O Yoshie

Kinki University, Ōsaka, Ōsaka, Japan

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Publications (269)1250.52 Total impact

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    ABSTRACT: Lung cancer cells have been reported to produce cytokines, resulting in systemic reactions. There have been few reports showing that these cytokines induced the formation of an inflammatory mass around lung cancers.
    BMC Cancer 08/2014; 14(1):588. · 3.33 Impact Factor
  • Osamu Yoshie, Kouji Matsushima
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    ABSTRACT: Chemokines and chemokine receptors orchestrate cell migration and homing in the body. Humans have at least 44 chemokines that are further classified into four subfamilies based on the N-terminal conserved cysteine motifs: CXC, CC, C and CX3C. All the known chemokine receptors are seven transmembrane-type receptors. Humans have 18 chemotactic and 5 atypical non-chemotactic (recycling or scavenging) receptors. CCR4 is the receptor for two CC chemokines, CCL17 (also called "thymus and activation-regulated chemokine"/TARC) and CCL22 (macrophage-derived chemokine/MDC). Among the various T cell subsets, CCR4 is predominantly expressed by type 2 helper T cells (Th2 cells), cutaneous lymphocyte antigen (CLA)-positive skin-homing T cells, and regulatory T cells (Treg cells). Thus, CCR4 attracts much attention for its possible clinical applications in diseases involving these T cell subsets. Furthermore, CCR4 is often highly expressed by mature T cell neoplasms such as adult T-cell leukemia/lymphoma (ATL) and cutaneous T-cell lymphomas (CTCLs). This article is a brief overview of basic and clinical research on CCR4 and its ligands, which has eventually led to the development of a humanized defucosylated anti-CCR4 antibody "Mogamulizumab" for treatment of relapsed/refractory ATL and CTCLs.
    International immunology. 08/2014;
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    ABSTRACT: Sixteen years ago, the Nomenclature Committee of the International Union of Pharmacology approved a system for naming human seven-transmembrane (7TM) G protein-coupled chemokine receptors, the large family of leukocyte chemoattractant receptors that regulates immune system development and function, in large part by mediating leukocyte trafficking. This was announced in Pharmacological Reviews in a major overview of the first decade of research in this field [Murphy PM, Baggiolini M, Charo IF, Hébert CA, Horuk R, Matsushima K, Miller LH, Oppenheim JJ, and Power CA (2000) Pharmacol Rev 52:145-176]. Since then, several new receptors have been discovered, and major advances have been made for the others in many areas, including structural biology, signal transduction mechanisms, biology, and pharmacology. New and diverse roles have been identified in infection, immunity, inflammation, development, cancer, and other areas. The first two drugs acting at chemokine receptors have been approved by the U.S. Food and Drug Administration (FDA), maraviroc targeting CCR5 in human immunodeficiency virus (HIV)/AIDS, and plerixafor targeting CXCR4 for stem cell mobilization for transplantation in cancer, and other candidates are now undergoing pivotal clinical trials for diverse disease indications. In addition, a subfamily of atypical chemokine receptors has emerged that may signal through arrestins instead of G proteins to act as chemokine scavengers, and many microbial and invertebrate G protein-coupled chemokine receptors and soluble chemokine-binding proteins have been described. Here, we review this extended family of chemokine receptors and chemokine-binding proteins at the basic, translational, and clinical levels, including an update on drug development. We also introduce a new nomenclature for atypical chemokine receptors with the stem ACKR (atypical chemokine receptor) approved by the Nomenclature Committee of the International Union of Pharmacology and the Human Genome Nomenclature Committee.
    Pharmacological reviews 01/2014; 66(1):1-79. · 17.00 Impact Factor
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    ABSTRACT: Gut-associated lymphoid tissues are responsible for the generation of IgA-secreting cells. However, the function of the caecal patch, a lymphoid tissue in the appendix, remains unknown. Here we analyse the role of the caecal patch using germ-free mice colonized with intestinal bacteria after appendectomy. Appendectomized mice show delayed accumulation of IgA(+) cells in the large intestine, but not the small intestine, after colonization. Decreased colonic IgA(+) cells correlate with altered faecal microbiota composition. Experiments using photoconvertible Kaede-expressing mice or adoptive transfer show that the caecal patch IgA(+) cells migrate to the large and small intestines, whereas Peyer's patch cells are preferentially recruited to the small intestine. IgA(+) cells in the caecal patch express higher levels of CCR10. Dendritic cells in the caecal patch, but not Peyer's patches, induce CCR10 on cocultured B cells. Thus, the caecal patch is a major site for generation of IgA-secreting cells that migrate to the large intestine.
