治性ネフローゼ患者におけるシクロスポリンの腎毒性発現因子の解析[招待有り]ポスター発表
- 第40回日本小児腎臓病学会, 2005年05月, 日本語, 日本小児腎臓病学会, 仙台, 国内会議膜性増殖性糸球体腎炎(MPGN)24例の長期予後に関する検討[招待有り]口頭発表(一般)
- 第40回日本小児腎臓病学会, 2005年05月, 日本語, 日本小児腎臓病学会, 仙台, 国内会議全国調査における典型的溶血性尿毒症症候群の治療の検討[招待有り]口頭発表(一般)
- 第22回日本TDM学会学術大会, 2005年05月, 日本語, 日本TDM学会, 宜野座, 国内会議小児難治性ネフローゼ患者におけるシクロスポリンの血中濃度推移と腎毒性の関係[招待有り]口頭発表(一般)
- 第41回日本小児腎臓病学会, 2005年05月, 日本語, 日本小児腎臓病学会, 仙台, 国内会議Gene Scanを用いることで遺伝子異常を発見できた3型バーター症候群の1例[招待有り]口頭発表(一般)
- 第40回日本小児腎臓病学会, 2005年05月, 日本語, 日本小児腎臓病学会, 仙台, 国内会議Gene Scanを用いることで遺伝子異常を発見できた3型バーター症候群の1例[招待有り]口頭発表(一般)
- 第108回日本小児科学会学術集会, 2005年04月, 日本語, 日本小児科学会, 東京, 国内会議当院における溶血性尿毒症症候群(HUS)の臨床的検討[招待有り]ポスター発表
- 日本薬剤学会第20年会, 2005年03月, 日本語, 日本薬剤学会, 東京, 国内会議小児腎疾患患者におけるシクロスポリン体内動態に及ぼす併用薬・腎機能の影響[招待有り]ポスター発表
- 日本薬剤学会第20回記念大会, 2005年03月, 日本語, 日本薬剤学会, 東京, 国内会議小児腎疾患患者におけるCsA体内動態に及ぼす併用薬・腎機能の影響[招待有り]口頭発表(一般)
- 第18回近畿小児科学会, 2005年03月, 日本語, 近畿小児科学会, 京都, 国内会議小児SLE患者に対する高用量ミゾリビン投与の試み口頭発表(一般)
- 第26回日本病院薬剤師会近畿学術大会, 2005年01月, 日本語, 日本病院薬剤師会近畿ブロック, 京都, 国内会議小児科領域におけるシクロスポリンの血中濃度推移と腎毒性との関係について[招待有り]ポスター発表
- 第26回日本小児腎不全学会, 2004年10月, 日本語, 日本小児腎不全学会, 長野, 国内会議腎機能が保たれている時期に腹膜透析を導入した難治性ネフローゼ症候群の一例[招待有り]口頭発表(一般)
- American Society of Nephrology 37th Annual Meeting, 2004年10月, 英語, American Society of Nephrology, St. Louis, 国際会議Mutatioral analysis of NKCC2, ROMK, CLCNKB and NCCT in 11 Japanese patients with clinically diagnosed Bartter syndrome.[招待有り]ポスター発表
- 第25回日本臨床薬理学会年会, 2004年09月, 日本語, 日本臨床薬理学会, 静岡, 国内会議小児患者におけるCycrosporineの体内動態とMDR1遺伝子多型の関連[招待有り]ポスター発表
- 第25回日本臨床薬理学会年会, 2004年09月, 日本語, 日本臨床薬理学会, 静岡, 国内会議小児患者におけるCyclosprineの体内動態とMDR1遺伝子多型の関連性[招待有り]ポスター発表
- 第39回日本小児腎臓病学会, 2004年07月, 日本語, 日本小児腎臓病学会, 熊本, 国内会議当院で経験したANCA関連血管炎症候群の2例の検討[招待有り]口頭発表(一般)
- 第39回日本小児腎臓病学会, 2004年07月, 日本語, 日本小児腎臓病学会, 熊本, 国内会議巣状膜性糸球体腎炎(FMGN)-びまん性膜性糸球体腎炎(DMGN)との比較検討-[招待有り]口頭発表(一般)
