13 research outputs found
Certolizumab pegol was effective for treating residual synovitis after total knee arthroplasty in a patient with rheumatoid arthritis: therapeutic monitoring by ultrasound
No full textInfluences of advanced age in rheumatoid arthritis: A multicentre ultrasonography cohort study
No full textNagasaki University (長崎大学)博士(医学)Objectives: We aimed to evaluate the effects of age on clinical characteristics and outcomes in biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-naïve patients with rheumatoid arthritis (RA). Methods: We analysed the cases of 234 Japanese b/tsDMARD-naïve RA patients who underwent b/tsDMARD treatment in a multicentre ultrasound prospective observational cohort. We compared the clinical characteristics at baseline and outcomes at 12 months between those aged ≥60 years and those <60 years. Results: Compared to the <60-year-old group (n = 78), the ≥60-year-old group (n = 156) had higher inflammatory marker values and ultrasound combined scores, especially wrist joints, at baseline. Age at baseline positively correlated significantly with the ultrasound scores at baseline; however, age was not a significant variable by the multiple regression analysis. The patients treated with different MOAs in the ≥60-year-old group had comparable outcomes and multiple regression analysis revealed that mechanism of action (MOA) was not a significant contributor to the Clinical Disease Activity Index at 12 months. Conclusions: RA patients with advanced age demonstrated distinctive clinical characteristics. The MOAs were not associated with clinical outcomes and ultrasound outcomes in RA patients with advanced age.長崎大学学位論文 学位記番号:共博(医歯薬)甲第47号 学位授与年月日:令和7年3月19日Author: Chieko Kawahara, Shoichi Fukui, Tohru Michitsuji, Ayako Nishino, Yushiro Endo, Toshimasa Shimizu, Masataka Umeda, Remi Sumiyoshi, Tomohiro Koga, Naoki Iwamoto, Tomoki Origuchi, Yukitaka Ueki, Nobutaka Eiraku, Takahisa Suzuki, Akitomo Okada, Naoki Matsuoka, HirokazuTakaoka, Hiroaki Hamada, TomomiTsuru, Yojiro Arinobu, Toshihiko Hidaka, Keita Fujikawa, TamamiYoshitama, YoshifumiTada, Hideo Ohtsubo, Jun Ishizaki, Tomoyuki Asano, Atsushi Kawakami and Shin-ya KawashiriCitation: Modern Rheumatology, 34(6), pp.1142–1148; 2024Nagasaki University (長崎大学), 博士(医学) (2025-03-19)doctoral thesi
A case of mixed connective tissue disease positive for proteinase 3 antineutrophil cytoplasmic antibody in a patient with slowly progressive type 1 diabetes mellitus and chronic thyroiditis
No full textA case of simultaneously diagnosed microscopic polyangiitis and lung adenocarcinoma
No full textAn octogenarian female who developed edema in the lower extremities and exertional dyspnea was admitted to our hospital.
A diagnosis of lung carcinoma was made from radiographic images and lung biopsy findings. Along with abnormal lung shadows, persistent pyrexia, elevated serum C-reactive protein levels, and progressive kidney dysfunction were also observed.
The findings of the myeloperoxidase-antineutrophil cytoplasmic antibody led to a diagnosis of microscopic polyangiitis together with lung and kidney symptoms. Physicians should be aware that microscopic polyangiitis and lung adenocarcinoma may
develop concomitantly.Acta medica Nagasakiensia, 62(2), pp.69-72; 2019departmental bulletin pape
A case of simultaneously diagnosed microscopic polyangiitis and lung adenocarcinoma
No full textAn octogenarian female who developed edema in the lower extremities and exertional dyspnea was admitted to our hospital.
A diagnosis of lung carcinoma was made from radiographic images and lung biopsy findings. Along with abnormal lung shadows, persistent pyrexia, elevated serum C-reactive protein levels, and progressive kidney dysfunction were also observed.