    Nature Communications 01/2014; 5:3704. · 10.02 Impact Factor
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    ABSTRACT: Scirrhous gastric cancer is associated with abundant stroma and frequently develops into peritoneal carcinomatosis with malignant ascites. Although malignant ascites is among the most deadly diseases worldwide, its molecular pathogenesis is poorly understood. We investigated the role of hepatocyte growth factor (HGF) in the production of peritoneal carcinomatosis with malignant ascites. We examined 3 scirrhous and 3 non-scirrhous human gastric cancer cell lines for the production of peritoneal carcinomatosis in vivo and responses to HGF in vitro. Furthermore, clinical scirrhous gastric cancer specimens were examined for HGF production. Among the 6 cell lines examined, only 2 scirrhous cell lines (NUGC4 and GCIY) produced peritoneal carcinomatosis with massive ascites after intraperitoneal injection in nude mice. Their proliferation was stimulated by exogenous HGF in vitro. On the other hand, a non-scirrhous cell line, MKN45, with MET amplification generated peritoneal tumors but not ascites. MET tyrosine kinase inhibitors, crizotinib and TAS-115, inhibited HGF-stimulated proliferation of NUGC4 and GCIY as well as constitutive proliferation of MKN45. Furthermore, crizotinib and TAS-115 prolonged the survival of mice bearing established tumors by NUGC4 or MKN45. In clinical specimens, HGF was markedly produced by stromal fibroblasts. Malignant ascitic fluids from patients with peritoneal carcinomatosis contained high levels of HGF. Our results strongly suggest that paracrine HGF-induced activation of MET-mediated signaling pathways plays an important role in the pathogenesis of peritoneal carcinomatosis in scirrhous gastric cancer. Thus, MET signaling pathway may be a potential therapeutic target for peritoneal carcinomatosis of gastric cancer, even without MET amplification. This article is protected by copyright. All rights reserved.
    Cancer Science 10/2013; · 3.48 Impact Factor
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    ABSTRACT: Key points SOX4 is consistently expressed in ATL, is involved in ATL cell growth, and induces genes such as GCRK, NAP1 and HDAC8 in ATL.FRA-2/JUND and SOX4 form an important oncogenic cascade in ATL, leading to up-regulation of genes such as HDAC8.
    Blood 03/2013; · 9.78 Impact Factor
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    ABSTRACT: Chemokine receptors (CCRs) play important roles in the pathogenesis of immune-mediated diseases, as well as in normal immune response. We examined the role of CCR6 and CCR4 in experimental autoimmune encephalomyelitis (EAE) by using CCR6-/-CCR4-/- double knockout (DKO) and single knockout mice. DKO mice developed less severe EAE and presented repressed recall response in the induction phase, especially in the activity of T helper 17 (Th17) cells. CCR6 expression in central nervous system (CNS)-infiltrated cells was diminished in DKO. Our results suggest that CCR6 and CCR4 were involved in a more rapid progression of EAE and that their regulation might be a therapeutic target of human inflammatory demyelinating diseases.
    Journal of neuroimmunology 03/2013; · 2.84 Impact Factor
  • Osamu Yoshie
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    ABSTRACT: Chemokines are a group of structurally related secretory and transmembrane proteins whose major tasks are to coordinately recruit various leukocyte populations into target tissue sites via specific receptors. In humans, there are close to 50 chemokines, 18 signal transducing receptors and 5 decoy/scavenger receptors. Functionally, chemokines are grouped into two major categories. Inflammatory chemokines are those attracting and activating cells such as neutrophils, monocytes, and eosinophils, and thus play major roles in acute-type inflammatory conditions. They are characterized by high ligand redundancy and receptor promiscuity. This probably enables robust recruitment of inflammatory cells in acute conditions. On the other hand, immune chemokines are those mainly attracting lymphoid cells and dendritic cells, and are thus involved in immune responses and chronic inflammatory diseases. Furthermore, their ligand-receptor relationships are relatively monogamous. Chemokine receptors are all seven-transmembrane G protein-couple receptors, the class of receptors frequently targeted by many successful drugs. Thus, chemokine receptors are considered to be highly promising drug targets for inflammatory and immunological diseases, and for the last two decades, many pharmaceutical companies have been trying to develop drugs blocking specific chemokine receptors. However, there are only few instances that have reached the approval for clinical use. There are several possible reasons for the present stalemate. For example, the intrinsic functional redundancy in the chemokine system may have made blocking a single receptor useless. Furthermore, the unprecedented species differences even between humans and mice may have caused problems in determination of clinical application of each chemokine receptor blockade from animal studies and also in conducting preclinical studies of candidate drugs in animals. Thus, the potential of the chemokine system as drug targets may still remain underexplored. This review first overviews current potential clinical applications of individual chemokine receptors and then describes in detail the drugs now in clinical use : Maraviroc (CCR5 antagonist), Plerixafor (CXCR4 antagonist), and Mogamulizmab (anti-CCR4).
