Misao Owada

Kagawa Nutrition University, Saitama, Saitama, Japan

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Publications (38)112.32 Total impact

  • Misao Owada · Teruo Kitagawa

    No preview · Article · Jan 2012
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    ABSTRACT: The most appropriate time for screening for Fabry disease (FD) is school age. For this reason, we developed non-invasive methods for measuring urinary alpha-galactosidase A (alpha-gal A) protein, using enzyme-linked immunosorbent assay (ELISA), and for globotriaosylceramide (GL-3), using tandem mass spectrometry (MS/MS). We measured these two biomarkers in the urine of previously diagnosed FD hemizygotes and heterozygotes, and in controls. All the classic FD hemizygotes were clearly distinguished from controls by either method alone, and combining the two assays produced 96% sensitivity for detecting heterozygotes. To assess the utility of these methods for screening school children and adults at high risk of FD, a pilot study was conducted. To distinguish FD from 432 controls, cut-off values for alpha-gal A protein and GL-3 were set at the 5th and 95th centile values of the controls, respectively. Among the high-risk patients, the measurements exceeded the cut-off values for both biomarkers in male and female subjects and were strong indicators for Fabry hemizygotes and heterozygotes. However, we recommend that if the results of the first measurements exceed the cut-off values for only one of these biomarkers, another urine sample should be requested for re-assay to confirm the result.
    No preview · Article · Oct 2008 · Pediatric Nephrology
  • Momoko MORIYA · Misao OWADA · Teruo KITAGAWA
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    ABSTRACT: Abstract Data collected in our institution, in which approximately one-fourth of the prenatal diagnoses for inborn errors of metabolism in Japan are performed, suggest somewhat higher prevalences of Gaucher disease and mucolipidoses in Japan than in the United States, European countries and Australia. Hunter disease seems to be more frequent than Hurler disease in Japan while the reverse is true in Europe and Australia. In contrast, family histories of Pompe disease or cystinosis were much less frequent indications for prenatal diagnosis in Japanese than in Caucasian populations. The results of a recent multicenter survey conducted in Japan on the indications for and reliability of prenatal diagnoses for inherited metabolic disease support the conclusions drown from our data. The relative frequencies of each of the lysosomal storage diseases, with the exception of the mucopolysaccharidoses, obtained from our prenatal diagnosis surveys were quite similar to those derived from an epidemiological study of lysosomal storage diseases in Japan. We conclude that prenatal diagnosis can be used an indicator of the prevalences of lysosomal storage diseases in Japan.
    No preview · Article · May 2008 · Congenital Anomalies
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    ABSTRACT: This study evaluated recent changes in the annual incidence of childhood type 2 diabetes in the Tokyo metropolitan area. From 1974 to 2004, a total of 236 students were diagnosed as having type 2 diabetes by the urine glucose screening program at school. The overall incidence of type 2 diabetes was 2.55/100,000. Overall, 83.9% of students with diabetes were obese; junior high school students had a significantly higher incidence than primary school students (0.75 vs. 6.27/100,000). The annual incidences over the 5-yr periods from 1974-2004 were 1.73, 3.23, 3.05, 2.90, 2.70 and 1.41/100,000, respectively. The incidences in 1974-1980 and 2001-2004 were significantly lower than those in 1981-1985, 1986-1990 and 1991-1995, because primary school students in 1974-1980 had a significantly lower incidence (0.27/100,000), and junior high school students in 2001-2004 had a somewhat lower incidence (3.66/100,000) than during 1981-2000. In recent years, Japanese children's lifestyle and eating habits have gradually improved, and this may have contributed to the trend toward decrease in the incidence of type 2 diabetes in 2001-2004 in the Tokyo metropolitan area.
    Preview · Article · May 2007 · Clinical Pediatric Endocrinology
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    ABSTRACT: A large number of children with type 2 diabetes have been detected by a urine glucose screening program conducted at schools in Japan since 1975. The incidence of type 2 diabetes in children has increased over the last three decades, and the incidence is estimated to be approximately 3.0/100,000/y during 1975-2000. The incidence of type 2 diabetes in junior high school children is three to six times higher than that in primary school children. More than 80% of children with type 2 diabetes are obese, and boys are more likely to be obese than girls. It is speculated that the increase in the incidence of childhood type 2 diabetes over the years may be a consequence of the increase in the frequency of obesity in school children. However, this trend of increasing incidence of childhood obesity has recently become weaker, and perhaps as a consequence, the incidence of type 2 diabetes has also decreased after the year 2000 in some cities of Japan. Improved attention to physical activity and eating habits among young people may be responsible at least in part to the decrease in the incidence of type 2 diabetes noted in recent years in big cities of Japan.
    Preview · Article · Mar 2007 · Pediatric Research
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    Tatsuhiko Urakami · Misao Owada · Teruo Kitagawa

