Comparative analysis of CD45RA- and CD45RO-positive CD4⁺T cells in peripheral blood, synovial fluid, and synovial tissue in patients with rheumatoid arthritis and osteoarthritis

&#8195;To determine whether the predominant infiltration with memory CD4+T cells in joints is specific to the local immune and inflammatory response in rheumatoid arthritis (RA), the proportions of CD45RA+ or CD45RO+ cells in the CD4+T cell populations in three different compartments (i.e., peripheral blood, synovial fluid, and synovial tissue) from patients with RA and osteoarthritis (OA) were compared by two-color flow-cytometric analysis. In the CD4+T cell population of peripheral blood, the number of CD45RO+ cells was relatively higher than CD45RA+ cells in both RA and OA patients, but their percentages did not differ from those found in healthy individuals. However, the great majority of CD4+T cells present in synovial fluid and synovial tissue were CD45RO-positive and CD45RA-negative in both patient groups; although CD4+T cells infiltrating both the disease compartments were markedly greater in RA joints, their mean percentages of CD45RO+ cells were not significantly different from those in OA joints. These data indicate that an accumulation of CD45RO+ memory CD4+T cells is a generalized phenomenon during local inflammatory responses in both RA and OA joints, and may be due mainly to the propensity of these cells to preferentially transmigrate into the inflamed joint via adhesion molecules as compared with CD45RA+ naive CD4+T cells.</p

Predictive Value of the Cardio-Ankle Vascular Index for Cardiovascular Events in Patients at Cardiovascular Risk

BACKGROUND: Arterial stiffness is an important predictor of cardiovascular events; however, indexes for measuring arterial stiffness have not been widely incorporated into routine clinical practice. This study aimed to determine whether the cardio-ankle vascular index (CAVI), based on the blood pressure-independent stiffness parameter beta and reflecting arterial stiffness from the origin of the ascending aorta, is a good predictor of cardiovascular events in patients with cardiovascular disease risk factors in a large prospective cohort. METHODS AND RESULTS: This multicenter prospective cohort study, commencing in May 2013, with a 5-year follow-up period, included patients (aged 40-74 years) with cardiovascular disease risks. The primary outcome was the composite of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. Among 2932 included patients, 2001 (68.3%) were men; the mean (SD) age at diagnosis was 63 (8) years. During the median follow-up of 4.9 years, 82 participants experienced primary outcomes. The CAVI predicted the primary outcome (hazard ratio, 1.38; 95% CI, 1.16-1.65; P CONCLUSIONS: This large cohort study demonstrated that the CAVI predicted cardiovascular events

Development of Radiation Hard N+-on-P Silicon Microstrip Sensors for Super LHC

Radiation tolerance up to 1015 1-MeV neq/cm2 is required for the silicon microstrip sensors to be operated at the Super LHC experiment. As a candidate for such sensors, we are investigating non-inverting n+-on-p sensors. We manufactured sample sensors of 1 times 1 cm in 4" and 6" processes with implementing different interstrip electrical isolation structures. Industrial high resistive p-type wafers from FZ and MCZ growth are tested. They are different in crystal orientations lang100rang and lang111rang with different wafer resistivities. The sensors were irradiated with 70-MeV protons and characterized in views of the leakage current increase, noise figures, electrical strip isolation, full depletion voltage evolution, and charge collection efficiency

Deep-vein thrombosis detection rates and consideration of the living environment in a tsunami disaster area during the disaster reconstruction phase: A cross-sectional study

Introduction: Tsunami victims of the Great East Japan Earthquake were screened for deep-vein thrombosis(DVT) in order to compare the DVT incidence rates between temporary and non-temporary housing residentgroups. Material and methods: Lower extremity venous ultrasonography was performed on 290 subjects (64 menand 226 women; mean age = 71.9 ± 7.9 years) at 44 months after the disaster. All subjects completedquestionnaires to gather information about their background factors which included the Kessler PsychologicalDistress Scale: K6. Results: The DVT detection rate was 10.7% in the temporary group. In the non-temporary group, it was 11.3%among the subjects who previously lived in temporary housing. For the subjects who were living in their own homes it was 9.2%. Psychological distress levels measured by K6 were significantly higher in the temporary housinggroup than in the non-temporary housing group. The multivariate analysis showed that the background factorassociated with DVT risk was SV (soleal vein) dilatation in all subjects as well as in the non-temporary housinggroup, while hypertension and use of sleeping pills were found to be the factors in the temporary housing group. Conclusions: DVT detection rates were similar between the temporary and non-temporary housing groups,and were higher than that in the Japanese general population. The psychological distress level of the tsunamivictims measured by K6 was also higher in the temporary housing group than in the non-temporary housinggroup. It is necessary to establish a long-term and awareness-raising disaster victim support system

Hospital and clinic cooperation for the treatment of rheumatoid arthritis in Okayama Prefecture, Japan

Objective: To survey the current status and problems of cooperation between clinics and hospitals in Okayama Prefecture, Japan for the treatment of rheumatoid arthritis (RA). 　Methods: We distributed a questionnaire to 300 of the 983 Okayama Prefecture clinics that had either an internal medicine or orthopedic surgery department, from December 2013 to February 2014. The questionnaire covered practice pattern for RA treatment in clinics, current status of the hospital and clinic cooperation, and acceptance of the biologic therapy. 　Results: One hundred clinics responded to the questionnaire. Seventy percent of the clinics reported making referrals to rheumatologists before the initiation of RA treatment, and half of the other 30% of the clinics administered methotrexate as the first-line treatment for RA by their own decision. Sixty-six clinics cooperated with flagship hospitals, conducting medical and laboratory examinations, providing prescriptions, and treating common diseases of patients. These clinics expected the cooperating rheumatologists to follow-up patients every 3 to 6 months and to make the diagnosis, make decisions regarding RA treatment changes, and perform surgery. Seventy-one percent of the clinics responded that cooperation with a hospital is possible even for patients who are administered biologics. As reasons for no cooperation with the flagship hospitals, clinics noted the lack of information about rheumatologists in the area and recent trends in the management of RA. 　Conclusion: The current study reported, for the first time, the actual conditions of management of RA in clinics, as well as future problems of hospital and clinic cooperation in Okayama Prefecture

The Dawn of a New Era in Atopic Dermatitis Treatment

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, and the condition is typified by barrier dysfunction and immune dysregulation. Recent studies have characterized various phenotypes and endotypes of AD and elucidated the mechanism. Numerous topical and systemic narrow targeting therapies for AD have been developed according to these findings. Topical medications, including Janus kinase (JAK) inhibitors, phosphodiesterase 4 inhibitors, and the aryl hydrocarbon receptor agonist tapinarof, are effective and safe for AD compared to topical corticosteroids. Oral JAK inhibitors and monoclonal antibodies targeting interleukin (IL)-4, IL-13, IL-31, IL-33, OX40, thymic stromal lymphopoietin, and sphingosine 1-phosphate signaling have displayed outstanding efficacy against moderate-to-severe AD. We are currently in a new era of AD treatment