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Publications (10)

  • [Show abstract] [Hide abstract] ABSTRACT: 目的: 高齢者気管支喘息患者に対する追加治療としての吸入ステロイドの増量治療とロイコトリエン受容体拮抗薬の追加投与治療を比較検討する. 対象・方法: 気道過敏性が亢進している中等症持続型気管支喘息患者に対して本検討を行った. 全例フルチカゾンプロピオネート (fluticasone propionate dry powderinhaler: FDP) 400μgが投与されており, 65歳以上の高齢者群と65歳未満の若年者群に分類し, ザフィルルカスト40mg (Leukotriene receptor antagonist: LTRA) の追加投与 (高齢者n=5, 若年者n=11) とFDP400μgの増量 (高齢者n=5, 若年者n=8) の追加治療を行った. 治療効果を追加投与開始時と追加投与4, 8週間後に気道過敏性を含めた呼吸機能により検討した. 結果: 高齢者では気道過敏性がLTRA追加投与群 (8週間後) のみに有意な改善を認めた (P=0.04). 一方, 若年者のFDP増量群では投与開始4週間後 (P=0.04), 8週間後 (P=0.04) に有意な改善を認め, LTRA追加投与群でも投与開始8週間後で有意な改善を認めた (P=0.01), 全ての群で一秒量の有意な改善はなく, 開始前後で末梢血総IgE値, 好酸球数の有意な変化は認められなかった. 結論: 高齢者気管支喘息患者において, LTRAの追加投与はFDP増量に比較して優位に気道過敏性改善効果が得られた. 高齢者気管支喘息症例の追加投与薬は吸入ステロイド薬 (inhaled corticosteroid: ICS) 増量よりLTRAの方がより効果的である可能性が示唆された.
    Article · Jan 2009
  • Takayuki Ohtomo · Shoichiro Miyatake · Yuichiro Kajiyama · [...] · Akio Mori
    [Show abstract] [Hide abstract] ABSTRACT: Conserved noncoding sequence-1 (CNS-1) is an important regulatory element for T helper 2 cytokine expression. IL-4, IL-5 and IL-13 expression as well as serum IgE level were attenuated in CNS-1-/- mice. CNS-1-/- and CNS-1+/+ mice were sensitized with ovalbumin (OVA) followed by antigen challenge. The number of eosinophils and T helper 2 cytokine concentration in the bronchoalveolar lavage fluid, OVA-specific IgE antibody (Ab) in the serum and bronchial responsiveness to methacholine were examined. Bronchoalveolar lavage fluid eosinophilia was significantly attenuated in CNS-1-/- mice compared to CNS-1+/+ mice, which were sensitized with OVA/aluminum once. OVA-specific IgE Ab was also attenuated. When mice were sensitized with OVA/aluminum twice, induction of eosinophilia and OVA-specific IgE Ab was not significantly different between CNS-1-/- and CNS-1+/+ mice. CNS-1 locus regulates eosinophilic inflammation in vivo.
    Article · Feb 2008 · International Archives of Allergy and Immunology
  • Article · Nov 2007 · World Allergy Organization Journal
  • Yuichiro Kajiyama · Makiko Umezu-Goto · Noriaki Kobayashi · [...] · Akio Mori
    [Show abstract] [Hide abstract] ABSTRACT: IL-9 is an important cytokine in allergic diseases such as asthma, atopic dermatitis, etc. T helper (Th) cells seem to be the main source of IL-9. Cellular and molecular mechanisms of IL-9 production by human Th cells have been poorly understood. Dermatophagoides farinae(Der f)-specific Th clones were established from peripheral blood lymphocytes of atopic asthmatics, and cytokine synthesis in response to various stimuli was determined by specific ELISAs. IL-9 was produced by 14 of 27 human Th clones upon T cell receptor (TCR) stimulation, immobilized anti-CD3 antibody (Ab). IL-9 production was significantly enhanced by the addition of anti-CD28 Ab into the culture, indicating the role of costimulatory signal on IL-9 synthesis. Pharmacologically, IL-9 production was induced by ionomycin (IOM) alone, and enhanced by phorbol 12-myristate 13-acetate (PMA). rIL-2 induced IL-9 production by 8 out of 19 Th clones. IL-9 production by Th clones stimulated with immobilized anti-CD3 Ab was significantly suppressed by the addition of anti-IL-2 neutralizing Ab into the culture. Approximately half of the Der f-specific Th clones derived from atopic asthmatics produced IL-9 upon TCR stimulation. Ca(2+) signal, CD28 signal, and IL-2 receptor signal seem to play important roles in IL-9 production by human Th cells. Moreover, synthesis of IL-9, a Th2 cytokine, is dependent on IL-2, a Th1 cytokine, which is produced by Th cells themselves.