    Preview · Article · Oct 2006 · Diabetes Care
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    ABSTRACT: Fabry disease is an X-linked sphingolipidosis due to a deficiency of alpha-galactosidase A, which leads to the accumulation of globotriaosylceramide (GL-3) in several organs. When recombinant human alpha-galactosidase A is intravenously administered repeatedly before the patient develops permanent tissue damage, there is evidence that the accumulation of GL-3 is decreased in some organs and that the clinical symptoms are alleviated in some patients. However, Fabry disease is rare and many patients are not diagnosed until adulthood after irreversible tissue damage has occurred. Our group has developed a simple and non-invasive screening method for Fabry disease that measures total GL-3 in whole urine samples by tandem mass spectrometry. Using this method, we found that the concentration of GL-3 in whole urine sample from hemizygous patients, including pre-symptomatic young children with classic type Fabry disease, was significantly higher than that in controls. The mean concentration of GL-3 in urine from heterozygotes with symptoms was significantly higher than control concentrations, but GL-3 levels in the urine from 2 out of 8 heterozygotes of classic type Fabry disease were within control levels. An asymptomatic 14-year old hemizygote in the family of a cardiac variant did not have elevated urinary GL-3. Therefore, screening for the classic type and probably renal variant of Fabry disease is possible by measuring urinary GL-3, using our method. The early diagnosis of cardiac variant hemizygotes and some heterozygotes with all types of Fabry disease will not be possible using our method. We propose that this procedure can be used as a reliable, non-invasive, simple method for general and high-risk population screening for hemizygotic patients with the classic type and probably renal variant of Fabry disease.
    No preview · Article · Aug 2005 · Molecular Genetics and Metabolism
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    ABSTRACT: The aim of this study was to evaluate the effect of metformin in addition to insulin therapy in adolescents and young adults with type 1 diabetes mellitus. Nine patients, two males and seven females, aged 18.1 +/- 3.0 years, with type 1 diabetes mellitus were studied. They were relatively overweight with a body mass index (BMI) of 24.2 +/- 1.8 and had high levels of HbA1c at 9.5 +/- 1.2% despite high doses of insulin of 74.0 +/- 31.2 U/day. Metformin at the dose of 500-750 mg daily was administered to the patients in addition to insulin therapy for 1 year. HbA1c, BMI and insulin dose were compared before 1 year without metformin therapy, at baseline, and at 3, 6 and 12 months during the use of metformin in addition to insulin therapy. HbA1c lowered (8.6 +/- 1.4**, 8.4 +/- 1.3**, 8.4 +/- 1.2*%), BMI was reduced (23.9 +/- 1.7*, 23.8 +/- 1.8, 23.5 +/- 1.8*), and insulin requirement decreased (69.8 +/- 29.7*, 68.7 +/- 29.8**, 67.3 +/- 29.1**U/d) significantly after the start of metformin therapy (*P < 0.05, **P < 0.01 vs at baseline). There were no adverse events, not even lactic acidosis, during the study period. Metformin is safe and may represent a useful adjunct to the management of type 1 diabetes mellitus in adolescents and young adults who have poor glycemic control despite a large amount of insulin.
    No preview · Article · Aug 2005 · Pediatrics International
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    ABSTRACT: This study investigates the annual incidence and clinical characteristics of type 2 diabetes among school-aged children as detected by urine glucose screening from 1974 to 2002 in the Tokyo metropolitan area. In total, 8,812,356 school children were examined for glucosuria. Morning urine was used for the analysis. When the urine was positive for glucose, an oral glucose tolerance test was carried out to confirm diabetes. In all, 232 students were identified to have type 2 diabetes. The overall annual incidence of type 2 diabetes was 2.63/100,000. The annual incidence after 1981 was significantly higher than that before 1980 (1.73 vs. 2.76/100,000, P < 0.0001). The annual incidence was significantly higher for junior high school students compared with primary school students (0.78 vs. 6.43/100,000, P < 0.0001). The overall male-to-female ratio of students with type 2 diabetes was 1.0:1.19 (P = 0.296), but it was 1.0:1.56 (P = 0.278) for primary school students. Overall, 83.4% of children with diabetes were obese (> or = 20% overweight). However, nonobese girls (<20% overweight) with diabetes accounted for 23.0% of the patients, whereas markedly obese boys (> or = 40% overweight) accounted for 61.5% of the patients. The frequency of a family history of type 2 diabetes in second- and first-degree relatives was 56.5%. We confirmed that the incidence of young people with type 2 diabetes increased after 1981 in the Tokyo metropolitan area. The increase in the frequency of this disorder seemed to be strongly related to an increasing prevalence of obesity. Age and genetic susceptibility may be associated with the occurrence of type 2 diabetes.