- 第39回日本小児腎臓病学会, 2004年07月, 日本語, 日本小児腎臓病学会, 熊本, 国内会議Rituximab の投与が、FSGSの移植後再発に対し有効であったと考えられた1例-FSGSとBリンパ球活性化の関与に関する考察-[招待有り]口頭発表(一般)
- 第39回日本小児腎臓病学会, 2004年07月, 日本語, 日本小児腎臓病学会, 熊本, 国内会議Bartter症候群8例における遺伝子解析[招待有り]口頭発表(一般)
- 第23回臨床細胞分子遺伝研究会, 2004年06月, 日本語, 臨床細胞分子遺伝研究会, 神戸, 国内会議遠位尿細管性アシドーシスを伴った東南アジア楕円赤血球症の分子遺伝学的解析[招待有り]口頭発表(一般)
- 2nd Pharmaceutical sciences world congress, 2004年06月, 英語, 京都, 国際会議C2 monitoring of cyclosporine in pediatric patients[招待有り]ポスター発表
- 2nd Pharmaceutical sciences world congress, 2004年06月, 英語, 京都, 国際会議Association of genetic polymorphism at positions 2677 and 3435 of MDR1 gene with pharmacokinetics of cyclosporine in Japanese pediatric patients[招待有り]ポスター発表
- 第47回日本腎臓学会学術総会, 2004年05月, 日本語, 日本腎臓学会, 栃木, 国内会議日本人家族性巣状分節性糸球体硬化症におけるαアクチニン4遺伝子とポドシン遺伝子変異の検索[招待有り]口頭発表(一般)
- 第47回日本腎臓学会学術総会, 2004年05月, 日本語, 日本腎臓学会, 栃木, 国内会議当院における典型的MPGNおよびAtypical MPGNの臨床的検討[招待有り]ポスター発表
- 第107回日本小児科学会, 2004年04月, 日本語, 日本小児科学会, 岡山, 国内会議非典型的膜性増殖性糸球体腎炎(Atypical MPGN)の臨床的検討[招待有り]ポスター発表
- 第13回医療薬学会年会, 2003年09月, 日本語, 日本医療薬学会, 神戸, 国内会議小児患者におけるシクロスポリンC2モニタリングに関する検討[招待有り]口頭発表(一般)
- 第25回日本小児腎不全学会, 2003年09月, 日本語, 日本小児腎不全学会, 群馬, 国内会議キャンピロバクター腸炎後に溶血性尿毒症症候群を発症し末期腎不全へと至った7歳女児例[招待有り]口頭発表(一般)
- 第25回日本小児腎不全学会, 2003年09月, 日本語, 日本小児腎不全学会, 群馬, 国内会議Blood access確保に難渋した、維持血液透析を余儀なくされた2歳女児例[招待有り]口頭発表(一般)
- 第38回日本小児腎臓病学会学術集会, 2003年07月, 日本語, 日本小児腎臓病学会, 東京, 国内会議非典型的な経過をとり腎生検を施行した溶血性尿毒症症候群についての検討[招待有り]口頭発表(一般)
- 第38回日本小児腎臓病学会学術集会, 2003年07月, 日本語, 日本小児腎臓病学会, 東京, 国内会議小児科におけるネオーラル薬物動態に関する研究[招待有り]口頭発表(一般)
- 第46回日本腎臓学会学術集会, 2003年05月, 日本語, 日本腎臓学会, 東京, 国内会議小児におけるネオーラル薬物動態に関する研究ポスター発表
- 第106回日本小児科学会学術集会, 2003年04月, 日本語, 日本小児科学会, 福岡, 国内会議小児科におけるネオーラル薬物動態に関する研究[招待有り]口頭発表(一般)
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2023年04月01日 - 2026年03月31日OCRL異常の病態解明とLowe症候群に対する酵素補充療法の開発
