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ABSTRACT: BACKGROUND AND OBJECTIVES: The sudden change in the dietary habits of the Japanese population towards a European/American-style diet since the 1960s is thought to be responsible for the recent increase in the incidence of inflammatory bowel disease (IBD) in Japan. Dietary fatty acid intake influences the fatty acid profiles of vital cell membranes, which might be a source of inflammatory mediators. METHODS: We investigated the fatty acid composition of the erythrocyte membrane in 90 healthy Japanese and 43 initial-onset IBD patients (ulcerative colitis, UC: 25; Crohn's disease, CD: 18) who had not undergone any dietary intervention to examine the role fatty acids play in the onset of IBD. RESULTS: The erythrocyte membrane n-3/n-6 ratio of the initial-onset IBD patients was 0.42 ± 0.13, which was not significantly different from that of the healthy Japanese subjects (0.41 ± 0.13). However, the CD patients displayed a significantly lower mean percentage weight (MPW) of linoleic acid (LA) than the healthy subjects (8.25 ± 1.75 vs. 9.90 ± 1.29; p < 0.001), while their MPW of arachidonic acid (AA) was significantly higher than those of the healthy subjects and UC patients (11.22 ± 2.18 vs. 9.76 ± 1.64, p < 0.01; vs. 9.58 ± 1.97, p < 0.01, respectively). The mean delta 6-desaturation index of the CD patients was significantly higher than that of the healthy subjects (1.61 ± 0.65 vs. 1.11 ± 0.26; p < 0.001). CONCLUSIONS: The CD patients displayed significantly higher and lower MPW of AA and LA, respectively, than the healthy subjects, suggesting that delta 6-desaturase is hyperactivated in CD. The cell membrane fatty acid profile might be a therapeutic target in CD.
Digestive Diseases and Sciences 01/2013; · 2.12 Impact Factor
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Kan Uchiyama MD,
Makoto Nakamura MD,
Shunichi Odahara MD,
Shigeo Koido MD,
Kiyohiko Katahira PhD,
Hiromi Shiraishi RD,
Toshifumi Ohkusa MD,
Kiyotaka Fujise MD,
Hisao Tajiri MD,
Kan Uchiyama, Makoto Nakamura,
Shunichi Odahara,
Shigeo Koido,
Kiyohiko Katahira,
Hiromi Shiraishi,
Toshifumi Ohkusa,
Kiyotaka Fujise,
Hisao Tajiri
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ABSTRACT: Background:N-3 polyunsaturated fatty acids (PUFA) are considered important pharmaconutrients for modulating mucosal immunity and therapeutic responses in patients with inflammatory bowel disease (IBD). We investigated the influence of diet therapy involving the use of an “n-3 PUFA food exchange table” (n-3DP) on the fatty acid composition of the erythrocyte membranes of IBD patients and its remission-maintaining effects.Methods:We analyzed the fatty acid composition of the erythrocyte membrane before and after n-3DP intervention in 20 initial-onset IBD patients who had not undergone any dietary intervention. We then analyzed it again and evaluated disease activity after 12–18 months intervention in 230 IBD patients (168 ulcerative colitis, 62 Crohn's disease; follow-up group) in whom n-3DP was introduced after remission had been achieved. The follow-up group was divided into remission and relapse groups.Results:In the 20 initial-onset patients, the mean n-3/n-6 ratio significantly increased after intervention (0.41 ± 0.16 versus 0.70 ± 0.20; P < 0.001). In the follow-up group the ratio in the remission group (n = 145) was significantly higher than that in the relapse group (n = 85) (0.65 ± 0.28 versus 0.53 ± 0.18; P < 0.001). The ratio significantly decreased in those who suffered a relapse after the beginning of treatment (P < 0.01).Conclusions:N-3DP significantly increased the erythrocyte membrane n-3/n-6 ratio in IBD patients, and this ratio was significantly higher in the remission group, suggesting that n-3DP alters the fatty acid composition of the cell membrane and influences clinical activity in IBD patients. (Inflamm Bowel Dis 2010)
Inflammatory Bowel Diseases 09/2010; 16(10):1696 - 1707. · 4.86 Impact Factor
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ABSTRACT: N-3 polyunsaturated fatty acids (PUFA) are considered important pharmaconutrients for modulating mucosal immunity and therapeutic responses in patients with inflammatory bowel disease (IBD). We investigated the influence of diet therapy involving the use of an "n-3 PUFA food exchange table" (n-3DP) on the fatty acid composition of the erythrocyte membranes of IBD patients and its remission-maintaining effects.
