Paracrine Effect of NRG1 and HGF Drives Resistance to MEK Inhibitors in Metastatic Uveal Melanoma.

Uveal melanoma patients with metastatic disease usually die within one year, emphasizing an urgent need to develop new treatment strategies for this cancer. MEK inhibitors improve survival in cutaneous melanoma patients but show only modest efficacy in metastatic uveal melanoma patients. In this study, we screened for growth factors that elicited resistance in newly characterized metastatic uveal melanoma cell lines to clinical-grade MEK inhibitors, trametinib and selumetinib. We show that neuregulin 1 (NRG1) and hepatocyte growth factor (HGF) provide resistance to MEK inhibition. Mechanistically, trametinib enhances the responsiveness to NRG1 and sustained HGF-mediated activation of AKT. Individually targeting ERBB3 and cMET, the receptors for NRG1 and HGF, respectively, overcome resistance to trametinib provided by these growth factors and by conditioned medium from fibroblasts that produce NRG1 and HGF. Inhibition of AKT also effectively reverses the protective effect of NRG1 and HGF in trametinib-treated cells. Uveal melanoma xenografts growing in the liver in vivo and a subset of liver metastases of uveal melanoma patients express activated forms of ERBB2 (the coreceptor for ERBB3) and cMET. Together, these results provide preclinical evidence for the use of MEK inhibitors in combination with clinical-grade anti-ERBB3 or anti-cMET monoclonal antibodies in metastatic uveal melanoma

Hokkaido fisheries and nurturing future fisheries workers

東京水産大学名誉教授・非常勤講師北海道小樽水産高等学校教

Framework for a cooperative program curriculum among elementary, junior, and senior high schools to develop students' qualities and competence in home economics: Proposal for implementing a cooperative program curriculum for encouraging students to develop an understanding of food cultures and deepen their learning

The purpose of this study is to use surveys to clarify students' awareness at the elementary, junior, and senior high school levels of food cultures and their related issues, and to formulate and implement a class program for junior and senior high schools based on the clarified results. The program will develop students' understanding of food cultures and seeks to combine and systematize home economics education among the three levels of schooling. The study found transformations among elementary and junior high school students, in terms of their understanding of the ideas of food cultures and related issues. In addition, class programs were formulated for Grade 9 students, to broaden their views on a range of topics, and for Grade 10 students, to broaden their view of changes over time, both of which ended with successful results

リソースに基づく代数的アーキテクチャモデルのプロセス代数CCSによる実装について

近年, システムの高分散化に伴い, ソフトウェアアーキテクチャを構成する上で, コンポーネント間のデータ転送方式の選択の重要性が高まってきている. データの転送方式は大きくPUSH型とPULL型に分けることができるが, いずれのデータ転送方式を採用するかが, システム全体の最終的な性能に大きな影響を及ぼす. そのため, 開発の初期の段階で適切にデータ転送方式を評価できることが望まれる.一般にアーキテクチャ設計を正しく評価するためには, アーキテクチャの設計内容を厳密に定義できる体系が必要となる. そのため, アーキテクチャモデル及びアーキテクチャ記述言語の研究が広く行われてきた. 本研究室では, データ転送方式の選択および評価の支援を目的とした代数的アーキテクチャモデルの提案を行っている. 提案アーキテクチャモデルは, 制御の流れに関する情報を捨象することによって, プロセス代数などのプロセスに基づく他の記述体系よりも抽象度の高い情報を記述することを可能にしている. そのため, 提案アーキテクチャモデルによって記述されたアーキテクチャ情報は, データ転送方式の選択の影響を受けないという特徴を持つ.本論文では, 既存の記述体系としてプロセス代数CCS を選び, 提案アーキテクチャモデルの記述から, データ転送方式の選択に応じてCCS による実装を自動生成できることを示し, 生成されたCCS 実装が元のアーキテクチャモデルと等価となることを証明する. また, 等価性を保ちながらデータ転送方式を変更するための十分条件を示す. これらによって, 提案アーキテクチャモデルに基づいてデータ転送方式をリファクタリングするための理論的な基盤の構築が可能となる

Cognitive and Emotional Changes in Peer Educators of Type 2 Diabetes Patients After Starting Peer-Support Activities

