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岡本 隼樹医学部附属病院 腎・血液浄化センター助教
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■ 受賞- 2026年01月 神戸腎臓ネットワーク, 第18回辻賞, ファブリー病におけるSGLT2阻害薬の腎保護効果
- 2025年07月 第20回日本ファブリー病フォーラム研究奨励賞, 兵庫県全域における血液透析患者のファブリー病スクリーニングに関する観察研究
- INTRODUCTION: Calcimimetics such as etelcalcetide (ET) are used to manage secondary hyperparathyroidism patients with chronic kidney disease (CKD) on dialysis. While their cardiovascular benefits-including left ventricular hypertrophy (LVH) suppression-are recognized, the underlying mechanisms remain unclear. This study investigated how ET suppresses LVH using rat models. METHODS: LVH was induced via transverse aortic coarctation, and CKD by 5/6 nephrectomy. Rats were assigned to the sham, CKD, LVH, or CKD/LVH groups, with each pathological group further divided into vehicle- or ET-treated subgroups. After eight weeks of treatment, echocardiography, histological, biochemical, and molecular analyses were conducted. RESULTS: ET reduced serum parathyroid hormone and fibroblast growth factor 23 (FGF23) levels in the CKD and CKD/LVH groups but not in the LVH group, where these levels were not increased. ET did not affect serum calcium, phosphorus, or vitamin D levels in the LVH and CKD/LVH groups. Nonetheless, ET suppressed cardiac hypertrophy and cardiomyocyte enlargement in the LVH and CKD/LVH groups despite no changes in systemic mineral metabolism parameters. Mechanistically, ET attenuated cardiac hypertrophy, serum aldosterone levels, and cardiac renin-angiotensin-aldosterone system (RAAS) components in the LVH and CKD/LVH groups. Cardiac FGF23 expression, elevated in the LVH and CKD/LVH groups, was also decreased by ET. The calcineurin/nuclear factor of the activated T-cell signaling pathway was unaffected. CONCLUSION: ET effectively suppressed LVH in the LVH and CKD/LVH groups. These findings suggest that ET's cardioprotective effects are mediated via the modulation of the RAAS and cardiac FGF23 expression rather than solely through the correction of CKD-mineral bone disorder abnormalities.2026年01月, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 196, 119054 - 119054, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Fabry disease (FD) is a rare X-linked lysosomal storage disorder characterized by globotriaosylceramide (Gb3) accumulation, resulting in kidney and cardiac dysfunction. Although enzyme replacement therapy (ERT) and chaperone therapy are the standard therapies, progression of renal decline persists. Sodium-glucose co-transporter 2 (SGLT2) inhibitors exert renoprotective effects in chronic kidney disease (CKD), but their efficacy in FD remains unknown. METHODS: We retrospectively analyzed data of 10 patients with FD treated with SGLT2 inhibitors and compared their renal outcomes to 18 patients with CKD without FD. The estimated glomerular filtration rate (eGFR) slope, urinary albumin-to-creatinine ratio (UACR), and plasma brain natriuretic peptide (BNP) levels were assessed 1 year before and after initiating SGLT2 inhibitor therapy. Linear mixed-effects models were employed for statistical analysis. RESULTS: In patients with FD, the annual eGFR decline significantly improved from -4.38 mL/min/1.73 m2/year (IQR: -10.57 to 0.59) before