We analyzed the fatty acid composition of the erythrocyte membrane before and after n-3DP intervention in 20 initial-onset IBD patients who had not undergone any dietary intervention. We then analyzed it again and evaluated disease activity after 12-18 months intervention in 230 IBD patients (168 ulcerative colitis, 62 Crohn's disease; follow-up group) in whom n-3DP was introduced after remission had been achieved. The follow-up group was divided into remission and relapse groups.
In the 20 initial-onset patients, the mean n-3/n-6 ratio significantly increased after intervention (0.41 ± 0.16 versus 0.70 ± 0.20; P < 0.001). In the follow-up group the ratio in the remission group (n = 145) was significantly higher than that in the relapse group (n = 85) (0.65 ± 0.28 versus 0.53 ± 0.18; P < 0.001). The ratio significantly decreased in those who suffered a relapse after the beginning of treatment (P < 0.01).
N-3DP significantly increased the erythrocyte membrane n-3/n-6 ratio in IBD patients, and this ratio was significantly higher in the remission group, suggesting that n-3DP alters the fatty acid composition of the cell membrane and influences clinical activity in IBD patients.
Inflammatory Bowel Diseases 03/2010; 16(10):1696-707. · 4.86 Impact Factor
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ABSTRACT: The main cause of azathioprine (AZA)/6-mercaptopurine (6MP)-induced adverse reactions is a reduction in the activities of the metabolizing enzymes thiopurine S-methyltransferase (TPMT) and inosine triphosphate pyrophosphohydrolase (ITPA). Adverse reactions develop at a high frequency in Japanese patients at half the dose required for European and American patients; however, the association with TPMT and ITPA gene polymorphisms in Japanese has not been fully investigated.
Gene mutations of TPMT and ITPA, the major AZA/6-MP -metabolizing enzymes, were investigated retrospectively in 16 Japanese patients with inflammatory bowel disease (IBD) in whom AZA/6MP treatment induced adverse reactions.
The TPMT gene was found to have a wild-type sequence in all patients, but in the ITPA gene a mutation, 94C>A, was detected at a rate of 50% (8/16), with 83.3% (5/6) occurring in patients with acute bone marrow suppression and 75% (3/4) in those with agranulocytosis. The 94C>A allele frequency was 10 of 32 (0.313; 95% CI, 0.180-0.486). Adverse reactions developed earlier in patients with the 94C>A mutation. However, in half the patients, no gene polymorphism was noted.
It is suggested that the ITPA gene mutation is closely related to the adverse reactions of AZA/6-MP in Japanese patients, and screening for the mutant allele is useful for predicting the most serious adverse reactions, agranulocytosis and acute bone marrow suppression.
Journal of Gastroenterology 01/2009; 44(3):197-203. · 4.16 Impact Factor
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ABSTRACT: The patient was a 35-year-old man who was observed after bone marrow transplantation for acute lymphocytic leukemia. Polyps were found by colonoscopy performed after a positive fecal occult blood test, and the patient was admitted for polypectomy. There were three polyps, which were all reddened and pedunculated and were, respectively, located in the transverse, descending, and sigmoid colons. Polypectomy was performed, and all lesions were histopathologically diagnosed to be inflammatory myoglandular polyps. Inflammatory myoglandular polyps have been reported to occur solitarily only, and this is the first report of multiple occurrence.
