悪性腫瘍関連筋炎の臨床疫学及び筋病理組織学的検討

学位の種別:課程博士University of Tokyo(東京大学

Induction of cyclooxygenase-2 in human synovial cells by β2-microglobulin

Induction of cyclooxygenase-2 in human synovial cells by β2-microglobulin.BackgroundProstaglandins (PGs) are important mediators of inflammation in arthritis. We evaluated the role of the cyclooxygenase-2 (COX-2) enzyme, which regulates PG biosynthesis, in osteoarthropathy associated with hemodialysis-associated amyloidosis (HAA) by characterizing COX-2 expression in β2-microglobulin–treated human synovial cells.MethodsWe examined the effects of β2-microglobulin (β2m), a major constituent protein of amyloid fibrils in HAA, on the COX-2 protein and mRNA expression in human synovial cells using Western blot and reverse transcriptase-polymerase chain reaction.Resultsβ2m selectively increased the biosynthesis of COX-2 protein and induction of COX-2 mRNA in a dose-dependent manner. Immunoabsorption of β2m–containing media by anti-β2m–specific antibody abrogated β2m–mediated COX-2 expression on synovial cells. On the other hand, dexamethasone markedly suppressed the induction of COX-2 protein and mRNA in β2m–stimulated synovial cells.ConclusionsOur results suggest that induction of COX-2 expression by β2m may be an important component of the inflammatory process in hemodialysis-associated osteoarthropathy

Fatty liver incidence and predictive variables.

Although fatty liver predicts ischemic heart disease, the incidence and predictors of fatty liver need examination. The objective of this study was to determine fatty liver incidence and predictive variables. Using abdominal ultrasonography, we followed biennially through 2007 (mean follow-up, 11.6+/-4.6 years) 1635 Nagasaki atomic bomb survivors (606 men) without fatty liver at baseline (November 1990 through October 1992). We examined potential predictive variables with the Cox proportional hazard model and longitudinal trends with the Wilcoxon rank-sum test. In all, 323 (124 men) new fatty liver cases were diagnosed. The incidence was 19.9/1000 person-years (22.3 for men, 18.6 for women) and peaked in the sixth decade of life. After controlling for age, sex, and smoking and drinking habits, obesity (relative risk (RR), 2.93; 95% confidence interval (CI), 2.33-3.69, P<0.001), low high-density lipoprotein-cholesterol (RR, 1.87; 95% CI, 1.42-2.47; P<0.001), hypertriglyceridemia (RR, 2.49; 95% CI, 1.96-3.15; P<0.001), glucose intolerance (RR, 1.51; 95% CI, 1.09-2.10; P=0.013) and hypertension (RR, 1.63; 95% CI, 1.30-2.04; P<0.001) were predictive of fatty liver. In multivariate analysis including all variables, obesity (RR, 2.55; 95% CI, 1.93-3.38; P<0.001), hypertriglyceridemia (RR, 1.92; 95% CI, 1.41-2.62; P<0.001) and hypertension (RR, 1.31; 95% CI, 1.01-1.71; P=0.046) remained predictive. In fatty liver cases, body mass index and serum triglycerides, but not systolic or diastolic blood pressure, increased significantly and steadily up to the time of the diagnosis. Obesity, hypertriglyceridemia and, to a lesser extent, hypertension might serve as predictive variables for fatty liver

Effect of extracted garlic powder ingestion for two months on exercise-induced immunological responses

Introduction. Exhaustive exercise is associated with an increased risk of upper respiratory tract infection. Previously, allicin supplementation has been reported to reduce the incidence of common cold symptoms and production of exercise-induced interleukin (IL)-6. However, it is not clear if daily ingestion of the edible portion of whole garlic (Allium sativum) alters the exercise-induced immunological response. The present study investigated the effects of extracted garlic powder ingestion for 2 months on immune cell counts, natural killer cell activity (NKCA), as well as changes in cytokines, cortisol, and lactic acid in response to high-intensity cycling exercise. Methods. The present study employed a before-after study design. Six sedentary male participants (age, 22.0±0.3 years) consumed extracted garlic powder for 2 months, and underwent 45 minutes of cycling exercise at 80% of the heart rate reserve once before and once after the supplementation period. A thousand milligrams of extracted garlic powder, comparable to 6 g (1 clove) of raw garlic, was ingested every day. Blood samples were obtained at the following five time points: before exercise, 0 min, 30 min, 60 min, and 120 min after exercise. We measured NKCA, leukocyte counts, neutrophil counts, lymphocyte counts, as well as levels of serum IL-6, IL-10, cortisol, and lactic acid. Repeated measures ANOVA was used for statistical analyses. When interaction effects were significant, measurement values at the various time points were compared between pre- and post-supplementation period using the paired t-test. Changes were deemed statistically significant when p\u3c0.05. Results. We observed no significant difference in pre-exercise measurements between pre- and post-supplementation periods. In addition, we found no significant interaction effect for leukocytes, neutrophils, NKCA, IL-10, and cortisol. However, we did identify a significant interaction effect for lymphocytes, IL-6, and lactic acid (p=0.033, p=0.030, and p\u3c0.001, respectively). Lymphocyte counts were significantly lower post-supplementation relative to pre-supplementation immediately after exercise (p=0.014). In addition, IL-6 was significantly lower post-supplementation relative to pre-supplementation immediately and 30 minutes after exercise (p=0.015 and p=0.018, respectively). Lactic acid levels were significantly lower post-supplementation relative to pre-supplementation immediately after exercise (p=0.018). Conclusions. The extracted garlic powder did not significantly influence exercise-induced responses by leukocytes, neutrophils, NKCA, IL-10, or cortisol. However, exercise-induced responses by lymphocytes, IL-6, and lactic acid were suppressed after ingestion of extracted garlic powder. Thus, daily ingestion of the edible portion of whole garlic may suppress exercise-induced immunological responses and lactic acid levels

