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1.
Behav Sci (Basel) ; 14(3)2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38540473

RESUMEN

Improvements in mental health through real-time feedback on emotions have consequences for productivity and employee wellness. However, we find few extant studies on how real-time feedback on emotions can influence subsequent behavior modification in the Japanese workplace. We conducted a randomized controlled trial (RCT) with 30 employees of an insurance company in Japan and observed their emotions for 10 working days using a wearable biometric device. We compared the emotions of employees who had access to real-time emotional states (treatment group) with those of employees who did not (control group). The results of the panel regression analysis showed that access to real-time emotions was negatively associated with happy emotions and positively associated with angry and sad emotions. The results indicated that even after having access to the objective statuses of emotions, participants were unable to continue with happy emotions and reverse angry and sad emotions to other comfortable emotions. Our findings imply that feedback on real-time emotional states should be associated with appropriate training and motivation to utilize feedback for behavioral modification.

2.
JAMA Netw Open ; 6(12): e2349942, 2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-38153729

RESUMEN

Importance: Kawasaki disease is an acute systemic vasculitis that primarily affects infants and young children. No reproducible risk factors have yet been identified, but a possible association between maternal folic acid supplementation and Kawasaki disease has been reported previously. Objective: To investigate the associations of exposure to maternal serum folic acid levels and maternal folic acid supplementation with onset of Kawasaki disease during infancy among offspring. Design, Setting, and Participants: This cohort study used data from the Japan Environment and Children's Study, a nationwide birth cohort, which has enrolled children since 2011. This study used the data set released in October 2019, and analysis was performed in January 2023. Exposures: Maternal serum folic acid levels (≥10 ng/mL classified as exposed) during the second and third trimesters and the frequency of maternal folic acid supplementation during the first trimester and during the second and third trimesters of pregnancy (once a week or more was classified as exposed). Main Outcomes and Measures: The primary outcome was onset of Kawasaki disease in offspring up to age 12 months. Odds ratios (ORs) for each exposure were estimated, and propensity score-adjusted logistic regression was conducted on the basis of the sets of variables. Results: The study population comprised 87 702 children who were followed-up for 12 months. Of these, 336 children developed Kawasaki disease. Mothers who took folic acid supplements (31 275 mothers [35.7%]; mean [SD] age, 32 [5] years) had higher serum folic acid levels than those who did not take supplements. Higher maternal serum folic acid levels were associated with a significantly lower risk of Kawasaki disease in offspring than lower levels (folic acid ≥10 vs <10 ng/mL, 56 of 20 698 children [0.27%] vs 267 of 64 468 children [0.41%]; OR, 0.68; 95% CI, 0.50-0.92). Children whose mothers took folic acid supplementation during the first trimester had a lower prevalence of Kawasaki disease than children whose mothers did not take folic acid (131 of 39 098 children [0.34%] vs 203 of 48 053 children [0.42%]), although the difference was not statistically significant (OR, 0.83; 95% CI, 0.66-1.04). Supplementation during the second and third trimesters was associated with a significantly lower risk of Kawasaki disease compared with no supplementation (94 of 31 275 children [0.30%] vs 242 of 56 427 children [0.43%]; OR, 0.73; 95% CI, 0.57-0.94). Conclusions and Relevance: In this cohort study, higher serum folic acid levels (≥10 ng/mL) and maternal folic acid supplementation more than once a week during the second and third trimesters were associated with reduced risk of Kawasaki disease in offspring during infancy.


Asunto(s)
Síndrome Mucocutáneo Linfonodular , Niño , Lactante , Femenino , Embarazo , Humanos , Preescolar , Adulto , Síndrome Mucocutáneo Linfonodular/epidemiología , Estudios de Cohortes , Cohorte de Nacimiento , Ácido Fólico , Madres
3.
Behav Sci (Basel) ; 13(5)2023 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-37232628

RESUMEN

Despite the attempt by the Japanese government to reduce alcohol consumption, reduction of alcohol consumption requires improvement. We explore this issue from the impulsivity perspective and investigate whether a causal relationship exists between impulsivity and drinking behavior. We used data from the Preference Parameter Study of Osaka University to capture respondents' drinking status. Our probit regression showed that procrastination, a proxy measure of impulsivity, was significantly associated with drinking behavior, while hyperbolic discounting, a direct measure of impulsivity, was insignificant. Our findings suggest that impulsive people will discount their health in the future; thus, the government should consider impulsivity in policymaking. For example, awareness programs should focus more on future healthcare costs from alcohol-related problems so that impulsive drinkers can understand how much they may need to spend in the future compared to current satisfaction with alcohol drinking.

