Biomedical subjects

Koichi Tsuneyama

Publications and source records attributed to Koichi Tsuneyama.

49 records · Page 3Linked to original sources

PubMed2003

Osteopontin is involved in the formation of epithelioid granuloma and bile duct injury in primary biliary cirrhosis.

Recently, it was shown that osteopontin (OPN) is involved as a chemoattractant cytokine in the recruitment of macrophages and T lymphocytes in the granulomas of diverse etiologies and also plays an important role in the production of autoantibodies and development of autoimmune diseases. Primary biliary cirrhosis (PBC) is characterized by immune-mediated bile duct damage with frequent epithelioid granulomas. In this study, the expression of OPN was immunohistochemically examined in 25 PBC and 52 control livers. Epithelioid cells within granuloma in PBC expressed OPN variably. These cells were also positive for CD68, suggesting their histiocyte/macrophage lineage. In addition, strong expression of OPN was seen in the cytoplasm of mononuclear cells infiltrating around granulomas and also damaged bile ducts in PBC. The number of such positive mononuclear cells and the ratio of OPN-positive cells/total infiltrating cells in portal tracts were higher in PBC than in controls. The majority of these OPN-positive cells were found to be IgG- or IgM-producing plasma cells. These suggest that in PBC, OPN is an important immune molecule in portal tracts, and contributes to the recruitment of mononuclear cells into epithelioid granuloma and also participates in bile duct injury via B-cell differentiation and plasma cell expansion.

Aged↗

PubMed2003

Combined hepatocellular and cholangiocarcinoma with marked squamous cell carcinoma components arising in non-cirrhotic liver.

We report a surgical case of liver tumor, 40 x 35 mm in size, with squamous cell carcinoma (SCC) and hepatocellular carcinoma (HCC) components in a 60-year-old Japanese man with steatohepatitis. Most of the SCC component showed typical intercellular bridge and keratinization, while most of the HCC components showed a thick trabecular pattern with mild to moderate nuclear atypia. Both components transit each other without undifferentiated foci; however, a small foci showing glandular structure was intermediated. No cyst formation was found in the liver. The primary site of the squamous cell carcinoma was not detected in general clinical and radiological examination. Immunohistochemical analysis revealed that part of the HCC components neighboring the SCC showed patchy and weak expression of cytokeratin 7. There are several possibilities for the origin of squamous cell carcinoma in this case: marked squamous metaplastic change of cholangiocarcinoma and/or HCC, and carcinoma originating from pleuripotential stem cells. Irregular fatty changes, scattered giant mitochondria and acellular fibrosis with bridging were seen in the liver; however, this patient had no episode of hepatitis-associated viral infection. This is an interesting case of combined hepatocellular and cholangiocarcinoma with marked SCC components arising in a non-cirrhotic fibrotic liver.

Bile Duct Neoplasms↗

PubMed2003

Aberrant expression of trefoil factor family 1 in biliary epithelium in hepatolithiasis and cholangiocarcinoma.

Stepwise progression of intrahepatic cholangiocarcinoma (ICC) has been proposed in hepatolithiasis. We examined the participation of trefoil factor family 1 (TFF1), which is critical for mucosal protection and tumor suppression in the stomach, in the development and progression of ICC. We used 16 livers of ICC with hepatolithiasis, 11 of biliary epithelial dysplasia with hepatolithiasis, 16 of hepatolithiasis without dysplasia or carcinoma, 18 of ICC without hepatolithiasis, and 39 control livers. TFF1 expression in the biliary epithelium was increased in hepatolithiasis compared with control livers (p < 0.01). In biliary epithelial dysplasia and noninvasive ICC with hepatolithiasis, TFF1 was extensively expressed and MUC5AC gastric mucin was usually colocalized with TFF1. However, TFF1 expression was significantly decreased in invasive ICC despite preserved expression of MUC5AC. A total of four missense mutations were detected: three in two noninvasive ICC with hepatolithiasis (28.6%) and one in invasive ICC (11%). Loss of heterozygosity of the TFF1 gene was not detectable. The decreased expression of TFF1 in invasive ICC may be explained by the methylation of the TFF1 promoter region. Up-regulation of TFF1 coupled with MUC5AC in biliary epithelium in hepatolithiasis, biliary epithelial dysplasia, and noninvasive ICC may reflect the gastric metaplasia and early neoplastic lesion. Under such conditions, decreased TFF1 expression may lead to increased cell proliferation and then to the invasive character of ICC.