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2023年04月01日 - 2026年03月31日遺伝性腎疾患におけるスプライシング異常の影響の全容解明および治療法の開発
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 社会医療法人愛仁会高槻病院(臨床研究センター), 2023年04月01日 - 2026年03月31日レニンアンギオテンシン系に着目した早産、低出生体重児の腎障害進展機序の解明研究
- 日本学術振興会, 科学研究費助成事業, 基盤研究(B), 神戸大学, 2023年04月01日 - 2026年03月31日リツキシマブによる小児ネフローゼ症候群の長期寛解誘導メカニズムの解明
- 日本学術振興会, 科学研究費助成事業, 基盤研究(B), 神戸大学, 2023年04月01日 - 2026年03月31日リツキシマブによる小児ネフローゼ症候群の長期寛解誘導メカニズムの解明
- 日本学術振興会, 科学研究費助成事業, 国際共同研究加速基金(国際共同研究強化(B)), 神戸大学, 2021年10月07日 - 2024年03月31日小児ネフローゼ症候群の国際GWASメタ解析と抗ネフリン抗体に関する国際共同研究本研究は、Boston Children’s Hospital-HarvardのMatthew Sampson博士との国際共同研究であり、①国際GWASメタ解析で明らかになった7つの新たな疾患感受性遺伝子候補領域から疾患感受性遺伝子を同定すること、②日本人小児NS患者の病因として抗ネフリン自己抗体がどの程度関与しているのか、どのようなメカニズムでネフリンに対する自己免疫が生じるのかを疾患感受性遺伝子の側面から解明することを目的とする。 令和3年度は、日本人若手研究分担者である長野が、2021年6月より、Sampson博士の研究室で、研究を開始し、7つの疾患感受性遺伝子候補領域のfine-mappingを実施し、Nephrotic Syndrome Study Network (NEPTUNE)が保有する特発性ネフローゼ症候群患者の全ゲノム情報と腎生検検体(腎糸球体及び尿細管)のRNA-Seq情報を統合したデータベース(NephQTL)や、Harvard大学が保有する免疫細胞RNA-Seqデータベースとの統合解析を実施し、それぞれの遺伝子の発現パターンを明らかにした。一方、神戸大学を中心とした日本側の研究者は、小児特発性ネフローゼ症候群患者15例の活動期(高度蛋白尿出現時)と寛解期(蛋白尿消失期)のペア血漿を収集し、そのサンプルをBoston Children’s Hospitalに送った。現在、その結果を待っているところである。
- 日本学術振興会, 科学研究費助成事業, 基盤研究(B), 神戸大学, 2020年04月01日 - 2023年03月31日iPS細胞由来腎臓オルガノイドを用いた小児ネフローゼ症候群の発症機序の解明小児ネフローゼ症候群(NS)は小児慢性腎疾患で最も頻度が高い原因不明の指定難病である。我々は最近、日本人小児NS患者のゲノムワイド関連解析及び国際メタ解析を行い、腎糸球体ポドサイトに強発現し、尿蛋白防止機構として最も重要なスリット膜の主要構成蛋白であるNephrinをコードする遺伝子-NPHS1のvariantがNSの発症に関連する可能性を世界で初めて見出した。しかし、それらのvariantが、どのような機序でNSの発症に関与するのかは依然として明らかではなく、そのメカニズムを解明する必要がある。 本研究では、小児NS患者由来のiPS細胞を分化誘導し作成した腎臓オルガノイドを用いて、NPHS1のvariantがNSの発症に関与するメカニズムを解明することを目的とする。なお、先行研究から、NPHS1領域の主なvariantは、eQTLやsQTLとして作用するのではなく、minor alleleすべて(risk haplotype)をheteroで有する患者で、Allele-specific expression(ASE)という現象が生じていることが示唆されている。 令和3年度には、研究分担者である理研の高里研究室において、令和2年度に作成した8名のNS患者由来のiPS細胞の一部で、NPHS1領域のrisk haplotypeをhomo, heteroの状態で有する患者由来のiPS細胞をマルチステップ分化誘導し腎臓オルガノイドの作成に成功した。