4.
Behav Sci (Basel) ; 12(12)2022 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-36546954

RESUMEN

Eldercare is a major public health concern in many East Asian countries, including Japan, because of the ever-growing elderly population, and significant changes in family caregiving norms. The changes are due to global diffusion and the influence of socioeconomic and demographic shifts. Consequently, perceptions of the norm of family caregiving need investigation. We examined how demographic and socioeconomic factors influence the perception of family caregiving norms in Japan, using data from Osaka University's preference parameter study. According to the results of the probit regression, age, education, full-time employment, marital status, the number of sons and daughters, interactions between females and age and females and full-time employment, and parents' education are negatively related to the participants' perceptions of family caregiving norms. Our results suggest that people traditionally perceived as caregivers are less likely to have a positive attitude towards family caregiving, despite the government's efforts through Universal Long-Term Care Insurance, implemented in 2000. Therefore, authorities must reassess the role of families, explore alternative forms of community-based care, and provide more assistance to caregivers.

6.
Pediatr Int ; 64(1): e14901, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34170585

RESUMEN

BACKGROUND: Neonates with hypoxic-ischemic encephalopathy (HIE) on therapeutic hypothermia (TH) therapy may show persistent pulmonary hypertension of the newborn (PPHN). In Japan, the reported mortality rate is lower than in the US, possibly due to treatment differences of newborns with moderate to severe HIE and PPHN. This study aimed to determine the feasibility and long-term outcomes of inhaled nitric oxide (iNO) and TH therapy in newborns with moderate to severe HIE and PPHN. METHODS: This was a retrospective review of neonates with moderate to severe HIE that were treated with TH from 2008 to 2017 at a large medical center in Japan. We documented their long-term neurological prognosis, measuring their developmental and Gross Motor Function Classification System level at 18 months old. RESULTS: A total of 37 neonates with moderate to severe HIE underwent TH therapy and six of them were started with iNO therapy for PPHN. iNO with TH was safely administered to all six newborns with moderate to severe HIE with PPHN. In two neonates TH was discontinued because of intraventricular hemorrhage (IVH) and severe hypotension. Neurological outcomes were similar in newborns who were treated with iNO and TH and those who were treated with TH alone. CONCLUSION: These initial findings suggest that monitoring hematological and cardiovascular status is important with iNO for severe asphyxia in infants with PPHN. Safer and more feasible protocols are needed for when iNO and TH therapy are administered together.


Asunto(s)
Hipotermia Inducida , Hipoxia-Isquemia Encefálica , Síndrome de Circulación Fetal Persistente , Humanos , Hipoxia-Isquemia Encefálica/tratamiento farmacológico , Lactante , Recién Nacido , Pulmón , Óxido Nítrico/uso terapéutico , Síndrome de Circulación Fetal Persistente/tratamiento farmacológico
7.
PLoS One ; 16(9): e0257138, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34499692

RESUMEN

OBJECTIVE: Kawasaki disease (KD) is a systemic vasculitis in childhood that can lead to coronary artery lesions (CALs). Although early diagnosis and treatment is important for preventing KD patients from development of CALs, diagnosis depends on the clinical features of KD. We studied the usefulness of leucine-rich alpha-2-glycoprotein 1 (LRG1) and angiotensinogen (AGT), previously reported as KD-related proteins, for KD diagnosis and estimation of intravenous immunoglobulin (IVIG) efficacy. METHODS: We undertook a prospective cohort study with patients having two or more KD symptoms in multiple centers in Japan, between July 2017 and February 2019. RESULTS: Two hundred forty-two patients were included. In multivariable analysis, one unit increase in LRG1 was associated with higher odds of KD diagnosis (Odds ratio [OR] 1.02 [95% confidence interval (CI) 1.001-1.03]). Double-positivity for AGT (≥ 26 µg/mL) and LRG1 (≥ 123.5 µg/mL) was an independent biomarker for KD diagnosis in both the total cohort and the subgroup of patients with two to four KD symptoms (OR 5.01 [95% CI 1.86-13.50] and 3.71 [95% CI 1.23-11.16], respectively). There was no association between LRG1/AGT and IVIG efficacy. CONCLUSION: Double-positivity for LRG1 and AGT is an biomarker for KD diagnosis, especially useful in diagnosing incomplete KD from non-KD. Future studies with larger cohorts should seek to determine whether LRG1 and AGT are valuable as definitive data referred at the diagnosis of KD and for estimating the risk of CALs.