Bile Duct Neoplasms↗

PubMed2002

Primary squamous cell carcinoma of the liver producing parathyroid hormone-related protein.

We report here an autopsy case of primary squamous cell carcinoma of the liver in a 63-year-old man who had hypercalcemia and an elevated serum level of parathyroid hormone-related protein. At autopsy, primary squamous cell carcinoma of the liver was found, without distinct preceding or associated hepatic or biliary diseases; no extrahepatic primary focus of squamous cell carcinoma was found. Bone involvement was not demonstrated, either radiologically or pathologically. Immunohistochemically, parathyroid hormone-related protein was detectable in the squamous cell carcinoma cells and it may have been responsible for the hypercalcemia. Such a case has not been reported so far in the English-language or the Japanese literature.

Carcinoma, Squamous Cell↗

PubMed2002

Lipopolysaccharide induces overexpression of MUC2 and MUC5AC in cultured biliary epithelial cells: possible key phenomenon of hepatolithiasis.

Bacterial infection, bile stasis, mucin hypersecretion, and an alteration of the mucin profile such as an aberrant expression of gel-forming apomucin (MUC2 and MUC5AC) in the intrahepatic biliary tree are thought to be important in the lithogenesis of hepatolithiasis. So far, there have been no detailed studies linking bacterial infection to altered mucus secretion of biliary epithelium. In this study, the influence of lipopolysaccharide (LPS), a bacterial component, on apomucin expression in cultured murine biliary epithelial cells was examined with emphasis on the participation of tumor necrosis factor (TNF)-alpha. It was found that LPS up-regulated the expression of MUC2 and MUC5AC in cultured murine biliary epithelial cells. LPS also induced the expression of TNF-alpha in biliary epithelial cells and its secretion into the culture medium. The up-regulation of these apomucins was inhibited by pretreatment with TNF-alpha antibody. TNF-alpha alone also induced the overexpression of MUC2 and MUC5AC in cultured biliary epithelial cells. This overexpression was inhibited by pretreatment with calphostin C, an inhibitor of protein kinase C. These findings suggest that LPS can induce overexpression of MUC2 and MUC5AC in biliary epithelial cells via synthesis of TNF-alpha and activation of protein kinase C. This mechanism might be involved in the lithogenesis of hepatolithiasis.

Animals↗

PubMed2002

Damaged interlobular bile ducts in primary biliary cirrhosis show reduced expression of glutathione-S-transferase-pi and aberrant expression of 4-hydroxynonenal.

BACKGROUND/AIMS: Chronic inflammation induces oxidative stress by producing reactive oxygen species. We investigated how the oxidative stress associated with chronic cholangitis induce bile duct damages in primary biliary cirrhosis. METHODS: The intracellular status of lipid peroxidation due to oxidative stress and that of glutathione, an endogenous cytoprotective molecule, were examined in primary biliary cirrhosis and controls by immunostaining of 4-hydroxynonenal and glutathione-S-transferase-pi. The former is a by-product of lipid peroxidation, and the latter is involved in the formation of intracellular glutathione. RESULTS: In the damaged bile ducts of primary biliary cirrhosis, glutathione-S-transferase-pi expression was markedly reduced, reflecting reduction of intracellular glutathione, and perinuclear expression of 4-hydroxynonenal was frequent, reflecting active lipid peroxidation associated with biliary epithelial damages. There was diffuse/luminal expression of 4-hydroxynonenal in the bile ducts frequent in primary biliary cirrhosis and controls, likely reflecting absorption of 4-hydroxynonenal, also a component of oxidized low-density lipoprotein, from bile via scavenger receptor class B type 1 on biliary epithelium. CONCLUSIONS: The data suggest that lipid peroxidation in the bile ducts with reduced expression of glutathione-S-transferase-pi, may be an important pathologic process leading to the bile duct damage of primary biliary cirrhosis.