Risk for Progression to Overt Hypothyroidism in an Elderly Japanese Population with Subclinical Hypothyroidism

Background: Few population-based studies report the changes with time in thyroid function tests in patients with subclinical hypothyroidism. We compared the risk for developing overt hypothyroidism in patients with subclinical hypothyroidism and euthyroid controls from the same population of elderly Japanese. We also sought associations of selected parameters with the development of overt hypothyroidism in the subclinical hypothyroid and euthyroid groups. Methods: We measured thyrotropin (TSH) and free thyroxine (T4) levels at baseline examinations performed from 2000 to 2003 in the cohort of Japanese atomic-bomb survivors and identified 71 patients with spontaneous subclinical hypothyroidism (normal free T4 and TSH >4.5 mIU/L without a history of thyroid treatment, mean age 70 year) and 562 euthyroid controls. We re-examined TSH and free T4 levels an average of 4.2 years later (range, 1.9-6.9). Results: The risk for progression to overt hypothyroidism was significantly increased in subclinical hypothyroid patients (7.0%) compared with control subjects (1.6%) after adjusting for age and sex (odds ratio, 4.56; p=0.009). Higher baseline TSH levels were associated with progression from subclinical to overt hypothyroidism (p=0.02) in the multivariate analysis, including age, sex, antithyroid peroxidase antibody, and ultrasonography (US) findings. The analysis using binary TSH data suggested that a TSH level >8 mIU/L was a predictive value for development of overt hypothyroidism (p=0.005). On the other hand, serum TSH levels spontaneously normalized in 38 (53.5%) of the patients with subclinical hypothyroidism. In the multivariate analysis, normalization of TSH levels was associated with lower baseline TSH levels (p=0.004) and normal and homogenous thyroid US findings (p=0.04). Atomic-bomb radiation dose was not associated with subclinical hypothyroidism or its course. Conclusions: Subclinical hypothyroidism was four times more likely to be associated with development of overt hypothyroidism than euthyroid controls in the sample population of Japanese elderly. TSH levels in half of the patients normalized spontaneously when assessed after an average follow-up period of 4.2 years. Baseline TSH level and thyroid US findings are potential predictors of future thyroid function in subclinical hypothyroidism

The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target

Effects of Demographic Variables on Subjective Neurocognitive Complaints Using the Neurocognitive Questionnaire (NCQ) in an Aged Japanese Population

Objectives: In an aged Japanese population, we investigated associations of demographic variables with subjective neurocognitive complaints using the Neurocognitive Questionnaire (NCQ). Methods: Participants (N = 649) provided answers to the NCQ in both 2011 and 2013. Using fully-completed NCQs from 503 participants in 2011, we identified latent factors of subjective neurocognitive complaints using exploratory factor analysis; then examined associations of demographic variables with the identified factors for all 649 participants over the two years. We also examined changes in factor scores over the 2-year period. Results: We identified four factors representing 20 of the 25 NCQ items and labelled them metacognition, emotional regulation, motivation/organization, and processing speed. In a regression model using all participants, we observed linear deterioration with age on emotional regulation and linear-quadratic deterioration with age on the other factors. Less education was associated with more problems for all factors, but we detected no evidence of interaction between age and education. In 314 participants completing both assessments, paired t-tests comparing the 2013 to 2011 responses corroborated the regression results, except for emotional regulation. Conclusions: On the NCQ, older age and less education were associated with more subjective neurocognitive complaints. This is compatible with the association of the same factors with objective cognition and suggests that subjective cognitive complaints complement objective cognition as a prodrome of non-normative cognitive decline