Asunto(s)
Angiotensinógeno/metabolismo , Glicoproteínas/metabolismo , Síndrome Mucocutáneo Linfonodular/diagnóstico , Síndrome Mucocutáneo Linfonodular/metabolismo , Adolescente , Biomarcadores/metabolismo , Proteína C-Reactiva/metabolismo , Niño , Preescolar , Femenino , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Lactante , Recién Nacido , Masculino , Síndrome Mucocutáneo Linfonodular/tratamiento farmacológico , Análisis Multivariante
8.
Semin Arthritis Rheum ; 51(5): 1045-1056, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34416626

RESUMEN

BACKGROUND: Kawasaki disease (KD) is a form of self-limiting vasculitis that causes coronary artery abnormalities in children. Although clinical trials of monoclonal antibodies and anti-cytokine biologics that block cytokine cascades have been conducted, the studies have revealed contradictory results. To examine the effectiveness of treatment with monoclonal antibodies and anti-cytokine biologics for KD patients, we conducted this systematic review and meta-analysis. METHODS: Relevant randomized controlled trials (RCTs) and observational studies (e.g., cohort studies, case-control studies, case-series, and case-reports) were included to summarize available evidence, both qualitatively and quantitatively. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and ICUSHI were used for systematic research. Meta-analysis of the included studies was conducted using fixed-effect or random-effects models, depending on the degree of between-study heterogeneity. We assessed coronary artery and treatment outcomes of the interventions. The certainty of evidence and risk of bias were assessed using the GRADE and Cochrane risk of bias tool. The protocol of this review is registered with PROSPERO (CRD42016033079). RESULTS: Results: Of all searched studies, 183 studies were qualitatively analyzed. We finally included four randomized controlled trials with 456 patients in quantitative syntheses. Monoclonal antibodies and anti-cytokine biologics did not reduce the frequency of CAA (risk ratio [RR], 0.93; 95% confidence interval [95%CI], 0.65 to 1.32, low certainty of evidence), compared with the conventional treatment with IVIG. However, the frequency of treatment resistance (RR, 0.60; 95%CI, 0.38 to 0.95, moderate certainty of evidence) was reduced by the antibodies. We found no statistical differences in either "any adverse event" (RR, 0.92; 95%CI, 0.80 to 1.06, low certainty of evidence) or "adverse events attributable to the administration of the medication" (RR, 1.10; 95%CI, 0.72 to 1.69, low certainty of evidence) between the two groups. CONCLUSION: Conclusions: Although monoclonal antibodies and anti-cytokine biologics were not effective in reducing the frequency of CAA in KD patients, the frequency of treatment resistance might be reduced by those agents compared with conventional IVIG therapy alone.


Asunto(s)
Antineoplásicos Inmunológicos , Productos Biológicos , Síndrome Mucocutáneo Linfonodular , Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Productos Biológicos/uso terapéutico , Niño , Citocinas , Humanos , Síndrome Mucocutáneo Linfonodular/tratamiento farmacológico
9.
Sci Rep ; 11(1): 13309, 2021 06 25.
Artículo en Inglés | MEDLINE | ID: mdl-34172781

RESUMEN

Kawasaki disease (KD) is an acute systemic vasculitis that mainly affects infants and young children. The etiology of KD has been discussed for several decades; however, no reproducible risk factors have yet been proven. We used the Japan Environment and Children's Study data to explore the association between the causal effects of exposure during the fetal and neonatal periods and KD onset. The Japan Environment and Children's Study, a nationwide birth cohort study, has followed approximately 100,000 children since 2011. We obtained data on exposures and outcomes from the first trimester to 12 months after birth. Finally, we included 90,486 children who were followed for 12 months. Among them, 343 children developed KD. Multivariate logistic regression revealed that insufficient intake of folic acid during pregnancy (odds ratio [OR], 1.37; 95% CI 1.08-1.74), maternal thyroid disease during pregnancy (OR, 2.03; 95% CI 1.04-3.94), and presence of siblings (OR, 1.33; 95% CI 1.06-1.67) were associated with KD onset in infancy. In this study, we identified three exposures as risk factors for KD. Further well-designed studies are needed to confirm a causal relationship between these exposures and KD onset.


