D-mannoheptulose による膵B細胞機能の阻害

We have reported that alloxan inhibits glucose metabolism and glucose-induced 45Ca uptake in the pancreatic B-cells, while non-B-islet cells are not inhibited by alloxan pretreatment. Therefore, it is possible to assess glucose metabolism and Ca uptake in the B-cells by measuring these parameters in alloxan treated and non-alloxan treated islets and determining the difference. In our previous paper, we found that the glucose dose-response relationships of glucose oxidation, glucose-induced 45Ca uptake and insulin release were closely interrelated.　　In this paper we have investigated the effect of D-mannoheptulose on glucose oxidation, glucose-induced 45Ca uptake and insulin release in the B-cells by incubating isolated rat islets with and without alloxan pretreatment (20 mg/dl, for 6 minutes) in order to investigate the role of hexokinase in the regulation of glucose-induced insulin release in the pancreatic B-cells.　　In the absence of D-mannoheptulose, the threshold of the three parameters (14CO₂ formation from 14C-U-D-glucose, glucose-induced 45Ca uptake and insulin release) in the B-cells was approximately 5.5mM glucose. The half-maximal responses for each of the three parameters occurred with 11.5mM, 13.5mM and 11.7mM glucose, respectively. The maximal response for these parameters occurred with 20mM glucose. When 1.0mM D-mannoheptulose was added to glucose, the threshold for the three parameters increased to 11.0mM with half maximal responses at 15.5mM, 15.8mM and 17.0mM glucose, respectively. The maximal responses of the three parameters were obtained at 27.8mM glucose. The addition of 2.5mM D-mannoheptulose to glucose required more glucose to achieve half-maximal responses of the three parameters (27.4mM, 27.5mM and 25.5mM, respectively) with maximal responses at 38.8mM glucose.　　The inhibitions by D-mannoheptulose of glucose oxidation, glucose-induced 45Ca uptake and insulin release respectively were closely related to each other. These data indicate that hexokinase may play a regulatory role in glucose metabolism in the pancreatic B-cells resulting in the tight control of glucose-induced Ca mobilization and insulin release

Differences in COVID-19 Vaccine Acceptance, Hesitancy, and Confidence between Healthcare Workers and the General Population in Japan

Little is known about the differences in coronavirus disease (COVID-19) vaccine acceptance and hesitancy between the general population and healthcare workers in Japan. To compare these differences, a nationwide web-based cross-sectional survey was conducted on 19 January 2021, shortly before the initiation of COVID-19 vaccinations in Japan. A total of 6180 men and women aged 20–69 years and 1030 healthcare workers aged 20–69 years were enrolled. Data on COVID-19 vaccine acceptance, basic characteristics, including socioeconomic factors, and confidence in immunization in general were collected. COVID-19 vaccine acceptance was also evaluated under hypothetical vaccine effectiveness and adverse event frequencies. Factors associated with vaccine hesitancy were examined using multinomial logistic regression analysis. The COVID-19 vaccine acceptance rate was 48.6% among the general population and was lower among nurses (45.5%) and medical clerks (40.7%). Women and young adults had significantly higher COVID-19 vaccine hesitancy odds ratios, and current smokers had significantly lower odds ratios. The frequency of adverse events was a COVID-19 vaccine hesitancy factor. Even if these factors were adjusted, COVID-19 vaccine hesitancy among nurses was 1.4 times higher than that among the general population. Thus, interventions to improve health literacy and vaccine hesitancy among the general population and healthcare workers, especially nurses, are needed

Safety of live attenuated varicella-zoster vaccine in patients with underlying illnesses compared with healthy adults: a prospective cohort study