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2019年04月01日 - 2022年03月31日遺伝性腎疾患におけるスプライシング異常症発症機序の解明および新規治療法の開発様々な遺伝性腎疾患において、その発症機序や重症度におけるスプライシング異常が大きく関わっていることを、in vitro、in vivo、臨床的観点から検討を行ってきた。その結果、これまでミスセンス変異として解釈されてきたエクソン最後の塩基の置換がスプライシング異常を来していることや、それにより、遺伝子型・臨床型の相関の解析が間違った情報を元にされていることが明らかになった。またスプライシングの制御により一部の遺伝性腎疾患では治療が可能であることも明らかとした。今後、核酸医薬を用いた治療法の開発へとつながる重要な情報を多数見いだすことに成功した。
- 国立研究開発法人日本医療研究開発機構 戦略推進部 難病研究課, 難治性疾患実用化研究事業Step1, 神戸大学, 2020年04月 - 2022年03月, 研究代表者Alport症候群に対するエクソンスキッピング療法の開発
- 日本学術振興会, 科学研究費助成事業, 国際共同研究加速基金(国際共同研究強化(B)), 神戸大学, 2018年10月09日 - 2021年03月31日小児ネフローゼ症候群疾患感受性遺伝子及び薬剤感受性遺伝子同定のための国際共同研究我々は、987例の小児ステロイド感受性ネフローゼ症候群患者検体と日本人健常者コントロール検体3,206例を対象として、「ジャポニカアレイ」を利用したGWASを行い、HLA-DR/DQ領域以外に19q13.12のNPHS1-KIRREL2領域と9q32のTNFSF15領域にゲノムワイド有意な関連を示すバリアント(多型)を同定した。この二つの領域から重要と考えられる複数のバリアントが、日本人コホートも含めた国際メタ解析で有意な関連を持つことも明らかにした。また、NPHS1領域のバリアントがNPHS1 mRNAの発現調節に関与する機能バリアントであることが明らかになった。
- 日本学術振興会, 科学研究費助成事業, 基盤研究(B), 神戸大学, 2017年04月01日 - 2020年03月31日アルポート症候群の重症化に関与する遺伝子の同定と重症化機序の解明X連鎖性アルポート症候群(XLAS)女性患者では臨床像と遺伝子型に相関は認めないことが確認された。α3, 4, 5(IV)鎖の分子シミュレーション解析では、ストップコドンを有するエクソンをスキップさせた場合に、正常なα3, 4, 5(IV)鎖とほぼ同様の立体構造を呈することが明らかになったことから、エクソンスキッピング療法によって、truncating変異をnon-truncating変異に修飾することで、XLASを軽症化する可能性が強く示唆された。また、ミスセンス変異症例の重症度は、α3, 4, 5(IV)鎖の三量体形成能と関連することも明らかになった。
- 日本医療研究開発機構, 戦略推進部(難病研究課)難病性疾患実用化研究事業, 2017年04月 - 2020年03月, 研究代表者Alport症候群に対する新規治療法の開発競争的資金