Asunto(s)
Síndrome Mucocutáneo Linfonodular/etiología , Adolescente , Adulto , Niño , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Japón , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Embarazo , Adulto Joven
10.
Mod Rheumatol Case Rep ; 5(2): 442-447, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33904379

RESUMEN

The new disease concept of multisystem inflammatory syndrome in children (MIS-C), which is a systemic inflammatory syndrome with multiple organ involvement after SARS-CoV2 infection, was established in 2020. MIS-C is common in Hispanic and black children in Europe and North America, with few reports in East Asians. A significant portion of patients with MIS-C develop Kawasaki disease (KD)-like symptoms. Therefore, differential diagnosis is challenging, especially in East Asia, where KD is most prevalent. No Japanese cases have been reported in the literatures so far. We report a case of MIS-C in Japan with KD-like symptoms. A 9-year-old Japanese boy, who was infected with SARS-CoV2 1 month previously along with his family, was admitted to our hospital owing to fever for 6 d and erythema mainly in the groyne and pubic area. He also had conjunctivitis, strawberry tongue and diarrhoea. His laboratory findings were as follows: WBC, 12,840/µL (lymphocytes, 4%); CRP, 22.6 mg/dL, pro-calcitonin, 1.8 ng/mL (normal, <0.50 ng/mL); NT pro-BNP, 7627 pg/mL (<125 pg/mL); and troponin T, 0.14 ng/mL (<0.01 ng/mL). His cardiac function was normal. We initially diagnosed him with KD. His fever rapidly resolved with intravenous immunoglobulin (IVIG) and there were no coronary artery lesions. Desquamation of the fingers was observed later. Finally, a history of SARS-COV2 infection, his age, atypical skin rash, elevation of markers of inflammation and heart failure and lymphopenia suggested the diagnosis of MIS-C rather than KD. Differentiation between KD and MIS-C is necessary even in Japan, especially in patients with atypical features of KD.


Asunto(s)
COVID-19/complicaciones , Citocinas , Síndrome de Respuesta Inflamatoria Sistémica , COVID-19/diagnóstico , Niño , Citocinas/sangre , Diagnóstico Diferencial , Humanos , Japón , Masculino , Síndrome Mucocutáneo Linfonodular/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico
11.
Immunol Lett ; 207: 64-72, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30653987

RESUMEN

PURPOSE: Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is attributed to inappropriate inflammatory response in intestinal mucosa. Transforming growth factor ß (TGF-ß)/SMAD signaling plays key role in differentiation of naïve CD4+ T cells to T helper 17 (Th17) cells or regulatory T (Treg) cells. This study aimed to investigate associations between single nucleotide polymorphisms (SNPs) of SMAD family genes and susceptibility to IBD in a Japanese cohort to elucidate genetic determinants of IBD. METHODS: This study included 81 patients with CD, 108 patients with UC, and 199 healthy subjects as controls. A total of 21 SNPs in four genes (SMAD2, SMAD3, SMAD4, and SMAD7) involved in the TGF-ß/SMAD signaling pathway were genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism, PCR-direct DNA sequencing, or PCR-high resolution melting curve analysis. RESULTS: Four SNPs (rs13381619, rs9955626, rs1792658, and rs1792671) within SMAD2, one SNP within SMAD3 (rs41473580), two SNPs within SMAD4 (rs7229678 and rs9304407), and one SNP within SMAD7 (rs12956924) were significantly associated with susceptibility only to UC. rs13381619 within SMAD2, rs4147358 within SMAD3, rs9304407 within SMAD4, and rs12956924 within SMAD7 exhibited the strongest association (p < 0.001, p = 0.021, p = 0.005, and p = 0.001, respectively). Furthermore, rs4147358 of SMAD3 altered the expression of a luciferase reporter gene in Jurkat T cell line in vitro. CONCLUSIONS: Genetic variants of several SMAD family of genes might alter the balance of differentiation between Th17 and Treg, resulting in the development of IBD, especially UC.