    Preview · Article · Aug 2005 · Diabetes Care
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    ABSTRACT: The aim of the study was to examine the optimal use of quick-acting insulin analogue (Q) switching from regular insulin (R) in combination with basal insulin and its long-term effects in 40 Japanese children and adolescents with type 1 diabetes. Insulin regimens after administration of Q were increased to twice daily injections of basal insulin and modified use of Q or R as bolus insulin depending on the blood glucose profile and lifestyles. The mean dose of total insulin remained unchanged during treatment with using Q, but that of basal insulin increased 12 months after the use of Q (baseline: 25.8 +/- 12.2, after 12 months: 27.1 +/- 12.6 U/day). After switching to Q, the mean HbA1c value decreased in all patients (baseline: 7.6 +/- 1.0, after 12 months: 7.3 +/- 0.8%), which reflected improvement of HbA1c in patients with HbA1c > or = 8% at baseline. These results indicated that insulin regimens after switching from R to Q varied with increases of the number and the dosage of basal insulin. Use of Q seems to be useful to improve hyperglycemia in patients with a poor glucose profile under conventional insulin treatment with using R. The choice of insulin regimens with using Q in consideration of the blood glucose profile as well as lifestyles may lead to better glycemic control.
    No preview · Article · Jun 2005 · Diabetes Research and Clinical Practice
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    ABSTRACT: Fabry Disease (alpha-galactosidase A deficiency) is an X-linked hereditary disorder leading to the pathological accumulation of globotriaosylceramide (GL-3) in lysosomes, particularly in the vascular endothelium of the kidney, heart and brain. We report the results of an open-label phase 2 study that was undertaken to evaluate whether ethnic differences exist that would affect agalsidase beta (Fabrazyme) treatment of Fabry patients in the Japanese population, relative to safety and efficacy. The study design mirrored the design of the completed phase 3 clinical trial that led to approval of the product agalsidase beta. The 13 Japanese, male Fabry patients enrolled in the study received the enzyme replacement therapy over a period of 20 weeks as biweekly infusions. All selected efficacy end points showed improvements that were comparable with findings from the phase 3 study. These improvements included reductions of GL-3 accumulation in both kidney and skin capillary endothelial cells to (near) normal levels (92% of patients). Kidney and plasma GL-3 levels decreased by 51.9% and 100%, respectively, by ELISA. Renal function remained normal. Fabry-associated pain, and quality of life, showed improvement over baseline in multiple categories. Related adverse events were mild or moderate in intensity and mostly infusion-associated (fever and rigors). As expected, IgG antibody formation was observed in 85% of the patients, but had no effect on treatment response. These results suggest that treatment with agalsidase beta is safe and effective in Japanese patients with Fabry disease. With regard to safety and efficacy, no differences were observed as compared to the caucasian population.
    Preview · Article · Feb 2005 · Journal of Inherited Metabolic Disease
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    ABSTRACT: Background Although cholesterol management reportedly reduces fatal and non-fatal coronary heart disease (CHD) events in subjects with or without evident atherosclerotic disease, it is still uncertain whether these benefits extend to Japanese. Methods and Results The study group comprised 8,009 subjects with mildly elevated total cholesterol who were randomized to treatment with 10-20 mg pravastatin plus diet (2,691 women, 1,267 men) or diet alone (2,758 women, 1,293 men). The groups were extremely well balanced with respect to baseline demographics and risk factors such as blood pressure and plasma lipids. Over a 5-year period of follow-up, the primary end-points will be a composite of fatal and non-fatal coronary events. Secondary end-points will include stroke and transient ischemic attack, all cardiovascular events and total mortality. Conclusions The 2 groups will be followed up until the end of March 2004 and end-points will be analyzed by full analysis set.
    No preview · Article · Sep 2004 · Circulation Journal
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    Preview · Article · Jan 2003 · Diabetes Care