- 日本学術振興会, 科学研究費助成事業, 若手研究(B), 神戸大学, 2017年04月01日 - 2019年03月31日次世代シークエンサーを用いたADPKDのTwo-hit theoryの検証。常染色体優性多発性嚢胞腎(ADPKD)の病態の解明を目的として、患者の血液検体および摘出腎などを用いて、two-hit theoryの検討および解明を行い、最終的にはその知見から新たな治療法の可能性を探る目的で研究を行った。 同意が得られた症例のNGSでの解析およびSanger法での直接での確認を行った。スクリーニングの検索効率向上のために、疾患パネルの作成を試みている。 患者血液由来のDNAと同時に患者から摘出した腎臓の嚢胞上皮細胞から抽出したDNAについても検査を行う予定であり、摘出腎臓からの組織片を用いた培養細胞の確立の手技を過去の文献を参考に確立し、手技の統一化を行った。
- 日本学術振興会, 科学研究費助成事業, 若手研究(B), 神戸大学, 2016年04月01日 - 2018年03月31日網羅的遺伝子解析を利用したAlport症候群の診断体系の確立我々は、次世代シークエンサー(NGS)を用いたtargeted sequencingにより既知のポドサイト関連45遺伝子を網羅的に解析できる診断体制を確率し、研究期間内にAlport症候群(AS)が疑われた185家系に対して解析を施行、147家系で原因遺伝子変異を同定した。多数の症例の解析を行った結果、X染色体連鎖型ASの女性患者における臨床像と遺伝子型の関係を解析することが可能となり報告を行った。また、AS疑い患者の中に含まれる他の遺伝性腎疾患の患者の診断や、コピー数異常や体細胞モザイクを有するAS患者の診断もNGSを用いて行うことが可能であることを明らかとし、報告を行った。
- 日本学術振興会, 学術研究助成基金助成金/基盤研究(C), 基盤研究(C), 神戸大学, 2015年04月 - 2018年03月, 研究代表者私たちはTarget sequenceにより、既知の遺伝性尿細管機能異常症の網羅的診断体制の確立を行なった。その結果、3年間でおよそ150例の遺伝子診断を行い、また現在も毎月5-10検体の解析依頼を受けるに至っている。その結果、1.ギッテルマン症候群イントロン内変異の新規同定法の開発およびイントロン内変異の病原性検索方法の確立、2.新規Copy Number Variation検索法の確立および新規偽性Bartter症候群発症原因遺伝子HNF1B欠失の同定、3.遺伝性高カルシウム尿性低カルシウム血症における偽性バーター症候群発症機序の解明等を行った。競争的資金
- 日本学術振興会, 科学研究費補助金/基盤研究(B), 基盤研究(B), 神戸大学, 2014年04月 - 2017年03月本研究は、その大半が40歳までに腎不全にいたるAlport症候群男性患者を対象として、アンチセンス核酸によるエクソンスキッピングを利用して、重症型変異を軽症型変異に修復することを目指す世界で初めての分子治療法開発の基礎となる研究である。アンチセンス核酸によりエクソンスキッピングを誘導できることを患者の培養細胞レベル及び患者と同じ変異を持つモデルマウスで確認することができ、今後、ヒトへの応用に発展させる予定である。競争的資金
- 日本学術振興会, 科学研究費助成事業, 若手研究(B), 神戸大学, 2013年04月01日 - 2016年03月31日溶血性尿毒症症候群における尿細管障害の包括的病態解明研究本研究はヒト尿細管培養細胞を用いて下痢関連溶血性尿毒症症候群(D+HUS)の尿細管障害機序を解明するものである。はじめにヒト尿細管培養細胞に志賀毒素(ST,1,2)を添加しアポトーシスが生じる適切な濃度と時間を検討したところ、10*-7μg/ml、24時間で適量のアポトーシスが起こることを確認した。次にarrayPCRを用いてmRNAレベルでアポトーシス関連蛋白を解析した。一部因子の増加を認めたが、特定のアポトーシスの経路関連因子ではなかった。またサイトカイン測定も行ったものの測定範囲内で増加は見られなかった。以上より本研究系ではD+HUSの尿細管障害機序解明は限界があると考えられた。