Background: Diabetes self-management education through peer support has beneficial effects, especially in regions with limited medical resources. To ensure peer educators continue to provide peer-led education programs, it is important that they remain motivated to instruct patients. Here, to explore measures to enhance peer-educators’ motivation toward such programs, we examined the cognitive and emotional changes in Filipino type 2 diabetics after 7-month activities as peer educators. Methods: We individually performed semi-structured interviews with 13 peer educators with 20 years of age or above in August 2017 (immediately before starting their peer-education activities) and in March 2018 (7 months after the start). The first interview was performed after the peer educators had received 2-day training of diabetes self-management. In both interviews, we asked the peer educators about their feelings toward peer-led educational activities (e.g., satisfaction, difficulty, reward, confidence, and challenges). Their replies about their own cognition and emotions were interpreted and integrated, and then analyzed qualitatively. Results: Four and seven categories were extracted from the first and second interviews, respectively. The category “Cognition of patients’ active learning attitudes and of positive changes in patients’ physical conditions and behavior” observed in the second interview led to “Cognition of growth as a peer educator” and “Satisfaction with supporting patients as a peer educator.” These two feelings gave the peer educators’ “Increased motivation to continue the activities as a peer educator.” This motivation was also associated with “Active collaboration among peer educators,” which was affected by “Difficulties and concerns in working as a peer educator.” Conclusion: To sustain diabetic peer-led education programs, we suggest that interventions be implemented that increase peer educators’ motivation toward their activities and stimulate their awareness of the importance of collaborating with one another. Such collaboration should help to overcome the difficulties they may face in providing peer-led education

Glutathione S-transferase pi localizes in mitochondria and protects against oxidative stress.

Glutathione S-transferases (GSTs) are multifunctional enzymes involved in the protection of cellular components against anti-cancer drugs or peroxidative stress. Previously we found that GST pi, an isoform of the GSTs, is transported into the nucleus. In the present study, we found that GST pi is present in mitochondria as well as in the cytosol and nucleus in mammalian cell lines. A construct comprising the 84 amino acid residues in the amino-terminal region of GST pi and green fluorescent protein was detected in the mitochondria. The mutation of arginine to alanine at positions 12, 14, 19, 71, and 75 in full-length GST pi completely abrogated the ability to distribute in the mitochondria, suggesting that arginine, a positively charged residue, is required for the mitochondrial transport of GST pi. Chemicals generating reactive oxygen species, such as rotenone and antimycin A, decreased cell viability and reduced mitochondrial membrane potential. The overexpression of GST pi diminished these changes. GST pi-targeting siRNA abolished the protective effect of GST pi on the mitochondria under oxidative stress. The findings indicate that the peptide signal is conducive to the mitochondrial localization of GST pi under steady-state conditions without alternative splicing or posttranslational modifications such as proteolysis, suggesting that GST pi protects mitochondria against oxidative stress

トクシマ ダイガク ビョウイン ノウソッチュウ センター ニオケル インナイ ハッショウ ノウソッチュウ ノ ケントウ

We assessed the current status of patients with acute in-hospital stroke. 63 patients with acute in-hospital stroke were enrolled. The most prevalent subtype of stroke was embolism（n＝24）. The main cause of hospitalization were malignant neoplasms in15. Only 5 patients were treated with rt-PA, 8 patients received endovascular interventions. In-hospital stroke is a sever complication of in-patients and is associated with an unfavorable prognosis, but endovascular interventions offer safe and feasible therapeutic treatment options

Effects of a Self-efficacy Theory-Based Training Program for Peers of Patients with Type 2 Diabetes

[Background] Training peer leaders to deliver patient education is expected to be a low-cost approach to providing healthcare in urban-poor areas affected by a shortage of healthcare professionals. The purpose of this study was to examine the effects of a training program on the self-efficacy and knowledge of peer leaders with type 2 diabetes. [Methods] A single-group longitudinal survey with baseline, intervention, and follow-up periods was conducted at a diabetes clinic in a small municipality in Metro Manila, Philippines. The intervention, a self-efficacy theory-based training program for peer-leaders of diabetic patients conducted in August 2017, comprised hands-on learning, demonstrations, quizzes, role-playing, group sharing, physical exercise, and a buffet lunch. The primary outcome was participants’ self-efficacy for management of their diabetes. Secondary outcomes were participants’ knowledge of diabetes and levels of emotional distress, motivation, and confidence for guiding their peers, satisfaction with the training program, hemoglobin A1c, and quality of life. [Results] At 12 and 18 months after the intervention, participants’ knowledge of diabetes was significantly increased compared with baseline (both P < 0.05). At earlier time points, an increasing, but not significant, trend was observed. The change in knowledge of diabetes from baseline to 18 months after intervention tended to be positively correlated with the change in self-efficacy (r = 0.594, P = 0.054). No significant differences were observed for any of the other outcomes, although the descriptive statistics showed an increasing trend for all of the outcomes except motivation. [Conclusion] The training program significantly improved participants’ knowledge of diabetes at 12 and 18 months after the training programs compared with baseline. A positive correlation between the changes in the levels of knowledge and self-efficacy suggested that the observed improvement of self-efficacy was facilitated by the improvement of knowledge of diabetes