Asunto(s)
Colitis Ulcerosa/genética , Genotipo , Proteína Smad2/genética , Proteína smad3/genética , Proteína Smad4/genética , Proteína smad7/genética , Linfocitos T/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Frecuencia de los Genes , Estudios de Asociación Genética , Antecedentes Genéticos , Predisposición Genética a la Enfermedad , Humanos , Japón , Células Jurkat , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Adulto Joven
12.
Pediatr Rheumatol Online J ; 15(1): 39, 2017 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-28511718

RESUMEN

BACKGROUND: The etiology of Kawasaki disease (KD) remains unknown. However, many studies have suggested that specific genetic factors and/or some infectious agents underlie the onset of KD. Previous studies have suggested that human adenovirus (HAdV) is one of the triggering pathogens of KD. Here, we report monozygotic twin boys who sequentially developed KD in conjunction with acute HAdV type 3 (HAdV-3) infection. CASE PRESENTATION: The patients were four-year-old monozygotic twin boys. The elder brother developed a high fever and was diagnosed with HAdV infection with an immunochromatographic kit for HAdV (IC-kit). He was transferred to our institute after persistent fever for 7 days. On admission, he already fulfilled all the diagnostic criteria for KD. His laboratory data were as follows: WBC, 9700/µl; CRP, 2.42 mg/dl; IFN-γ, 99.8 pg/ml; and TNF-α, 10.9 pg/ml. He received intravenous immunoglobulin (IVIG) and aspirin and responded well, with no coronary artery abnormalities. The younger brother, who was also IC-kit-positive, was hospitalized on the same day as his elder brother after persistent fever for 3 days. His data on admission were as follows: WBC, 12,600/µl; CRP, 5.54 mg/dl; IFN-γ, 105.0 pg/ml; and TNF-α, 33.6 pg/ml. Although he developed all of the typical KD symptoms by day 4, his fever subsided spontaneously on day 6 without IVIG or aspirin. However, he developed a dilation of the coronary artery in the region of the left circumflex artery bifurcation on day 10. His coronary artery dilation had resolved 3 months after onset. HAdV-3 DNA was detected with PCR in stool samples from both patients, and HAdV3 was isolated from the younger brother's stool sample. Serum neutralizing antibodies to AdV3 were also significantly elevated in both patients, suggesting seroconversion. CONCLUSIONS: There have been few reports of the simultaneous development of KD in monozygotic twins. Notably, both twins had an acute HAdV-3 infection immediately before they developed KD. These cases strongly suggest that KD was triggered by HAdV-3 infection, and they indicate that specific immune responses to some pathogens (such as HAdV-3), arising from genetic susceptibility, play a critical role in the pathogenesis of KD.


Asunto(s)
Infecciones por Adenovirus Humanos/complicaciones , Enfermedades en Gemelos , Síndrome Mucocutáneo Linfonodular/complicaciones , Gemelos Monocigóticos , Antiinflamatorios no Esteroideos/uso terapéutico , Aspirina/uso terapéutico , Preescolar , Aneurisma Coronario/etiología , Enfermedades en Gemelos/tratamiento farmacológico , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Factores Inmunológicos/uso terapéutico , Masculino , Síndrome Mucocutáneo Linfonodular/tratamiento farmacológico
13.
Syst Rev ; 5: 60, 2016 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-27072358