- 日本学術振興会, 科学研究費補助金/研究活動スタート支援, 研究活動スタート支援, 神戸大学, 2013年08月 - 2015年03月, 研究代表者1.アルポート症候群250家系において、遺伝子変異の同定及び遺伝子型と臨床像の相関に関する検討を行い、遺伝子型と臨床型の相関を明らかとしてきた。2.患者尿中落下細胞の培養により、患者由来尿細管上皮細胞のcell lineの作成に成功した。3.培養尿細管上皮細胞における4型コラーゲンα5鎖免疫染色を行い、ナンセンス変異を有する細胞では陰性、ミスセンス変異を有する細胞では陽性であることが明らかとなった。4.アンチセンスオリゴを作成し、目的とするエクソンスキッピングを誘導させることに成功した。今後、実際の患者由来細胞に対して投与を行い、その治療効果を判定する。競争的資金
- 日本学術振興会, 科学研究費補助金/若手研究(B), 若手研究(B), 神戸大学, 2009年 - 2010年, 研究代表者先天性尿細管チャネル・輸送体異常症として発症頻度の高い、Bartter症候群、Gitelman症候群、偽性低アルドステロン症に関する最新の解析技術を用い、良好な結果を得たので報告を行った。 1, Bartter症候群・Gitelman症候群:それぞれの病気において、遺伝子解析における変異検出率は決して高くないことが知られているが、私たちは、従来のゲノムDNAからのPCRおよび直接シークエンス法に加え、尿中落下細胞から抽出したmRNAを用いたRT-PCR法やPCR半定量による広範囲ヘテロ接合体欠失の同定など、最新の遺伝子解析技術を駆使することで、その変異検出率を大幅に向上させることに成功した(Nozu Pediat Research 2009, Nozu Hum Genet 2009)。 2, 偽性低アルドステロン症:同疾患は新生児期に高カリウム血症、体重増加不良を認めるものの自然軽快する疾患である。更に本疾患は常染色体優性遺伝形式をとる疾患であるが、その発症機序は変異のあるalleleが産生するタンパクによるdominant negative効果により発症するか、一つのalleleに変異があるためMR受容体産生量が減少することによるhaplo insufficiency効果により発症するのか未だに不明である。私たちは従来の解析方法でMR遺伝子に新規の変異を同定し、さらに尿中落下細胞から抽出したmRNAを用いたsplicing異常の同定により、dominant negative効果により発症する機序が否定できないことを証明した(Kanda, Nozu BMC Nephrol 2009)。競争的資金
- 日本学術振興会, 科学研究費助成事業, 基盤研究(B), 神戸大学, 2008年 - 2010年CNV解析による先天性腎尿路奇形の新規原因遺伝子同定と遺伝子診断システムの確立本研究は、小児期腎不全の主要な原因である先天性腎尿路奇形(Congenital anomalies of kidney and urinary tract:CAKUT)を対象に、遺伝子欠失、重複などが頻繁に起こるcopy number variation(CNV)領域を、世界最高水準の解析技術を用いて網羅的・系統的に解析することにより、CAKUTの新規原因遺伝子の同定を行うとともに、包括的CAKUT遺伝子診断システムを確立することを目的とする。我々は、腎低形成、腎異形成、多嚢胞性異形成腎、腎無形成などのCAKUT症例を対象として、全染色体のCNV領域を中心とした35万個のプローブ(プローブ間隔:約1kb)を持つAgilent genome-wide CNV 400k array等を用いてCNVを検出した。このうち、CAKUT症例にのみ認められコントロールには認められず、さらに、複数のデータベースでも検出されていない4つのCNVを発見し、これらのCNV領域内あるいは近傍に存在する8つの遺伝子を同定した。このうちの一つの遺伝子は、CAKUT特有のCNVにより3エクソンのヘテロの欠失が生じることが明らかになった。今後、これらの遺伝子が新規CAKUT原因遺伝子であるか否かの検討を進める予定である。これと平行して、我々は、HNF1B,PAX2,EYA1,SIX1,SALL1などの比較的頻度の高いCAKUT原因遺伝子の簡便で検出頻度の高い包括的遺伝子診断システムを構築した。