  • No preview · Article · Jul 2002 · Pediatrics International
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    ABSTRACT: We conducted a mass-screening method to detect presymptomatic Wilson's disease in children by measuring urinary holoceruloplasmin. Two cases of Wilson's disease were found by testing urine samples from 48,819 children. The diagnosis was confirmed by clinical laboratory tests and the detection of a mutated ATP 7B gene.
    No preview · Article · Jun 2002 · Journal of Pediatrics
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    ABSTRACT: We studied the clinical characteristics of Japanese children with idiopathic type 1 diabetes who had had a remarkably rapid onset, severe metabolic disorder and absolute insulin deficiency at diagnosis. In 85 Japanese children with type 1 diabetes, 14 (16.5%) were classified as idiopathic type 1 diabetes mellitus with no evidence of anti-islet autoantibodies. Among the 14 patients with the idiopathic form, three were identified as having a fulminant onset form. These three patients had had a remarkably rapid onset with a short symptomatic period of less than seven days prior to the onset of overt diabetes. They exhibited severe ketoacidosis and had low levels of HbA1c despite high concentrations of blood glucose at diagnosis. Their initial serum C-peptide levels were extremely low or undetectable. Most of the patients experienced viral infections prior to the onset of the disease. These findings suggest that the nonautoimmune, fulminant onset form of type 1 diabetes may be not rare in the Japanese population. This form is characterized by a remarkably rapid onset with severe metabolic disorder and absolute deficiency of insulin secretion at onset. Viral infections may be associated with the rapid destruction of beta-cells without an autoimmune mechanism.
    No preview · Article · Jan 2002 · Clinical Pediatric Endocrinology
  • Misao Owada · Kikumaro Aoki · Teruo Kitagawa
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    ABSTRACT: Low-phenylalanine formula for phenylketonuria (PKU) made from free amino acids as a protein source (AAM formula) has a poor taste and smell. We developed a more palatable formula using low-phenylalanine peptide (LPP) as a protein source. Palatability tests performed by 41 healthy adults confirmed that the palatability of LPP formula was significantly better than that of AAM formula. A group of 48 patients with PKU who had been administered AAM formula since the newborn period were assessed for their preference between the AAM and LPP formulae and their feeding behaviour was compared to that in healthy children. Of patients, 90.9% and 66.6% of healthy infants less than 18 months of age took both formulae without apparent preference, suggesting that sensitivity to taste and smell is more immature in infancy than in later life. Of patients with PKU aged between 18 months and 11 years, 29.1% liked AAM formula rather than the LPP formula, while 66.7% took both formulae without apparent preference. Most healthy children in the same age group who had never previously tasted therapeutic formulae disliked it, although they tended to prefer the LPP formula. Of patients aged between 11 and 17 years, 84.6% preferred the LPP formula while 15.4% preferred the AAM formula. In the controls of this age group, 33% disliked therapeutic formulae, but they tended to prefer the LPP formula. CONCLUSION: In some young children with phenylketonuria the characteristic taste of amino acid mixture formula encountered in early life is considered to be imprinted and remains as a preference for a long time. Since school children with phenylketonuria usually obtain about 50% of their energy intake from natural food containing small amounts of protein, these patients are considered to have come to have similar preferences as healthy people which result from a waning of the imprinted taste of amino acid mixture formula.