Aldehydes↗

PubMed2002

Type1 and type2 memory T cells imbalance shown by expression of intrahepatic chemokine receptors relates to pathogenesis of primary biliary cirrhosis.

Primary biliary cirrhosis (PBC) is characterized by the immunopathologic destruction of interlobular bile ducts. Generally, immunereaction induced by the antigenetic stimulation is divided to cellular and humoral reactions, which are regulated by type1 and type2 memory T cells, respectively. The relative strength of type1 and type2 responses is an important factor in the pathophysiology of immune-mediated diseases. Chemokine receptors are disproportionally expressed in type1 and type2 T cells, providing a basis for tissue-specific recruitment of helper and cytotoxic T cell subsets. In this study, the expression of CXC chemokine receptor 3 (CXCR3) and CC chemokine receptor 4 (CCR4), which are preferentially expressed on type1 and type2, respectively, were examined to clarify their imbalance in the PBC liver tissue (23 cases). As a control, 16 livers of chronic viral hepatitis (CVH) were used. Reverse transcription-polymerase chain reaction and semiquantitative analysis revealed that the relative ratio of CXCR3/CCR4 mRNAs was higher in early PBC (0.76+/-0.56) rather than in advanced PBC (0.25+/-0.11), and was comparable to that in active CVH (0.67+/-0.43). By immunohistochemistry, the ratio of CXCR3-/CCR4-positive mononuclear cells in portal tracts of early PBC (4.77+/-1.70) is significantly higher than that of advanced PBC (3.11+/-1.26), and also than that of mild and of active CVH. In early PBC, mononuclear cells positive for CXCR3 were dense around the damaged bile ducts. These data suggest that the enhanced shift toward type1 occurs in portal tracts of early PBC and that the imbalance of type1/type2 changes during the course of PBC. This study provides further support for the state of enhanced type1 response in early PBC and potentially offers a possibility to suppress the bile duct lesions and to prevent the progression of PBC from early to advanced stages by reversing the type1/type2 imbalance.

Journal Article↗

PubMed2002

Incomplete septal cirrhosis associated with Wegener's granulomatosis.

Incomplete septal cirrhosis, which is included in the spectrum of hepatoportal sclerosis, is characterized by parenchymal nodularity, incomplete fibrous septa, clustered or dispersed portal tract remnants, and abnormal spacing of portal tracts and hepatic veins. Hepatoportal sclerosis is known to be associated with collagen vascular diseases. Here, we describe a 73 year-old-female with incomplete septal cirrhosis. At 57 years, she presented with respiratory symptoms, and lung biopsy disclosed active arteritis with granuloma. Perinuclear antineutrophilic cytoplasmic antibody was also positive. Immunosuppressive therapy was done under the diagnosis of Wegener's granulomatosis. At 63 years, liver dysfunction was noted, and laparoscopy revealed uneven surface of the liver and dilatation of the umbilical vein. Liver dysfunction progressed, and she developed encephalopathy and massive ascites. She died of sepsis at 73 years. At autopsy the liver (700 g) was macronodular with several deep depressions. The parenchyma showed fine and diffuse nodularity. Grossly visible portal and hepatic veins were patent. The above-mentioned histologic features characterizing incomplete septal cirrhosis were found. This is the first report of incomplete septal cirrhosis associated with Wegener's granulomatosis implying that vascular and extravascular lesions of Wegener's granulomatosis might have been related to the pathogenesis of incomplete septal cirrhosis.