Anti-complement 5 antibody ameliorates antibody-mediated rejection after liver transplantation in rats

Antibody-mediated rejection (AMR) remains a refractory rejection after donor-specific antibody (DSA)-positive or blood-type incompatible liver transplantation (LT), even in the era of pre-transplant rituximab desensitization. This is due to the lack of not only effective post-transplant treatments but also robust animal models to develop/validate new interventions. Orthotopic LT from male Dark Agouti (DA) to male Lewis (LEW) rats was used to develop a rat LT-AMR model. LEW were pre-sensitized by a preceding skin transplantation from DA 4–6 weeks before LT (Group-PS), while sham procedure was performed in non-sensitized controls (Group-NS). Tacrolimus was daily administered until post-transplant day (PTD)-7 or sacrifice to suppress cellular rejections. Using this model, we validated the efficacy of anti-C5 antibody (Anti-C5) for LT-AMR. Group-PS+Anti-C5 received Anti-C5 intravenously on PTD-0 and -3. Group-PS showed increased anti-donor (DA) antibody-titers (P &lt;0.001) and more C4d deposition in transplanted livers than in Group-NS (P &lt;0.001). Alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bile acid (TBA), and total bilirubin (T-Bil) were all significantly higher in Group-PS than in Group-NS (all P &lt;0.01). Thrombocytopenia (P &lt;0.01), coagulopathies (PT-INR, P =0.04), and histopathological deterioration (C4d+h-score, P &lt;0.001) were also confirmed in Group-PS. Anti-C5 administration significantly lowered anti-DA IgG (P &lt;0.05), resulting in decreased ALP, TBA, and T-Bil on PTD-7 than in Group-PS (all P &lt;0.01). Histopathological improvement was also confirmed on PTD-1, -3, and -7 (all P &lt;0.001). Of the 9,543 genes analyzed by RNA sequencing, 575 genes were upregulated in LT-AMR (Group-PS vs. Group-NS). Of these, 6 were directly associated with the complement cascades. In particular, Ptx3, Tfpi2, and C1qtnf6 were specific to the classical pathway. Volcano plot analysis identified 22 genes that were downregulated by Anti-C5 treatment (Group-PS+Anti-C5 vs. Group-PS). Of these, Anti-C5 significantly down-regulated Nfkb2, Ripk2, Birc3, and Map3k1, the key genes that were amplified in LT-AMR. Notably, just two doses of Anti-C5 only on PTD-0 and -3 significantly improved biliary injury and liver fibrosis up to PTD-100, leading to better long-term animal survival (P =0.02). We newly developed a rat model of LT-AMR that meets all the Banff diagnostic criteria and demonstrated the efficacy of Anti-C5 antibody for LT-AMR

The impact of human leukocyte antigen mismatch on recipient outcomes in living‐donor liver transplantation

Donor–recipient human leukocyte antigen (HLA) compatibility has not been considered to significantly affect liver transplantation (LT) outcomes; however, its significance in living-donor LT (LDLT), which is mostly performed between blood relatives, remains unclear. This retrospective cohort study included 1954 LDLTs at our institution (1990–2020). The primary and secondary endpoints were recipient survival and the incidence of T cell–mediated rejection (TCMR) after LDLT, respectively, according to the number of HLA mismatches at all five loci: HLA-A, HLA-B, HLA-C, HLA-DR, and HLA-DQ. Subgroup analyses were also performed in between-siblings that characteristically have widely distributed 0–10 HLA mismatches. A total of 1304 cases of primary LDLTs were finally enrolled, including 631 adults (recipient age at LT ≥18 years) and 673 children (<18 years). In adult-to-adult LDLT, the more HLA mismatches at each locus, the significantly worse the recipient survival was (p = 0.03, 0.01, 0.03, 0.001, and <0.001 for HLA-A, HLA-B, HLA-C, HLA-DR, and HLA-DQ, respectively). This trend was more pronounced when multiple loci were combined (all p < 0.001 for A + B + DR, A + B + C, DR + DQ, and A + B + C + DR + DQ). Notably, a total of three or more HLA-B + DR mismatches was an independent risk factor for both TCMR (hazard ratio [HR] 2.66, 95% confidence interval [CI] 1.21–5.87; p = 0.02) and recipient survival (HR 2.44, 95% CI 1.11–5.35; p = 0.03) in between-siblings. By contrast, HLA mismatch did not affect pediatric LDLT outcomes at any locus or in any combinations; however, it should be noted that all donor–recipient relationships are parent-to-child that characteristically possesses one or less HLA mismatch at each locus and maximally five or less mismatches in total. In conclusion, HLA mismatch significantly affects not only TCMR development but also recipient survival in adult LDLT, but not in children