    No preview · Article · Dec 2000 · European Journal of Pediatrics
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    ABSTRACT: We describe an interesting new mutation in a Japanese patient with Fanconi-Bickel syndrome.
    No preview · Article · Dec 2000 · European Journal of Pediatrics
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    ABSTRACT: We investigated the prevalence and clinical features of patients with eating disorders among juvenile-onset type 1 diabetes mellitus (DM). Among one hundred patients with type 1 DM, eating disorders were found in four females, two adolescent girls and two young women. In the four affected patients, three were diagnosed as having binge eating disorders and one as anorexia nervosa. The overall prevalence of eating disorders was 4.0% (4/100); that in females was 7.1% (4/56); that in adolescents and young adults was 4.8% (4/84); and that in adolescent females and young adults was 8.5% (4/47). Patients with eating disorders had irregular eating habits and showed antipathy to dietary restraint. In most cases, they had poor glycemic control associated with noncompliance with self-management of diabetes. They declared indifferent or false reports in self-monitoring of blood glucose and used inuslin omission and underdosing. On the basis of these findings, adolescent girls and young women with type 1 DM seemed to have risk factors for developing eating disorders. In cases suspected of having eating disorders, a flexible and individualized psychological approach would appear to be paticularly important.
    No preview · Article · Jan 2000 · Clinical Pediatric Endocrinology
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    ABSTRACT: A membrane-bound cytochrome b 558 , a heterodimer consisting of gp91-phox and p22-phox, is a critical component of the superoxide (O2-)-generating reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in phagocytes. Chronic granulomatous disease (CGD) is characterized by recurrent bacterial infection caused by a defect of the oxidase. Both subunits are absent from phagocytes in typical X-linked recessive CGD patients who are primarily defective in gp91-phox. We report here an atypical case of X-linked CGD in which neutrophils showed a complete absence of O2–-forming NADPH oxidase activity, but a small amount (about 10% of control) of both subunits was detected by immunoblot analysis. Spectrophotometric studies of the neutrophils with a recently developed sensitive method gave no evidence for the heme spectrum in the cytochrome b 558 of this CGD. Reverse transcription/polymerase chain reaction and sequence analysis revealed a C to T transition replacing histidine at amino acid position 101 (His101) by tyrosine in gp91-phox. These results provide evidence that His101 of gp91-phox is the one of the heme-binding ligands of cytochrome b 558 .
    No preview · Article · Nov 1998 · Human Genetics

Publication Stats

835 Citations
112.32 Total Impact Points

Institutions

  • 2005-2008
    • Kagawa Nutrition University
      Saitama, Saitama, Japan
  • 1996-2005
    • Nihon University
      • Department of Pediatrics
      Edo, Tōkyō, Japan
  • 1982
    • Nippon Bunri University
      Edo, Tōkyō, Japan
  • 1979
    • The Jikei University School of Medicine
      • Department of Pediatrics
      Edo, Tōkyō, Japan