Digestive Endoscopy 09/2007; 19(4):192 - 194. · 1.19 Impact Factor
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Kan Uchiyama, Makoto Nakamura,
Shintaro Tsukinaga,
Shigeo Koido,
Tateki Yamane,
Kiyotaka Fujise,
Kazuhisa Yoshimoto,
Takayuki Ishii,
Mitsuharu Ohmura,
Yutaka Yamaguchi,
Hisao Tajiri
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ABSTRACT: A 46-year-old man was admitted because of ileus. He had undergone an operation for lung carcinoma (stage IA) 8 years previously in another hospital. Because small bowel enema study showed widespread stricture of the ileum, we performed an operation. During the operation we diagnosed metastatic small bowel carcinoma. Because the resected sample of the small bowel carcinoma was similar to the lung carcinoma pathologically and detailed examination after the operation showed no other neoplasm, we considered this case to be small bowel metastasis of the lung carcinoma resected 8 years previously.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 04/2007; 104(3):381-7.
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ABSTRACT: A 50-year-old man with type B liver cirrohosis was admitted with jaundice and ascites. He had undergone an operation for esophageal variceal rupture at another hospital. Abdominal CT scan and ultrasonography showed cystic dilatation of the extrahepatic portal vein, and Doppler ultrasonography showed it to be a portal vein aneurysm. After admission, jaundice progressed, and not only liver failure but also biliary tract obstruction was suspected as its etiology. Therefore, endoscopic retrograde cholangiography was performed, and it showed a remarkably bent extrahepatic bile duct thought to be caused by extrinsic compression. By combining the finding of endoscopic ultrasonography, we considered that the portal vein aneurysm had displaced the bile duct. We suspected that it also caused cholestasis and cholangitis.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 10/2006; 103(9):1067-72.
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ABSTRACT: The patient was a 63-year-old woman with attacks of fever and abdominal pain, starting from the age of 53 years and recurring every month. Despite various examinations at another hospital, the etiology remained unclear. She was under symptomatic treatment, and was referred to our department for further evaluation. Although she had onset in middle age, the clinical symptoms and examination findings suggested familial Mediterranean fever, and administration of colchitine inhibited the attacks completely. Therefore, the patient was diagnosed as having the disease. We were not able to analyze the entire MEFV gene, but detected only a heterozygous M694I mutation. Amyloidosis did not develop as a complication. The disease is rare in Japan, and its onset in the fifties is extremely rare in the world.
Internal Medicine 02/2006; 45(8):515-7. · 0.94 Impact Factor
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Tateki Yamane, Makoto Nakamura,
Kan Uchiyama,
Takayuki Ishii,
Toshiyuki Sakurai,
Kazuhiro Matsunaga,
Toru Furuya,
Shigeo Koido,
Mitsuhiro Omura,
Tomohiro Kato,
Kiyotaka Fujise,
Masayuki Kobayashi
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 10/2005; 102(9):1176-82.
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Tateki Yamane,
Atsushi Saito,
Kenichi Marumo,
Shigeo Koido, Makoto Nakamura,
Toru Furuya,
Minoru Niiya,
Nobuaki Onizawa,
Kiyotaka Fujise,
Hideyuki Kashiwagi,
Mitsuhiro Omura,
Takayuki Ishii,
Tomohiro Kato,
Masayuki Kobayashi,
Gotaro Toda
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 11/2004; 101(10):1095-101.
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Tateki Yamane,
Shigeo Koido, Makoto Nakamura,
Atsushi Saito,
Yasuhiro Sato,
Minoru Niiya,
Nobuaki Onizawa,
Kiyotaka Fujise,
Mitsuhiro Omura,
Masayuki Kobayashi,
Gotaro Toda
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 04/2004; 101(3):274-80.
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Tateki Yamane,
Mitsuhiro Omura, Makoto Nakamura,
Toshiyuki Sakurai,
Yasuhiro Sato,
Shigeo Koido,
Minoru Niiya,
Kiyotaka Fujise,
Hiroshi Arakawa,
Masayuki Kobayashi,
Gotaro Toda
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 06/2003; 100(5):562-6.