    Japanese Journal of Clinical Immunology 01/2013; 36(4):189-96.
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    ABSTRACT: Chemokines are a large family of small cytokines that are involved in host defence and body homeostasis through recruitment of cells expressing their receptors. Their genes are known to undergo rapid evolution. Therefore, the number and content of chemokine genes can be quite diverse among the different species, making the orthologous relationships often ambiguous even between closely related species. Given that rodents and rabbit are useful experimental models in medicine and drug development, we have deduced the chemokine genes from the genome sequences of several rodent species and rabbit and compared them with those of human and mouse to determine the orthologous relationships. The interspecies differences should be taken into consideration when experimental results from animal models are extrapolated into humans. The chemokine gene lists and their orthologous relationships presented here will be useful for studies using these animal models. Our analysis also enables us to reconstruct possible gene duplication processes that generated the different sets of chemokine genes in these species.
    BioMed research international. 01/2013; 2013:856265.
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    ABSTRACT: Colorectal cancer (CRC) is a typical lifestyle-related disease, and it metastasizes mostly to the liver. It is important to understand the molecular mechanisms of CRC metastasis in order to design new and effective treatments for CRC patients. Chemokines are known to have antitumor effects as their chemoattractant properties stimulate the accumulation of infiltrating immune cells (TILs) in tumors. Chemokine (C-X-C motif) ligand 16 (CXCL16), also known as SR-PSOX, is a unique membrane-bound chemokine that induces the expression of its specific receptor CXCR6. We previously reported that the expression of CXCL16 by cancer cells enhances the recruitment of TILs, thereby improving the prognosis of CRC. It has since been reported that CXCL16/CXCR6 expression is involved in the metastasis of various types of cancer. However, there is no report of the association between CXCL16 expression and liver metastasis in CRC. In this study, we investigated the role of cancer-derived CXCL16 and the possibility of gene therapy using CXCL16. Therefore, we examined the metastasis of colon 38 SL4 cells to the liver in an experimental model. Following injection of cancer cells into the intraportal vein, CXCL16-expressing CRC cells drastically inhibited liver metastasis. We also found that CD8 T cells and natural killer T (NKT) cells, known as CXCR6-expressing cells, increased in CXCL16-expressing metastatic tissue. Collectively, the inhibitory effect on metastasis to the liver by CXCL16 was observed in NKT cell-depleted mice but not in CD8 T cell-depleted mice. These results demonstrate the inhibitory effect of CXCL16 on liver metastasis via NKT cells in CRC.
    Oncology Reports 12/2012; · 2.30 Impact Factor
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    ABSTRACT: The genes involved in host defences are known to undergo rapid evolution. Therefore, it is often difficult to assign orthologs in multigene families among various vertebrate species. Chemokines are a large family of small cytokines that orchestrate cell migration in health and disease. Herein, we have surveyed the genomes of 18 representative vertebrate species for chemokine genes and identified a total of 553 genes. We have determined their orthologous relationships and classified them in accordance with the current systematic chemokine nomenclature system. Our study reveals an interesting evolutionary history that gave origin and diversification to the vertebrate chemokine superfamily.
    Genes to Cells 11/2012; · 2.73 Impact Factor
  • Osamu Yoshie
    Nippon rinsho. Japanese journal of clinical medicine 11/2012; 70 Suppl 8:212-7.