The findings of the myeloperoxidase-antineutrophil cytoplasmic antibody led to a diagnosis of microscopic polyangiitis together with lung and kidney symptoms. Physicians should be aware that microscopic polyangiitis and lung adenocarcinoma may
develop concomitantly.Acta medica Nagasakiensia, 62(2), pp.69-72; 201
A case of simultaneously diagnosed microscopic polyangiitis and lung adenocarcinoma
No full textAn octogenarian female who developed edema in the lower extremities and exertional dyspnea was admitted to our hospital.
A diagnosis of lung carcinoma was made from radiographic images and lung biopsy findings. Along with abnormal lung shadows, persistent pyrexia, elevated serum C-reactive protein levels, and progressive kidney dysfunction were also observed.
The findings of the myeloperoxidase-antineutrophil cytoplasmic antibody led to a diagnosis of microscopic polyangiitis together with lung and kidney symptoms. Physicians should be aware that microscopic polyangiitis and lung adenocarcinoma may
develop concomitantly
Protein-losing gastroenteropathy in a patient with concomitant systemic lupus erythematosus and Sjögren’s syndrome
No full textClinical and ultrasound features of difficult-to-treat rheumatoid arthritis: A multicenter RA ultrasound cohort study
No full textNagasaki University (長崎大学)博士(医学)Objective: The optimal strategy for difficult-to-treat (D2T) rheumatoid arthritis (RA) has not been identified, and the ultrasound characteristics of D2T RA have not been reported. We investigated the clinical characteristics and factors contributing to the outcome in D2T RA in a multicentre RA ultrasound observational cohort. Method: We reviewed 307 Japanese patients diagnosed with RA who underwent treatment with biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). We compared the differences in patient characteristics between the D2T RA and non-D2T RA groups. We examined the factors contributing to a good response [defined as b/tsDMARD continuation and Clinical Disease Activity Index (CDAI) ≤ 10 at 12 months] in the D2T RA patient group. Results: Forty-three patients (14%) were categorized as D2T RA and the remaining 264 (86%) as non-D2T RA at baseline. The grey-scale (GS) score, disease duration, and CDAI at the initiation of treatment were significantly higher in the D2T RA group than in the non-D2T RA group. In contrast, the power Doppler (PD) score was not significantly different between the two groups. Of the 43 D2T RA patients, 20 achieved a good response. The introduction of CTLA4-Ig (n = 5) was significantly associated with a good response in analysis based on inverse probability weighting with propensity score. GS and PD scores at baseline were not significantly associated with therapeutic response at 12 months in D2T RA patients. Conclusions: Patients with D2T RA had high clinical and ultrasound activity and poor responses to treatment with b/tsDMARDs. CTLA4-Ig was associated with a good response at 12 months in D2T RA patients.長崎大学学位論文 学位記番号:共博(医歯薬)甲第36号 学位授与年月日:令和6年3月6日Author: T Michitsuji, S Fukui, S Morimoto, Y Endo, A Nishino, S Nishihata, Y Tsuji, T Shimizu, M Umeda, R Sumiyoshi, T Koga, N Iwamoto, T Origuchi, Y Ueki, T Yoshitama, N Eiraku, N Matsuoka, A Okada, K Fujikawa, H Ohtsubo, H Takaoka, H Hamada, T Tsuru, M Nawata, Y Arinobu, T Hidaka, Y Tada, A Kawakami, S-Y KawashiriCitation: Scandinavian Journal of Rheumatology, 53(2), pp.123-129; 2023Nagasaki University (長崎大学), 博士(医学) (2024-03-06)doctoral thesi
原発性シェーグレン症候群患者の口唇唾液腺におけるtoll-like receptor 7シグナルの活性化