treatment to 1.25 (IQR: -4.16 to 9.74) after treatment (p < 0.05). This improvement remained significant after adjusting for confounding factors. In contrast, the annual eGFR decline in patients with CKD without FD also tended to improve, albeit without significance. Notably, the initial eGFR decline usually seen with SGLT2 inhibitors in CKD was not observed in the FD cohort. UACR and plasma BNP levels remained unchanged after SGLT2 inhibitor therapy. CONCLUSIONS: SGLT2 inhibitors substantially attenuated the decline in eGFR in patients with FD. These findings support their potential as a renoprotective adjunct in the management of FD.2025年12月, Molecular genetics and metabolism reports, 45, 101271 - 101271, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Increased serum anti-nephrin antibody titers and co-localization of nephrin and IgG in kidney tissues have been reported in minimal change disease (MCD) and post-transplant recurrent focal segmental glomerulosclerosis (FSGS). These results indicate an association of anti-nephrin antibodies with nephrotic syndrome (NS); however, the exact relationship remains unclear. Herein, we evaluated nephrin/IgG co-localization in the glomeruli of patients with various kidney diseases, including monogenic NS, to clarify the association between idiopathic nephrotic syndrome (INS) and anti-nephrin antibodies. METHODS: IgG and nephrin co-localization was investigated in 52 kidney tissue biopsy samples, comprising INS in the active phase (n = 26; MCD, n = 19; FSGS, n = 7) and remission (n = 6), monogenic NS (n = 3), and other kidney diseases (n = 17). Double-immunofluorescence staining for nephrin/IgG was performed in unfixed frozen sections for 2 h at room temperature with Alexa Fluor-labeled nephrin/IgG cocktail antibodies. Nephrin/IgG co-localization was assessed using optical sectioning under a fluorescence microscope. RESULTS: Nephrin/IgG co-localization was observed in 81% (21/26, children: 15/17, adults: 6/9) of active INS cases, 84% (16/19) of MCD cases, and 71% (5/7) of FSGS cases. No co-localization was observed in NS with monogenic variants or other kidney diseases. CONCLUSION: Nephrin/IgG co-localization in the kidney tissue is finding observed in active INS, strongly indicating an association between anti-nephrin antibodies and INS onset. The nephrin/IgG cocktail antibody is a rapid and effective approach for investigating INS pathogenesis that facilitates the differential diagnosis of immune-mediated NS from other kidney diseases, including monogenic NS.2025年08月, Clinical and experimental nephrology, 29(12) (12), 1821 - 1828, 英語, 国内誌研究論文(学術雑誌)
- (一社)日本腎臓学会, 2025年06月, 日本腎臓学会誌, 67(4) (4), 571 - 571, 日本語混合効果モデルを用いたFabry病患者におけるSGLT2阻害薬のeGFR slopeへの影響に関する検討
- (一社)日本移植学会, 2024年11月, 移植, 59(2) (2), 208 - 209, 日本語
- (一社)日本腎臓学会, 2024年09月, 日本腎臓学会誌, 66(6-W) (6-W), 1051 - 1051, 日本語臨床研究フロンティア ファブリー病患者における骨密度についての知見とスクリーニングへの取り組み
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 644 - 644, 日本語カルシウム感知受容体(CaSR)作動薬による心肥大抑制とレニン-アンジオテンシン-アルドステロン系(RAAS)の変化
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 675 - 675, 日本語Fabry病における酵素補充療法前後の血中Lyso-Gb3の変化率に関する検討
- (一社)日本腎臓学会, 2024年06月, 日本腎臓学会誌, 66(4) (4), 675 - 675, 日本語Fabry病におけるSGLT2阻害薬による心・腎保護効果の検討