    Article · Feb 2007 · International Archives of Allergy and Immunology
  • Makiko Umezu-Goto · Yuichiro Kajiyama · Noriaki Kobayashi · [...] · Akio Mori
    [Show abstract] [Hide abstract] ABSTRACT: IL-9 might play a critical role in pathogenesis and development of atopic asthma, but there are few reports on allergen-specific IL-9 production by peripheral blood mononuclear cells (PBMCs) obtained from adult asthmatics. PBMCs were obtained from adult atopic asthmatics and incubated with Dermatophagoides farinae(Der f) extract for the designated time periods. The resulting supernatants were assayed for IL-9 by specific sandwich ELISA. IL-9 production was detectable on day 2 and reached maximum on day 6 after stimulation of PBMCs with Der f extract. IL-9 production in response to Der f extract increased in a dose-dependent manner. CD2- or CD4-bearing cell depletion completely abolished IL-9 production by PBMCs, while CD8-bearing cell depletion did not affect it. CD4+ lymphocytes are the principal source of IL-9 produced by PBMCs of adult atopic asthmatics.
    Article · Feb 2007 · International Archives of Allergy and Immunology
  • [Show abstract] [Hide abstract] ABSTRACT: A 51-year-old man underwent left upper lobectomy due to pulmonary adenocarcinoma (cT2N1M0, stage IIB) in August, 2003. Since he turned out pT2N3M0 stage IIIB, he received combination chemotherapy with carboplatin and gemcitabine. During a second course chemotherapy, he was admitted again because of dyspnea and the deterioration of diffuse interstitial shadows in both lungs. He was treated with various antibiotics and corticosteroids. Unfortunately, he could not recover. An autopsy was performed. Microscopic features of the lung revealed diffuse alveolar damage and pulmonary hemorrhage. In this case, pulmonary hemorrhage should be considered as a complication of gemcitabine-induced lung injury.
    Article · Apr 2006
  • Akio Mori · Koji Ogawa · Yuichiro Kajiyama · [...] · Osamu Kaminuma
    [Show abstract] [Hide abstract] ABSTRACT: Eosinophilic inflammation in the bronchial mucosa has been recognized as a prominent pathological feature of bronchial asthma. Th2 cells have been implicated in the local infiltration and activation of eosinophils. The migration of eosinophils as well as Th2 cells is controlled by chemokines, suggesting a crucial role of chemokines in the pathogenesis of bronchial asthma. To elucidate the mechanism by which Th2 cells induce eosinophilic inflammation, a Th2-cell-dependent murine model of asthma was employed in this study. Along with the infiltration of eosinophils and antigen-specific Th2 cells, CC chemokine receptor-3-active eotaxin, monocyte chemoattractant protein (MCP)-3 and RANTES, as well as CC chemokine receptor-3-inactive MCP-1 were produced in the lungs of Th2-cell-transferred mice after antigen provocation in vivo. On the other hand, differentiated antigen-specific Th2 cells produced MCP-3 and RANTES but not eotaxin or MCP-1 upon stimulation in vitro. Chemokines synthesized by Th2 cells and other cell types are involved in the development of eosinophilic inflammation in bronchial asthma.
    Article · Feb 2006 · International Archives of Allergy and Immunology
  • Tomomi Hashimoto · Noriaki Kobayashi · Yuichiro Kajiyama · [...] · Akio Mori
    [Show abstract] [Hide abstract] ABSTRACT: Interleukin (IL)-5 and IL-13 are important cytokines in allergic diseases such as asthma and atopic dermatitis. We have reported that the production of IL-5 and IL-13 by mite-responsive T helper cells (Th) is controlled under similar signal requirements, but precise mechanisms are not yet well characterized. Allergen-specific Th clones were established from peripheral blood lymphocytes of atopic asthmatics, and cytokine synthesis in response to various stimuli was determined by specific ELISAs. IL-13 gene expression was enumerated by quantitative real-time PCR. IL-13 production was clearly induced by IL-2. IL-13 mRNA expression was also induced. The IL-2 signal by itself causes IL-13 synthesis independent of T cell receptor stimulation.
    Article · Feb 2006 · International Archives of Allergy and Immunology
  • [Show abstract] [Hide abstract] ABSTRACT: We evaluated diagnosis and treatment of four cases of meningeal carcinomatosis associated with primary lung cancer: case 1; small cell carcinoma (64 years old), case 2; small cell carcinoma (50 years old), case 3; adenocarcinoma (53 years old), and case 4; adenocarcinoma (55 years old). Determination of tumor markers in cerebrospinal fluid (CSF) together with the MRI findings that Gd-DTPA-enhanced T1-weighted image showing high intensity signal along the spinal cord was clinically useful in the diagnosis of meningeal carcinomatosis. Two of four patients received intrathecal chemotherapy and/or CSF drainage through Ommaya-Reservoir, resulting in dramatic improvement of various symptoms such as motor weakness and vesicorectal disorder. Intrathecal chemotherapy and placement of an Ommaya-Reservoir for CSF drainage should be considered to provide better Quality of Life (QOL) when patient can tolerate it.
    Article · Apr 2005
  • Akihiko Ohwada · Yuichiro Kajiyama · Naoko Hirashima · [...] · Masaru Suzuki
    [Show abstract] [Hide abstract] ABSTRACT: A 78-year-old man suffered from refractory aspiration pneumonia as a result of a minor medullary stroke. The only neurological symptom observed in this patient was difficulty in swallowing. He was managed with i.v. hyperalimentation with termination of oral intake, including water. However, he still experienced several episodes of aspiration pneumonia. As he was considered to have a bacterial infection because of silent aspiration of colonized oropharyngeal material, inhalation of tobramycin was introduced and successful control of airway infection was attained.
    Article · Dec 2004 · Respirology