Abstract Background In Japan, freeze-dried live attenuated varicella-zoster vaccine is available for adults aged ≥50 years to prevent herpes zoster. However, limited evidence has been accumulated regarding vaccine safety for patients with underlying illnesses, who have been considered as the high-risk group for herpes zoster. Methods A prospective cohort study of 1200 healthy adults and 300 patients with underlying illnesses such as malignancy, diabetes mellitus, autoimmune diseases, and renal diseases was conducted. All subjects were vaccinated and then their adverse events (AEs) were followed for 28 days after vaccination. Key safety measures included any AEs, severe AEs (SAEs), and vaccine-related AEs such as injection-site AEs and systemic AEs. The frequencies and 95% confidence intervals of AEs were calculated. Results During the follow-up period, 2 SAEs (bone fracture and acute cholecystitis) among healthy adults and 1 SAE (disseminated mycobacteriosis) among patients with underlying illnesses were reported, although none of them was diagnosed as vaccine-related. Vaccine-related AEs were reported in 42% of healthy adults and patients with underlying illnesses, and the proportions were similar between the groups. The most frequent AEs were injection-site AEs in both groups (i.e., 41 and 39%), and systemic AEs were observed in 4% of both groups. Only among healthy adults, those with a history of herpes zoster were more likely to report injection-site AEs than those without a history of herpes zoster (53% vs 39%). Conclusions The present study confirmed the safety of freeze-dried, live attenuated varicella-zoster vaccine even in patients with underlying illnesses. A history of herpes zoster might be related to development of injection-site AEs in healthy adults. Trial registration The study was prospectively registered on Japic-Clinical Trials Information as JapicCTI-163415 on October 31, 2016

Effectiveness of Live Attenuated Varicella-Zoster Vaccine in Adults Older than 50 Years in Japan: A Retrospective Cohort Study

Background: In Japan, freeze-dried live attenuated varicella-zoster vaccine BIKEN is available for adults aged ≥50 years to prevent herpes zoster (HZ). A prospective cohort study of 1200 healthy adults and 300 patients with underlying illness confirmed vaccine safety between 2016 and 2017. However, evidence of vaccine effectiveness (VE) is limited. Methods: VE against HZ and postherpetic neuralgia (PHN) was evaluated in the vaccinated cohort of the previous safety study in a follow-up study between 2021 and 2022 and compared with unvaccinated family members. Self-administered questionnaires determined retrospective experiences of HZ and PHN diagnosis. Logistic regression estimated the VE by calculating the outcome odds ratio (OR) in vaccinated vs. unvaccinated groups: VE = (1 − OR) × 100(%). Results: Overall, 1098 vaccinated and 518 unvaccinated subjects were analysed. Between 2016 and 2022, 26 vaccinated (2.4%) and 22 unvaccinated (4.2%) subjects reported HZ diagnosis, and 3 vaccinated (0.3%) and 2 unvaccinated (0.4%) subjects reported PHN. Adjusted VE against a clinical diagnosis was 41% for HZ [−6% to 67%], with marginal significance, and 16% [−408% to 86%] for PHN. Stratification by age, sex, or comorbidities had an adjusted VE against HZ of ~40%, which was similar between strata. Conclusion: Freeze-dried live attenuated varicella-zoster vaccine reduces the risk of HZ regardless of age, sex, or comorbidities

Identification of the simultaneous use of multiple hypnotics as a risk factor for falls in hospitalized patients by a matched case-control study.

AimThe risk of falls owing to simultaneous use of multiple hypnotics has not been clarified. The aim of this study was to assess the association between the simultaneous use of 2 hypnotics and the occurrence of falls in hospitalized patients.MethodsA matched case-control study was conducted at Tokyo Medical University Hospital in Tokyo, Japan, utilizing data from medical records. Cases were 434 hospitalized patients who experienced falls during their hospital stay between January 2016 and December 2016, and controls were 434 hospitalized patients without falls, individually matched by age, sex, and clinical department. The outcome was the occurrence of an in-hospital fall. The associations between the use of 1 hypnotic and falls, and between the use of 2 hypnotics and falls were assessed by conditional logistic regression analyses. The main multivariable conditional logistic regression model was adjusted for potential risk factors, including the use of other classes of psychotropics (antipsychotics, antidepressants, and anxiolytics), in addition to patient characteristics.ResultsThe main multivariable conditional logistic regression analyses showed that the simultaneous use of 2 hypnotics (odds ratio [OR] = 2.986; 95% confidence interval [CI], 1.041-8.567), but not the use of a single hypnotic (OR = 1.252; 95% CI, 0.843-1.859), was significantly associated with an increased OR of falls.ConclusionThe simultaneous use of 2 hypnotics is a risk factor for falls among hospitalized patients, whereas the use of a single hypnotic may not