No full textThe aim of this study was to determine the expressions of Toll-like receptors (TLRs) 7–9 and type I interferon (IFN) signal in labial salivary glands (LSGs) and cultured salivary gland epithelial cells (SGECs) from primary Sjögren's syndrome (pSS) patients. We performed an immunohistochemistry analysis of LSGs from 11 patients with pSS as defined by American–European Consensus Group classification criteria and five healthy subjects. The pSS patients' SGECs were analyzed by immunofluorescence and western blotting. IFN-α expression was examined by immunosorbent assay and flow cytometry. Mononuclear cells (MNCs) from pSS patients' LSGs showed TLR-7-dominant expression. B cells, plasma cells and plasmacytoid dendritic cells (pDCs) co-expressed with TLR-7. Myeloid differentiation primary response gene 88 (MyD88), tumor necrosis factor receptor-associated factor 6 (TRAF6) and interferon regulatory factor 7 (IRF7) co-expressed with the pDC marker CD303 in LSGs. Ducts from pSS patients dominantly expressed TLR-7, and TLR-7 in the ducts co-expressed with MyD88, TRAF6 and IRF7. Type I IFNs including IFN-α and IFN-β were detected in MNCs and ducts in pSS patients' LSGs. Increased TRAF6 expression and the nuclear translocation of IRF7 in SGECs were detected by immunofluorescence following loxoribine (a TLR-7 ligand) stimulation despite IFN-β pretreatment. Western blotting showed increased TRAF6 expression in SGECs following IFN-β and loxoribine stimulation. Although no increase in IFN-α was detected in supernatant from stimulated SGECs, the IFN-α in supernatant from stimulated peripheral blood pDCs from pSS patients was significantly increased. Our findings suggest that TLR-7 is dominantly expressed in both MNCs and ducts with downstream signals for type I IFNs, indicating that TLR7-dominant innate immunity is related to the development of sialadenitis in pSS.長崎大学学位論文 学位記番号:博(医歯薬)甲第1137号 学位授与年月日:平成31年3月20日Author: T. Shimizu, H. Nakamura, A. Takatani, M. Umeda, Y. Horai, S. Kurushima, T. Michitsuji, Y. Nakashima, A. KawakamiCitation: Clinical & Experimental Immunology, 196(1), pp.39-51; 201
早期関節リウマチ患者において、初診時のMRI骨髄浮腫が1年後の急速骨破壊進行を予測する：長崎大学早期関節炎コホートの解析
No full textObjective. To clarify whether magnetic resonance imaging (MRI) bone edema predicts the development of rapid radiographic progression (RRP) in the Nagasaki University Early Arthritis Cohort of patients with early-stage rheumatoid arthritis (RA). Methods. Patients with early-stage RA (n = 76) were enrolled and underwent 1.5-T MRI of both wrists and finger joints. Synovitis, bone edema, and bone erosion were evaluated using the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS). RRP was defined as an annual increment > 3 at 1 year by the Genant-modified Sharp score of plain radiographs. A multivariate logistic regression analysis was performed to establish the risk factors for RRP. Results. Median disease duration at enrollment was 3 months. RRP was found in 12 of the 76 patients at 1 year. A univariate analysis revealed that matrix metalloprotease-3, RAMRIS bone edema score, and RAMRIS bone erosion score were associated with RRP. Multivariate logistic regression analyses demonstrated that the RAMRIS bone edema score at enrollment (5-point increase, OR 2.18, 95% CI 1.32–3.59, p = 0.002) was the only independent predictor of the development of RRP at 1 year. A receiver-operating characteristic analysis identified the best cutoff value for RAMRIS bone edema score as 5. RRP was significantly rare among the patients with a RAMRIS bone edema score < 5 at enrollment (2 from 50 patients). Conclusion. Our findings suggest that MRI bone edema is closely associated with the development of RRP in patients with early-stage RA. Physicians should carefully control the disease activity when MRI bone edema is observed in patients with early RA.長崎大学学位論文 学位記番号:博(医歯薬)甲第870号 学位授与年月日:平成28年6月1日Author: Yoshikazu Nakashima, Mami Tamai, Junko Kita, Toru Michitsuji, Toshimasa Shimizu, Shoichi Fukui, Masataka Umeda, Ayako Nishino, Takahisa Suzuki, Yoshiro Horai, Akitomo Okada, Takayuki Nishimura, Tomohiro Koga, Shin-ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Yasuko Hirai, Kazuhiko Arima, Satoshi Yamasaki, Hideki Nakamura, Tomoki Origuchi, Shoichiro Takao, Masataka Uetani, Kiyoshi Aoyagi, Katsumi Eguchi and Atsushi KawakamiCitation: The Journal of Rheumatology, 43(7), pp.1278-1284; 2016出版時論題変