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    Albert Zlotnik, Osamu Yoshie
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    ABSTRACT: The chemokine superfamily consists of a large number of ligands and receptors. At first glance, this family appears redundant and their ligand-receptor relationships promiscuous, making its study challenging. However, analyzing this family from the evolutionary perspective greatly simplifies understanding both the organization and function of this apparently complex system. In particular, the functions of a subgroup of chemokines (designated homeostatic chemokines) have played pivotal roles in advancing our understanding of the organization and function of the cellular networks that shape the immune system. Here, we update the full scope of the human and mouse chemokine superfamilies and their relationships and summarize several important roles that homeostatic chemokines play in the immune system.
    Immunity 05/2012; 36(5):705-16. · 19.80 Impact Factor
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    ABSTRACT: Adult T-cell leukemia/lymphoma (ATLL) and cutaneous T-cell lymphomas (CTCLs) are known to frequently express CC chemokine receptor 4 (CCR4). Previously, we investigated the transcriptional control of CCR4 expression in ATLL and have found that an activating protein 1 (AP1) family member, FBJ murine osteosarcoma viral oncogene homolog (FOS)-related antigen 2 (FRA2), is consistently expressed at high levels in ATLL and, together with v-JUN avian sarcoma virus 17 oncogene homolog D (JUND), up-regulates the expression of CCR4 as well as that of several proto-oncogenes such as v-MYB myeloblastosis viral oncogene homolog (MYB), murine double minute 2 homolog (MDM2), and B-cell lymphoma 6 (BCL6). Here, we examined the expression of these genes in clinical samples of CTCLs. We detected the transcripts of FRA2, JUND, CCR4, MYB, MDM2, and BCL6 at high levels in CTCL skin lesions. Except for BCL6, we confirmed protein expression of FRA2, JUND, CCR4, MYB, and MDM2 in CTCL skin lesions. Furthermore, siRNA-mediated knockdown of FRA2 or JUND suppressed cell growth and the expression of CCR4, MYB, MDM2, and BCL6 in CTCL cell lines. Our results, thus, demonstrate the presence of a common oncogenic cascade initiated by FRA2/JUND in CCR4-expressing mature T-cell malignancies such as ATLL and CTCLs.
    Anticancer research 04/2012; 32(4):1367-73. · 1.71 Impact Factor
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    ABSTRACT: Lymphocyte-rich gastric cancer (Ly-rich GC) is characterized by lymphoid stroma. To understand its formation, we studied the expression of a chemokine ligand (CCL)20 and its receptor CCR6 in 36 and 37 cases of Ly-rich- and conventional GC, respectively. Lymphoid tissues in the alimentary tract were studied in parallel. By quantitative polymerase chain reaction, Ly-rich GC contained CCL20 and CCR6 mRNAs at higher levels than conventional GC. By immunohistochemistry, CCL20 was expressed by cancer cells more frequently in Ly-rich GC than in conventional GC. This was comparable with its expression in epithelial cells of the alimentary tract lymphoid tissues. CCR6 was mostly expressed by dendritic cells (DC) and B cells in Ly-rich GC, which was also comparable with its expression in the alimentary tract lymphoid tissues. Cancer cells also expressed CCR6. However, its expression did not differ between Ly-rich- and conventional GC, nor was it related to the stage of cancer. Given that the CCL20-CCR6 axis is involved in the formation of alimentary tract lymphoid tissue, the similarity between the lymphoid stroma of Ly-rich GC and the alimentary tract lymphoid tissues supports the notion that it plays a significant role in the formation of lymphoid stroma in Ly-rich GC.
    Pathology International 11/2011; 61(11):645-51. · 1.72 Impact Factor
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    ABSTRACT: The chemokine receptor CCR4 has been implicated in Th2 cell-mediated immune responses. However, other T cell subsets are also known to participate in allergic inflammation. The role of CCR4 in Th1, Th2, and Th17 cell-mediated allergic airway inflammation was investigated. We generated an allergic airway inflammation model by adoptive transfer of in vitro-polarized ovalbumin (OVA)-specific Th1, Th2, and Th17 cells. The effect of a low-molecular weight CCR4 antagonist, Compound 22, on this model was examined. Upon in vitro polarization of DO11.10 naïve T cells, Th1- and Th2-polarized cells dominantly expressed CXCR3 and CCR4, respectively, while Th17-polarized cells expressed CCR6 and CCR4. Intranasal OVA-challenge of mice transferred with each T cell subset induced accumulation of T cells in the lungs. Eosinophils were also massively accumulated in Th2-transferred mice, whereas neutrophils were preferentially recruited in Th1- and Th17-transferred mice. Compound 22, as well as anti-CCL17 or anti-CCL22 antibody selectively suppressed accumulation of Th2 cells and eosinophils in the lungs of Th2-transferred and OVA-challenged mice. Compound 22 also inhibited bronchial hyperresponsiveness but had little effect on goblet cell hyperplasia in Th2-transferred and OVA-challenged mice. There were notable differences in allergic lung inflammation mediated by different T cell subsets. CCR4 blockage was selectively effective for suppression of Th2-mediated allergic inflammation by blocking infiltration of Th2 cells.