- 日本学術振興会, 科学研究費補助金/若手研究(B), 若手研究(B), 神戸大学, 2007年 - 2008年, 研究代表者Bartter症候群(BS)、Gitelman症候群(GS)は常染色体劣性尿細管機能異常症で、低カリウム血症、代謝性アルカローシス、高レニン、高アルドステロン血症などを特徴とする。日本人におけるこれらの疾患を有する患者において、臨床的および遺伝学的検討はこれまで行われてこなかったが、私たちは今回の研究で、現在までに53例で遺伝子解析による確定診断を行ってきた。その結果、典型例ではそのほとんどで遺伝子変異を同定することができ、本疾患においては遺伝子診断率が高い疾患であることが分かった。また、解析方法に関する工夫を行い、尿中落下細胞からmRNAを抽出し、RT-PCRを用いて解析を行うという非侵襲的かつ斬新な方法を導入することで、遺伝子診断率を向上させることに成功し、さらに、これまでこれらの疾患で遺伝子診断率が低かった原因として、従来の直接シークエンス法による解析では広範囲のヘテロ接合体欠失の検出はできず、BS患者においてはこの変異が多いためであることを明らかにした。そこで、PCR半定量法を導入することで、それらの変異の検出に成功した。現在まで私たちは90%以上の患者において遺伝子変異の検出に成功した。競争的資金
- 日本学術振興会, 科学研究費補助金/若手研究(B), 若手研究(B), 神戸大学, 2005年 - 2006年, 研究代表者Bartter症候群(BS)、Gitelaman症候群(GS)は常染色体劣性遺伝性尿細管機能異常症で、低カリウム血症,代謝性アルカローシス、高レニン、高アルドステロン血症を認めるにも関わらず正常血圧を示すことなどを特徴とする。現在までにI型からV型BSおよびGSの責任遺伝子が明らかとされている。 日本人におけるこれらの疾患を有する患者において、臨床的および遺伝学的検討はこれまで行われてこなかったが、私たちは今回の研究で、BSではI型9名、II型2名、III型5名、IV型1名、GSでは11名の患者において、その遺伝子異常を明らかとしている。また、解析方法に関する工夫を行い、尿中落下細胞からmRNAを抽出し、RT-PCRを用いて解析を行うという非侵襲的かつ斬新な方法を導入することで、遺伝子診断率を向上させることに成功し、英文学術誌に投稿を行った(Pediatric Research in press)。さらに、これまでこれらの疾患で遺伝子診断率が低かった原因として、従来の直接シークエンス法による解析では広範囲のヘテロ接合体欠失の検出はできず、BS患者においてはこの変異が多いためであることを明らかにした。そこで、PCR半定量法を導入することで、それらの変異の検出に成功した(現在投稿中)。また、日本人においては2型BSの報告例はこれまで1例もなかったが、2型BSでは低カリウム血症を認めない症例もいることを明らかとし、診断がついていない症例の存在の可能性を明らかとした(Pediatric Nephrology in press)。現在まで私たちは90%以上の患者において遺伝子変異の検出に成功している。更なる症例の蓄積を行い、日本人におけるこれらの疾患の患者の特徴を明らかとしていく予定である。競争的資金
- 日本学術振興会, 科学研究費助成事業, 基盤研究(B), 神戸大学, 2003年 - 2004年マレーシアにおける新生児Gilbert症候群の分子疫学的調査1(目的)我々は、マレーシアにおける新生児Gilbert症候群の頻度を調べるために、105人のマレー・マレーシア人新生児(黄疸群55人と非黄疸群50人)を対象に、UGT1A1遺伝子変異の有無をDHPLC法でスクリーニングし、塩基配列解析によって確認した。また、変異TATA boxの有無をGeneScan法で検討した。 2(G71R変異)G71R変異については、黄疸群ではG/G型52人、G/R型3人、R/R型0人であり、その71Rアリル頻度は0.027であった。