Arteries↗

PubMed2002

Overlap of idiopathic portal hypertension and scleroderma: report of two autopsy cases and a review of literature.

Idiopathic portal hypertension (IPH) is characterized by dense fibrosis of portal tracts and portal venous obliteration. Little is known about the etiopathogenesis of IPH. Association of various autoimmune diseases such as systemic lupus erythematosus in IPH suggests that IPH may share immunological disturbances with such autoimmune diseases. We recently experienced two autopsy cases presenting with both diffuse scleroderma and IPH. Dense fibrosis was found in both the dermis and intrahepatic portal tract of these cases. In addition, small vascular damages were commonly observed to various degrees in these fibrotic areas of both organs. The activation of fibroblasts and vascular damages mediated by various growth factors and cytokines reportedly involved in the dermis in scleroderma might have also been operative in portal tracts in these two cases of IPH. A review of literature disclosed eight overlapping cases of IPH and scleroderma (middle- to old-aged females), and scleroderma was diagnosed earlier than IPH. These findings suggest that similar pathogenetic processes are operative in the dermis as well as in the portal tracts of the liver in these cases.

Female↗

PubMed2002

Portal and parenchymal alterations of the liver in idiopathic portal hypertension: a histological and immunochemical study.

Idiopathic portal hypertension (IPH) is characterized by presinusoidal portal hypertension owing to the intrahepatic, presinusoidal portal venous block, whereas the primary cause and initial vascular lesions(s) remain only speculative. In this study, a total of 97 IPH livers were histopathologically and immunohistochemically examined, placing emphasis on hepatic parenchymal fibrosis and atrophy as well as on portal tract fibrosis. Alcoholic cirrhosis and normal livers were used as controls. When compared with normal livers, the expression of connective tissue growth factor (CTGF) in periductal mononuclear cells was significant. Matrix metalloproteinase (MMP)9-positive mononuclear cells were fewer in number in the portal tract of IPH liver, when compared with alcoholic cirrhosis. These findings suggest a possible pathogenesis of collagen and elastin deposition because of increased CTGF expression and decreased MMP-9 expression in portal tracts of IPH. Sinusoidal dilatation associated with hepatocellular atrophy and apoptosis occurred frequently, but focally in 20% of the IPH cases. These changes were most often found in hyperplastic hepatocellular areas and in the perivenular areas of hepatic lobules. In these areas, pericellular fibrosis and thin fibrous septa were also frequently seen. In these fibrotic areas, there were deposited not only collagen fibers, but also elastic fibers, in which alpha-smooth muscle actin-positive sinusoidal cells, reflecting activated hepatic stellate cells, were frequently detected. It is possible that in IPH cases, continuing portal venous blood insufficiency may be responsible for hepatic parenchymal damage, which may be followed by hepatocellular apoptotic dropout and then by hepatic parenchymal atrophy and fibrosis.

Atrophy↗

PubMedDate not supplied

An immunohistochemical study of P53 and Ki-67 in gastrointestinal adenoma and adenocarcinoma using tissue microarray.

BACKGROUND: Gastrointestinal carcinogenesis generally follows the adenoma-adenocarcinoma sequence and tumor metastasis determines the survival time of the patients. The expressions of p53 and ki-67 in gastrointestinal adenoma and adenocarcinoma (GIA) were explored and their clinicopathological significance determined. MATERIALS AND METHODS: The expressions of mutant p53 and ki-67 were examined on tissue microarray containing GIA, adjacent mucosa or adenoma and metastases by immunostaining. Their expressions were compared with the clinicopathological parameters of tumors. RESULTS: The expressions of mutant p53 and ki-67 were gradually increased from gastrointestinal mucosa to adenocarcinoma through adenoma (p<0.05). Mutant p53 expression showed a positive association with depth of invasion, local invasion via vessels and lymph node metastasis of GIA (p<0.05). Ki-67 expression was positively correlated with local invasion via vessels and negatively with dedifferentiation and liver metastasis of GIA (p<0.05). The expressions of both markers in metastases of GIA were consistent with their corresponding primary foci (p < 0.05). A positive association between both markers was found in the primary foci of GIA (p<0.05). CONCLUSION: The up-regulated expressions of mutant p53 and ki-67 are involved in the carcinogenesis and progression of GIA. They appear to be objective and effective markers to reflect the development of GIA.

