内反型変形性足関節症でのX線像による病期分類を検証するための荷重をシミュレーションしたコンピュータ断層撮影について : 横断研究

Background: Varus ankle osteoarthritis is classified using only weightbearing anteroposterior ankle radiographs; however, sagittal ankle alignment may also affect the position and extent of joint space obliteration. We hypothesized that the sagittal alignment of the ankle may also affect the position and extent of joint space obliteration visible on the coronal section; therefore, we identified the sites of joint space obliteration in patients with stage 3 varus ankle osteoarthritis for comparison with the sites observed on simulated weightbearing computed tomography and investigated the effects of anterior and posterior ankle subluxation. Methods: Simulated weightbearing computed tomography scans of 83 ft with varus ankle osteoarthritis (26 stage 3a, 57 stage 3b) were performed to check for joint space obliteration in the ankle. Further classification as exhibiting either anterior, posterior, or no subluxation on weightbearing lateral radiographs was performed. Results: Anterior, posterior, and no subluxation was seen in 5, 9, and 12 ankles among the 26 classified as stage 3a, respectively, and in 22, 12, and 23 ankles among the 57 classified as stage 3b, respectively. The mean tibial lateral surface angle on weightbearing lateral radiographs in stage 3a ankles was 75.6, 83.3, and 80.3 degrees in the anterior, posterior, and no subluxation groups, respectively; and 75.5, 86.6, and 82.7 degrees in stage 3b ankles (p < .05). In stage 3b ankles, widespread joint space obliteration was observed at the anterior distal articular surface of the tibia in all 22 ankles with anterior subluxation and at the posterior distal articular surface of the tibia in all 12 ankles with posterior subluxation. Conclusions: Simulated weightbearing computed tomography revealed joint space obliteration at the anterior distal articular surface of the tibia in stage 3b ankles with anterior subluxation and at the posterior side in stage 3a and 3b ankles with posterior subluxation. In some patients with stage 3 varus ankle osteoarthritis, the obliteration of the joint space is difficult to evaluate accurately using only weightbearing anteroposterior radiographs; weightbearing lateral radiographs should also be performed.博士（医学）・乙第1514号・令和3年12月21日© The Author(s). 2021, corrected publication 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/ licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data

Eotaxins and CCR3 Interaction Regulates the Th2 Environment of Cutaneous T-Cell Lymphoma

CC chemokine receptor 3 (CCR3), the sole receptor for eotaxins, is expressed on eosinophils and T helper type 2 (Th2) cells. In Hodgkin’s disease, eotaxin-1 secreted by fibroblasts collects Th2 cells and eosinophils within the tissue. Similarly, many Th2 cells infiltrate the lesional skin of cutaneous T-cell lymphoma (CTCL). In this study, we investigated the role of eotaxins in the development of the Th2 environment of CTCL. We revealed that fibroblasts from lesional skin of CTCL expressed higher amounts of eotaxin-3 messenger RNA (mRNA) compared with those from normal skin. Lesional skin of CTCL at advanced stages contained significantly higher levels of eotaxin-3 and CCR3 mRNA, compared with early stages of CTCL. IL-4 mRNA was expressed in some cases at advanced stages. Immunohistochemistry revealed that keratinocytes, endothelial cells, and dermal fibroblasts in lesional skin of CTCL showed a stronger expression of eotaxin-3 than did normal skin. CCR3+ lymphocytes and IL-4 expression were observed in some cases of advanced CTCL. Furthermore, both serum eotaxin-3 and eotaxin-1 levels of CTCL patients at advanced stages were significantly higher than those of healthy individuals. The concentrations of these chemokines correlated with serum soluble IL-2 receptor levels. These results suggest that interaction of eotaxins and CCR3 regulates the Th2-dominant tumor environment, which is closely related to the development of CTCL

Lymphatic Dysfunction Impairs Antigen-Specific Immunization, but Augments Tissue Swelling Following Contact with Allergens

The lymph transports tissue-resident dendritic cells (DCs) to regional lymph nodes (LNs), having important roles in immune function. The biological effects on tissue inflammation following lymphatic flow obstruction in vivo, however, are not fully known. In this study, we investigated the role of the lymphatic system in contact hypersensitivity (CHS) responses using k-cyclin transgenic (kCYC+/-) mice, which demonstrate severe lymphatic dysfunction. kCYC+/- mice showed enhanced ear swelling to both DNFB and FITC, as well as stronger irritant responses to croton oil compared with wild-type littermates. Consistently, challenged ears of kCYC+/- mice exhibited massive infiltrates of inflammatory cells. In contrast, DC migration to regional LNs, drainage of cell-free antigen to LNs, antigen-specific IFN-γ production, and lymphocyte proliferation were impaired during the sensitization phase of CHS in kCYC+/- mice. Transfer experiments using lymphocytes from sensitized mice and real-time PCR analysis of cytokine expression using challenged ear revealed that ear swelling was enhanced because of impaired lymphatic flow. Collectively, we conclude that insufficient lymphatic drainage augments apparent inflammation to topically applied allergens and irritants. The findings add insight into the clinical problem of allergic and irritant contact dermatitis that commonly occurs in humans with peripheral edema of the lower legs

釧路湿原3湖沼の水生植物の現状

[論文] Articl

Tissue Inhibitor of Metalloproteinase 1 (TIMP-1) May Be an Autocrine Growth Factor in Scleroderma Fibroblasts.

In scleroderma (systemic sclerosis, SSc), an autoimmune disorder in which excessive extracellular matrix is deposited in skin and internal organs, one of the suggested contributory factors to the development of fibrosis is a decrease in collagenase activity that may be related to levels of serum tissue inhibitors of metalloproteinases 1 (TIMP-1). We recently reported that the serum TIMP-1 levels in SSc patients were elevated compared with normal controls. To determine the biologic significance of TIMP-1 in SSc, we compared the proliferative effects of TIMP-1 between normal and SSc fibroblasts. TIMP-1 showed significant mitogenic activity for both normal and SSc fibroblasts. The mitogenic responses to TIMP-1 (33–100ng/ml) in SSc fibroblasts, however, were significantly greater than those in normal controls and were completely neutralized in the presence of antiTIMP-1 IgG. Moreover, anti-TIMP-1 IgG partially but significantly blocked the basal mitogenic activities of SSc fibroblasts. SSc fibroblasts produced increased amounts of TIMP-1 relative to normal fibroblasts, as confirmed by western blotting, ELISA, and RT-PCR techniques. In contrast, transforming growth factor β1 (TGF-β1) upregulated TIMP-1 production in normal fibroblasts but not in SSc fibroblasts with elevated spontaneous secretion of TIMP-1. These observations suggest that TIMP-1 may play an important role as an autocrine growth factor in the fibrotic process in SSc