- BACKGROUND: Fabry disease (FD) is an inherited disorder that causes organ dysfunction. However, only a few studies have reported on bone mineral density (BMD) in FD patients, and the relationship between BMD and clinical factors such as globotriaosylsphingosine (lyso-Gb3) remains unclear. Therefore, the current study sought to investigate BMD in FD patients, the relationship between BMD and lyso-Gb3, and the effects of enzyme replacement therapy (ERT) on changes in BMD and lyso-Gb3. METHODS: This single-center, observational study included 15 patients who visited our facility for FD between January 2008 and June 2021. We assessed BMD and clinical characteristics in study patients, including plasma lyso-Gb3 levels, and examined the relationship between BMD and plasma lyso-Gb3 levels, and changes in BMD after starting ERT. RESULTS: Male patients' BMD had reduced, whereas female patients' BMD was preserved. Male patients had significantly higher plasma lyso-Gb3 levels than female patients. Moreover, plasma lyso-Gb3 levels were found to be significantly related to the lumbar spine and femoral BMD. These were strongly linked with plasma lyso-Gb3 levels in male patients, whereas no strong link was observed in female patients. Furthermore, BMD significantly increased only in male patients although plasma lyso-Gb3 levels significantly decreased by ERT in all patients. CONCLUSION: BMD decreased possibly due to Gb3 accumulation, and ERT could increase BMD in male FD patients.2023年08月, Molecular genetics and metabolism, 139(4) (4), 107634 - 107634, 英語, 国際誌研究論文(学術雑誌)
- (一社)日本腎臓学会, 2023年05月, 日本腎臓学会誌, 65(3) (3), 258 - 258, 日本語慢性腎臓病+心肥大モデルラットにおけるカルシウム受容体作動薬の効果
- (一社)日本移植学会, 2025年10月, 移植, 60(2) (2), 138 - 139, 日本語
- (一社)日本腎臓学会, 2025年09月, 日本腎臓学会誌, 67(6-W) (6-W), 993 - 993, 日本語アバコパン投与後に胆管消失症候群をきたした多発血管炎肉芽腫症の一例
- (一社)日本腎臓学会, 2025年06月, 日本腎臓学会誌, 67(4) (4), 571 - 571, 日本語混合効果モデルを用いたFabry病患者におけるSGLT2阻害薬のeGFR slopeへの影響に関する検討
- 2025年, 日本腎臓学会誌(Web), 67(6-W) (6-W)アバコパン投与後に胆管消失症候群をきたした多発血管炎肉芽腫症の一例
- 2025年, 移植(Web), 60(2) (2)移植後拒絶を疑う腎機能低下から腎動脈狭窄が判明した一例
- 2025年, 臨床透析, 41(4) (4)長期透析の現況・課題と対策 3 長期透析患者にみられる病態(4)心血管疾患
- 2025年, 日本臨床腎移植学会プログラム・抄録集, 58th抗ネフリン抗体による巣状分節性糸球体硬化症再発の一例
- 2025年, 日本腎臓学会誌(Web), 67(4) (4)混合効果モデルを用いたFabry病患者におけるSGLT2阻害薬のeGFR slopeへの影響に関する検討
- 2024年, 日本腎臓学会誌(Web), 66(4) (4)Fabry病における酵素補充療法前後の血中Lyso-Gb3の変化率に関する検討
- 2024年, 日本腎臓学会誌(Web), 66(4) (4)Fabry病におけるSGLT2阻害薬による心・腎保護効果の検討
- 2024年, 日本腎臓学会誌(Web), 66(4) (4)カルシウム感知受容体(CaSR)作動薬による心肥大抑制とレニン-アンジオテンシン-アルドステロン系(RAAS)の変化
- 2024年, 日本腎臓学会誌(Web), 66(6-W) (6-W)ファブリー病患者における骨密度についての知見とスクリーニングへの取り組み
- 2024年, 移植(Web), 59(2) (2)抗ネフリン抗体の関与が疑われた巣状分節性糸球体硬化症の腎移植後再発の一例
- 2023年, 日本腎臓学会誌(Web), 65(3) (3)慢性腎臓病+心肥大モデルラットにおけるカルシウム受容体作動薬の効果
- 2022年, 臨床透析, 38(2) (2)症例による透析患者の画像診断 透析アミロイドーシスが原因と考えられた大腿骨頸部骨折の1例
- 2021年, 日本高血圧学会総会プログラム・抄録集(CD-ROM), 43rd透析導入期の血清リン値の厳格管理が血管石灰化に及ぼす影響
- (一社)日本糖尿病学会, 2020年07月, 糖尿病, 63(7) (7), 510 - 510, 日本語播種性アスペルギルス症にて急速な死の転帰を辿った糖尿病性ケトアシドーシスの1例
- 2020年, 糖尿病(Web), 63(7) (7)播種性アスペルギルス症にて急速な死の転帰を辿った糖尿病性ケトアシドーシスの1例
- 2019年, 日本腎臓学会誌, 61(6) (6)右水腎症発症を契機に診断に至ったIgG4関連大動脈周囲炎の一例
- 2018年, 日本高血圧学会総会プログラム・抄録集(CD-ROM), 41st血液透析患者における二次性副甲状腺機能亢進症のレニン・アルドステロン系への影響
- 2018年, 日本高血圧学会総会プログラム・抄録集(CD-ROM), 41st総腸骨動脈狭窄症による急激な血圧上昇と腎機能低下を認めた腎移植患者の一例
- 2017年, 日本透析医学会雑誌, 50(Supplement 1) (Supplement 1)シナカルセト内服を契機に頻脈発作が増悪した一例