RESUMEN

BACKGROUND: Kawasaki disease (KD) is a form of self-limiting vasculitis that causes coronary artery abnormality in children. Based on reports of elevated plasma level of cytokines such as tumor necrosis factor-α in KD patients, clinical trials of monoclonal antibodies that block cytokine cascades have been conducted. However, the studies have revealed contradictory results. The objective of this study is to examine the effectiveness of treatment with monoclonal antibodies for KD patients. METHODS: Relevant randomized controlled trials (RCTs), cluster RCTs, quasi-RCTs, cross-over trials, and any observational studies (e.g., cohort studies, case-control studies, case series, and case reports) will be included to summarize available evidence both qualitatively and quantitatively. Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and ICUSHI will be searched. We will assess coronary artery and treatment outcomes of the interventions. Two authors will independently screen studies for inclusion and consulting with a third author where necessary to resolve discrepancies. The risk of bias of included studies will be assessed using the Cochrane Collaboration risk of bias tool and quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analysis of the included studies will be conducted using fixed effects or random effects models depending on the degree of between-study heterogeneity. Results will be presented using risk ratios with 95 % confidence interval (CI) for dichotomous outcomes and standardized mean differences with 95 % CI for continuous outcomes. DISCUSSION: This systematic review and meta-analysis protocol does not require ethical approval. We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals. TRIAL REGISTRATION: PROSPERO CRD42016033079 .


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Metaanálisis como Asunto , Síndrome Mucocutáneo Linfonodular/tratamiento farmacológico , Revisiones Sistemáticas como Asunto , Humanos , Proyectos de Investigación
14.
Pediatr Rheumatol Online J ; 11(1): 28, 2013 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-23902667

RESUMEN

BACKGROUND: Persistent fever after intravenous immunoglobulin (IVIG) is considered to be a major criterion of IVIG resistance in Kawasaki disease (KD), and a risk factor for the development of coronary artery abnormalities (CAA). However, the importance of persistent non-fever symptoms after defervescence has not yet been investigated. We examined the relationship between persistent non-fever symptoms and CAA in KD. METHODS: We conducted a retrospective cohort study of patients hospitalized with KD at the National Center for Child Health and Development between 1 April 2008 and 31 March 2009. Patients were divided into two groups; group A included patients who still had non-fever symptoms one month after onset of the illness and group B included patients who did not have persistent non-fever symptoms. Demographic, clinical variables were compared between the groups. RESULTS: Seventy-seven KD patients treated with IVIG were retrospectively analyzed. Patients were divided into two groups; group A included 12 (15.6%) patients and group B 65 (84.4%) patients. Demographic data, baseline laboratory data, and fever duration did not differ between the groups. In group A patients the most common persistent non-fever symptoms were lip erythema (n = 6) and bulbar conjunctivitis (n = 8). One month after onset of the illness CAA developed in seven of 77 patients (9.1%), four (33%) in group A and three (4.6%) in group B (odds ratio 10.3; 95% CI 1.9-54.8). Three patients in group A and one patient in group B developed CAA after the resolution of fever. CONCLUSIONS: Persistence of non-fever symptoms after IVIG may suggest persistence of latent inflammation, which may increase the risk of CAA. Therefore, patients with persistent non-fever symptoms may be at risk of developing CAA, even after defervescence. A prospective trial of additional IVIG for such patients should be considered.

15.
Bioorg Med Chem ; 20(19): 5705-19, 2012 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-22959556

RESUMEN

Dipeptidyl peptidase IV (DPP-4) inhibition is suitable mechanism for once daily oral dosing regimen because of its low risk of hypoglycemia. We explored linked bicyclic heteroarylpiperazines substituted at the γ-position of the proline structure in the course of the investigation of l-prolylthiazolidines. The efforts led to the discovery of a highly potent, selective, long-lasting and orally active DPP-4 inhibitor, 3-[(2S,4S)-4-[4-(3-methyl-1-phenyl-1H-pyrazol-5-yl)piperazin-1-yl]pyrrolidin-2-ylcarbonyl]thiazolidine (8 g), which has a unique structure characterized by five consecutive rings. An X-ray co-crystal structure of 8 g in DPP-4 demonstrated that the key interaction between the phenyl ring on the pyrazole and the S(2) extensive subsite of DPP-4 not only boosted potency, but also increased selectivity. Compound 8 g, at 0.03 mg/kg or higher doses, significantly inhibited the increase of plasma glucose levels after an oral glucose load in Zucker fatty rats. Compound 8 g (teneligliptin) has been approved for the treatment of type 2 diabetes in Japan.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Inhibidores de la Dipeptidil-Peptidasa IV/química , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Hipoglucemiantes/química , Hipoglucemiantes/uso terapéutico , Pirazoles/química , Pirazoles/uso terapéutico , Tiazolidinas/química , Tiazolidinas/uso terapéutico , Animales , Glucemia/metabolismo , Cristalografía por Rayos X , Diabetes Mellitus Tipo 2/enzimología , Dipeptidil Peptidasa 4/metabolismo , Inhibidores de la Dipeptidil-Peptidasa IV/farmacocinética , Inhibidores de la Dipeptidil-Peptidasa IV/farmacología , Prueba de Tolerancia a la Glucosa , Haplorrinos , Humanos , Hipoglucemiantes/farmacocinética , Hipoglucemiantes/farmacología , Masculino , Simulación del Acoplamiento Molecular , Pirazoles/farmacocinética , Pirazoles/farmacología , Ratas , Ratas Wistar , Ratas Zucker , Tiazolidinas/farmacocinética , Tiazolidinas/farmacología
16.
Lipids Health Dis ; 11: 75, 2012 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-22698140