    Clinical & Experimental Allergy 09/2011; 42(2):315-25. · 4.79 Impact Factor
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    ABSTRACT: CD4(+) T cells, particularly T helper (Th) 2 cells, play a pivotal role in the pathophysiology of allergic asthma. Suppressor of cytokine signaling (SOCS) proteins control the balance of CD4(+) T cell differentiation. Mice that lack SOCS3 in T cells by crossing SOCS3-floxed mice with Lck-Cre-transgenic mice have reduced allergen-induced eosinophilia in the airways. Here, we studied the effects of SOCS3 silencing with small interfering (si) RNA in primary CD4(+) T cells on Th2 cell differentiation and on asthmatic responses in mice. Th2 cells were generated from ovalbumin (OVA)-specific T cell receptor-transgenic mice in vitro and transferred into recipient mice. Transfection of SOCS3-specific siRNA attenuated Th2 response in vitro. Adoptive transfer of SOCS3-siRNA T cells exhibited markedly suppressed airway hyperresponsiveness and eosinophilia after OVA challenge, with a concomitant decrease in OVA-specific CD4(+) T cell accumulation in the airways. To investigate the mechanism of this impaired CD4(+) T cell accumulation, we inactivated SOCS3 of T cells by crossing SOCS3-floxed (SOCS3(flox/flox)) mice with CD4-Cre transgenic mice. CD4-Cre × SOCS3(flox/flox) mice exhibited fewer IL-4-producing cells and more reduced eosinophil infiltration in bronchoalveolar lavage fluids than control mice in a model of OVA-induced asthma. Expression of CCR3 and CCR4 in CD4(+) T cells was decreased in CD4-Cre × SOCS3(flox/flox) mice. CCR4 expression was also decreased in CD4(+) T cells after transfer of SOCS3 siRNA-treated T cells. These findings suggest that the therapeutic modulation of SOCS3 expression in CD4(+) T cells might be effective in preventing the development of allergic asthma.
    American Journal of Respiratory Cell and Molecular Biology 04/2011; 44(4):448-55. · 4.15 Impact Factor
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    ABSTRACT: Chemokines receptors are involved in the recruitment of various cell types in inflammatory and physiological conditions. There are 23 known chemokine receptor genes in the human genome. However, it is still unclear how many chemokine receptors exist in the genomes of various vertebrate species other than human and mouse. Moreover, the orthologous relationships are often obscure between the genes of higher and lower vertebrates. In order to provide a basis for a unified nomenclature system of the vertebrate chemokine receptor gene family, we have analysed the chemokine receptor genes from the genomes of 16 vertebrate species, and classify them into 29 orthologous groups using phylogenetic and comparative genomic analyses. The results reveal a continuous gene birth and death process during the vertebrate evolution and an interesting evolutionary history of the chemokine receptor genes after the emergence in agnathans.
    Developmental and comparative immunology 02/2011; 35(7):705-15. · 3.29 Impact Factor
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    ABSTRACT: Latent infection of human T-cell leukemia virus type 1 (HTLV-1) is considered to be preferentially associated with CCR4(+) CD4(+) T cells. Here we report that c-Maf, one of the critical transcription factors for Th2 differentiation, suppresses the transcriptional activity of HTLV-1 Tax by competing for CREB-binding protein. Notably, c-maf expression is selectively induced in a fraction of CCR4(+) CD4(+) T cells upon activation. Furthermore, c-Maf significantly decreases Tax-induced HTLV-1 envelope gp46 gene expression from an infectious HTLV-1 molecular clone and tax expression in a cell-free HTLV-1 infection system. Collectively, c-Maf may play a role in latent infection of HTLV-1 in CCR4(+) CD4(+) T cells by negatively regulating Tax activity.