非黄疸群ではG/G型47人、G/R型3人、R/R型0人であり、その71Rアリル頻度は0.030であった。従って、黄疸群と非黄疸群の遺伝子型の分布については有意差を認めなかった。また、黄疸群のG/R型3人は母児間血液型不適合を有していたのに対し、非黄疸群のG/R型3人は母児間血液型不適合を有していなかった。 3(G493R変異)G493R変異については、黄疸群ではG/G型54人、G/R型1人、R/R型0人であり、その71Rアリル頻度は0.009であった。非黄疸群ではG/G型50人、G/R型0人、R/R型0人であり、その71Rアリル頻度は0.000であった。また、黄疸群のG/R型1人は母児間血液型不適合その他の黄疸危険因子を有していなかった。 4(変異TATA box)黄疸群ではTA-6/TA-6型41人、TA-6/TA-7型10人、TA-7/TA-7型4人であり、そのTA-7アリル頻度は0.16であった。非黄疸群ではTA-6/TA-6型43人、TA-6/TA-7型6人、TA-7/TA-7型1人であり、そのTA-7アリル頻度は0.08であった。 5(結論)「黄疸の有無にかかわらず、UGT1A1遺伝子変異を有する新生児を新生児Gilbert症候群と定義する」ならば、マレーシアにおける新生児Gilbert症候群の頻度は、出生児の30%にも達することが明らかになった。 また、マレー・マレーシア人集団のUGT1A1遺伝子においては、変異TATA boxの頻度が他の変異の頻度よりも高かったことが注目される。しかも、統計学的な有意差を生じるには至らなかったが、黄疸群の変異TATA boxの頻度のほうが非黄疸群のそれよりも高い傾向は明らかであった。このことより、変異TATA boxはマレーシアにおいては新生児黄疸の危険因子になるものと思われた。
研究シーズ
■ 研究シーズ- アルポート症候群に対するエクソンスキッピング療法の開発シーズカテゴリ:ライフサイエンス研究キーワード:エクソンスキッピング, 核酸医薬, アンチセンス核酸, Alport, アンチセンスオリゴヌクレオチド研究の背景と目的:アルポート症候群は指定難病のひとつである重篤な遺伝性腎疾患で、男性患者では大半が30歳までに末期腎不全へと進行するが、未だに有効な治療法が存在しない。本疾患はtruncating変異を有する場合には、non-truncating変異を有する場合と比較し、約20年末期腎不全進行年齢が早いことが判明している。本研究では核酸医薬を用いた、遺伝子を標的とする分子生物学的治療法開発を行う。研究内容:重症型であるtruncating変異を有する患者に対し、アンチセンスオリゴヌクレオチド(ASO)によるエクソンスキッピングを利用して、比較的軽症型であるnon-truncating変異に置換する治療法を確立する。すでにin vitroおよび遺伝子改変モデルマウス(エクソン21変異マウスを独自に作成)をもちいたin vivo実験系において、有効性評価試験が終了し、生存日数の著明な改善、尿蛋白の排泄量の抑制、組織学的所見の進行の有意な抑制および腎臓における4型コラーゲンα5鎖の発現をもたらすことに成功し、明確な有効性の証明に成功した。ヒトに対しても本治療法の有効性が強く期待できる状況となっている。現在、非臨床の安全性評価を行っており、その安全性の確認後、治験プロトコル作成まで終了の上、速やかに医師主導治験を開始したいと考えている。期待される効果や応用分野:アルポート症候群に対する世界初の特異的治療法の開発につながる可能性が高い。関係する業績:論文 Yamamura T, Nozu K et al: Development of an exon skipping therapy for X-linked Alport syndrome with truncating variants in COL4A5. Nat Commun, 11: 2777, 2020 特許 特願2016-254906、アルポート症候群治療薬