RESUMEN

BACKGROUND: Resynthesis of triglycerides in enterocytes of the small intestine plays a critical role in the absorption of dietary fat. Acyl-CoA:monoacylglycerol acyltransferase-2 (MGAT2) is highly expressed in the small intestine and catalyzes the synthesis of diacylglycerol from monoacylglycerol and acyl-CoA. To determine the physiological importance of MGAT2 in metabolic disorders and lipid metabolism in the small intestine, we constructed and analyzed Mgat2-deficient mice. RESULTS: In oral fat tolerance test (OFTT), Mgat2-deficient mice absorbed less fat into the circulation. When maintained on a high-fat diet (HFD), Mgat2-deficient mice were protected from HFD-induced obesity and insulin resistance. Heterozygote (Mgat2+/-) mice had an intermediate phenotype between Mgat2+/+ and Mgat2-/- and were partially protected from metabolic disorders. Despite of a decrease in fat absorption in the Mgat2-deficient mice, lipid levels in the feces and small intestine were comparable among the genotypes. Oxygen consumption was increased in the Mgat2-deficient mice when maintained on an HFD. A prominent upregulation of the genes involved in fatty acid oxidation was observed in the duodenum but not in the liver of the Mgat2-deficient mice. CONCLUSION: These results suggest that MGAT2 has a pivotal role in lipid metabolism in the small intestine, and the inhibition of MGAT2 activity may be a promising strategy for the treatment of obesity-related metabolic disorders.


Asunto(s)
Dieta Alta en Grasa/efectos adversos , Grasas/metabolismo , Resistencia a la Insulina/fisiología , Absorción Intestinal/fisiología , Obesidad/metabolismo , Animales , Composición Corporal/genética , Composición Corporal/fisiología , Prueba de Tolerancia a la Glucosa , Resistencia a la Insulina/genética , Absorción Intestinal/genética , Ratones , Ratones Noqueados , N-Acetilglucosaminiltransferasas , Obesidad/genética , Reacción en Cadena de la Polimerasa
17.
PLoS One ; 6(8): e23401, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21853128

RESUMEN

Mutations in mitochondrial DNA (mtDNA) might contribute to expression of the tumor phenotypes, such as metastatic potential, as well as to aging phenotypes and to clinical phenotypes of mitochondrial diseases by induction of mitochondrial respiration defects and the resultant overproduction of reactive oxygen species (ROS). To test whether mtDNA mutations mediate metastatic pathways in highly metastatic human tumor cells, we used human breast carcinoma MDA-MB-231 cells, which simultaneously expressed a highly metastatic potential, mitochondrial respiration defects, and ROS overproduction. Since mitochondrial respiratory function is controlled by both mtDNA and nuclear DNA, it is possible that nuclear DNA mutations contribute to the mitochondrial respiration defects and the highly metastatic potential found in MDA-MB-231 cells. To examine this possibility, we carried out mtDNA replacement of MDA-MB-231 cells by normal human mtDNA. For the complete mtDNA replacement, first we isolated mtDNA-less (ρ(0)) MDA-MB-231 cells, and then introduced normal human mtDNA into the ρ(0) MDA-MB-231 cells, and isolated trans-mitochondrial cells (cybrids) carrying nuclear DNA from MDA-MB-231 cells and mtDNA from a normal subject. The normal mtDNA transfer simultaneously induced restoration of mitochondrial respiratory function and suppression of the highly metastatic potential expressed in MDA-MB-231 cells, but did not suppress ROS overproduction. These observations suggest that mitochondrial respiration defects observed in MDA-MB-231 cells are caused by mutations in mtDNA but not in nuclear DNA, and are responsible for expression of the high metastatic potential without using ROS-mediated pathways. Thus, human tumor cells possess an mtDNA-mediated metastatic pathway that is required for expression of the highly metastatic potential in the absence of ROS production.