    Cancer Science 01/2011; 102(4):890-4. · 3.48 Impact Factor
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    ABSTRACT: Eotaxin-3/CCL26 is a functional ligand for CCR3 and abundantly produced by IL-4-/IL-13-stimulated vascular endothelial cells. CCL26 also functions as a natural antagonist for CCR1, CCR2, and CCR5. In this study, we report that CCL26 is yet a functional ligand for CX3CR1, the receptor for fractalkine/CX3CL1, which is expressed by CD16(+) NK cells, cytotoxic effector CD8(+) T cells, and CD14(low)CD16(high) monocytes. Albeit at relatively high concentrations, CCL26 induced calcium flux and chemotaxis in mouse L1.2 cells expressing human CX3CR1 but not mouse CX3CR1 and competed with CX3CL1 for binding to CX3CR1. In chemotaxis assays using human PBMCs, CCL26 attracted not only eosinophils but also CD16(+) NK cells, CD45RA(+)CD27(-)CD8(+) T cells, and CD14(low)CD16(high) monocytes. Intraperitoneal injection of CCL26 into mice rapidly recruited mouse eosinophils and intravenously transferred human CD16(+) NK cells into the peritoneal cavity. IL-4-stimulated HUVECs produced CCL26 and efficiently induced adhesion of cells expressing CX3CR1. Real-time PCR showed that skin lesions of psoriasis consistently contained CX3CL1 mRNA but not CCL26 mRNA, whereas those of atopic dermatitis contained CCL26 mRNA in all samples but CX3CL1 mRNA in only about half of the samples. Nevertheless, the skin lesions from both diseases consistently contained CX3CR1 mRNA at high levels. Thus, CCL26 may be partly responsible for the recruitment of cells expressing CX3CR1 in atopic dermatitis particularly when the expression of CX3CL1 is low. Collectively, CCL26 is another agonist for CX3CR1 and may play a dual role in allergic diseases by attracting eosinophils via CCR3 and killer lymphocytes and resident monocytes via CX3CR1.
    The Journal of Immunology 10/2010; 185(11):6472-9. · 5.52 Impact Factor

Publication Stats

15k Citations
1,250.52 Total Impact Points


  • 1999–2014
    • Kinki University
      • Faculty of Medicine
      Ōsaka, Ōsaka, Japan
    • Fukuoka University
      Hukuoka, Fukuoka, Japan
  • 2012
    • University of California, Irvine
      • Department of Physiology & Biophysics
      Irvine, CA, United States
  • 2008–2011
    • National Hospital Organization Sagamihara Hospital
      Sagamihara, Kanagawa, Japan
  • 1999–2011
    • Kumamoto University
      • • Department of Molecular Enzymology
      • • Department of Medical Biochemistry
      Kumamoto, Kumamoto Prefecture, Japan
  • 2006–2009
    • University of Toyama
      • • Division of Pathogenic Biochemistry
      • • Institute of Natural Medicine
      Тояма, Toyama, Japan
    • Kanazawa University
      • Cancer Research Institute
      Kanazawa-shi, Ishikawa-ken, Japan
  • 2002–2009
    • Osaka City University
      Ōsaka, Ōsaka, Japan
  • 1998–2007
    • The University of Tokyo
      • Faculty & Graduate School of Medicine
      Tokyo, Tokyo-to, Japan
  • 2003–2005
    • Osaka University
      • School of Pharmaceutical Sciences
      Ōsaka-shi, Osaka-fu, Japan
  • 2004
    • Kyoto Pharmaceutical University
      Kioto, Kyōto, Japan
    • Kyushu University
      • Faculty of Dental Science
      Fukuoka-shi, Fukuoka-ken, Japan
  • 1998–2003
    • Kyoto University
      • • Department of Cardiovascular Medicine
      • • Institute for Virus Research
      Kyoto, Kyoto-fu, Japan
  • 1998–2001
    • Chiba University Hospital
      Tiba, Chiba, Japan
  • 2000
    • Palo Alto Institute for Research and Education
      Palo Alto, California, United States
  • 1997–1999
    • Shionogi & Co., Ltd.
      Ōsaka, Ōsaka, Japan
  • 1986–1989
    • Tohoku University
      • Department of Pediatrics
      Sendai-shi, Miyagi-ken, Japan
  • 1984
    • Yale University
      New Haven, Connecticut, United States