Asunto(s)
Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , ADN Mitocondrial/genética , Mutación/genética , Animales , Línea Celular Tumoral , Núcleo Celular/genética , Femenino , Genoma Humano/genética , Genotipo , Humanos , Células Híbridas/metabolismo , Ratones , Metástasis de la Neoplasia , Fenotipo
18.
J Clin Immunol ; 29(6): 815-25, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19653082

RESUMEN

OBJECTIVE: An association between susceptibility to inflammatory bowel disease (IBD) and polymorphisms of both the tyrosine kinase 2 gene (TYK2) and the signal transducer and activator of transcription 3 gene (STAT3) was examined in a Japanese population in order to identify the genetic determinants of IBD. METHODS: The study subjects comprised 112 patients with ulcerative colitis, 83 patients with Crohn's disease (CD), and 200 healthy control subjects. Seven tag single-nucleotide polymorphisms (SNPs) in TYK2 and STAT3 were detected by PCR-restriction fragment length polymorphism. RESULTS: The frequencies of a C allele and its homozygous C/C genotype at rs2293152 SNP in STAT3 in CD patients were significantly higher than those in control subjects (P = 0.007 and P = 0.001, respectively). Furthermore, out of four haplotypes composed of the two tag SNPs (rs280519 and rs2304256) in TYK2, the frequencies of a Hap 1 haplotype and its homozygous Hap 1/Hap1 diplotype were significantly higher in CD patients in comparison to those in control subjects (P = 0.023 and P = 0.024, respectively). In addition, the presence of both the C/C genotype at rs2293152 SNP in STAT3 and the Hap 1/Hap 1 diplotype of TYK2 independently contributes to the pathogenesis of CD and significantly increases the odds ratio to 7.486 for CD (P = 0.0008). CONCLUSION: TYK2 and STAT3 are genetic determinants of CD in the Japanese population. This combination polymorphism may be useful as a new genetic biomarker for the identification of high-risk individuals susceptible to CD.


Asunto(s)
Enfermedad de Crohn/genética , Predisposición Genética a la Enfermedad , Polimorfismo Genético , Factor de Transcripción STAT3/genética , TYK2 Quinasa/genética , Estudios de Casos y Controles , Enfermedad de Crohn/epidemiología , Enfermedad de Crohn/etiología , Frecuencia de los Genes , Marcadores Genéticos , Genotipo , Haplotipos , Japón/epidemiología , Polimorfismo de Longitud del Fragmento de Restricción , Polimorfismo de Nucleótido Simple
19.
FEBS Lett ; 582(23-24): 3525-30, 2008 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-18805414

RESUMEN

We addressed the issue of whether enhanced glycolysis caused by mtDNA mutations independently induces metastasis in tumor cells using mtDNA transfer technology. The resultant trans-mitochondrial cybrids sharing the same nuclear background of poorly metastatic carcinoma P29 cells, P29mtA11 and P29mtDelta cybrids, possessed mtDNA with a G13997A mutation from highly metastatic carcinoma A11 cells and mtDNA with a 4696bp deletion mutation, respectively. The P29mtDelta cybrids expressed enhanced glycolysis, but did not express ROS overproduction and high metastatic potential, whereas P29mtA11 cybrids showed enhanced glycolysis, ROS overproduction, and high metastatic potential. Thus, enhanced glycolysis alone does not induce metastasis in the cybrids.


Asunto(s)
ADN Mitocondrial/genética , Glucólisis/genética , Mitocondrias/metabolismo , Metástasis de la Neoplasia/genética , Animales , Línea Celular Tumoral , Núcleo Celular/metabolismo , Respiración de la Célula/genética , Genotipo , Ratones , Mitocondrias/genética , Mutación , Proteína 1 de la Secuencia de Leucemia de Células Mieloides , Proteínas Proto-Oncogénicas c-bcl-2/biosíntesis , Especies Reactivas de Oxígeno/metabolismo , Transfección
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