Adenocarcinoma↗

PubMedDate not supplied

Expressions of MMP-2, MMP-9 and VEGF are closely linked to growth, invasion, metastasis and angiogenesis of gastric carcinoma.

BACKGROUND: Gastric carcinoma is still a major leading cause of cancer death in East Asia. Since angiogenesis is a necessary condition for invasion and metastasis, its regulation is of essential significance. MATERIALS AND METHODS: Expressions of MMP-2, MMP-9 and VEGF were examined with microarray of gastric carcinoma tissue samples (n = 249) by immunostaining. In addition, microvessel density (MVD) was assessed after labelling with the anti-CD34 antibody. Data were cross-compared with clinicopathological parameters of tumors, including PTEN expression. RESULTS: Expressions of MMP-2, MMP-9 and VEGF were positively correlated with tumour size, depth of invasion, lymphatic and venous invasion, lymph node metastasis, UICC staging and MVD of gastric carcinomas (p < 0.05).VEGF expression was positively linked with levels of MMP-2 and MMP-9 (p < 0.05), but negatively with PTEN (p < 0.05). The latter was also inversely associated with the MVD in gastric carcinomas (p < 0.05). CONCLUSION: MMP-2, MMP-9 and VEGF largely contribute to the angiogenesis and progression of gastric carcinomas. PTEN might inhibit the processes by down-regulating VEGF expression. These parameters should be regarded as good markers to indicate pathobiological behaviours of gastric carcinomas.

Adenocarcinoma↗

PubMedDate not supplied

Expression of Aurora-B kinase and phosphorylated histone H3 in hepatocellular carcinoma.

BACKGROUND: Aurora-B, a chromosomal passenger protein forming a complex with INCENP (inner centromere protein) and survivin, regulates stable bipolar spindle-kinetochore attachment in mitosis and chromosome segregation and cytokinesis. It was recently documented that Aurora-B directly phosphorylated histone H3, not only at Ser10, but also at Ser28, which contributed to chromosome number instability and mitotic chromosome condensation. This study aimed at investigating the expression of Aurora-B kinase (Aurora-B) and phosphorylated histone H3 (H3-P) and their roles in hepatocellular carcinogenesis. MATERIALS AND METHODS: The expressions of Aurora-B and H3-P were examined in hepatocellular carcinoma (HCC) by immunohistochemistry. A hepatoblastoma cell line, HepG2, was targeted and the isolation and characterization of alternative variants of Aurora-B were carried out. The Aurora encoding protein was detected in COS-7 transfected with different Aurora transcripts by Western blot. Finally, the expression of Aurora-B and its variant forms was examined in 17 HCCs by RT-PCR. RESULTS: Immunohistochemically, Aurora-B was observed only in a few cases of HCC, while H3-P expression was more frequently detected in carcinoma foci than in non-carcinoma foci (p < 0.05). The isolation and characterization of two alternative variant forms of Aurora-B (termed Aurora-B1 and -B2) in the HepG2 cell line were successful. Aurora-B-transfected COS-7 cells expressed two different proteins, one of which was similar to the expression product of Aurora-B1 in size. Aurora-B transcripts were detected in 12 out of 17 (70.5%) HCC cases examined. Aurora-B2 was predominantly detected in 9 (52.9%) cases, while regular Aurora-B and Aurora-B1 were detected in 6 (35.2%) and 7 (41.1%) cases, respectively. CONCLUSION: Aberrant expression of Aurora-B and H3-P plays a role in hepatocarcinogenesis. Alterative splicing of Aurora-B produces different sizes of proteins in HCC. Temporally altered phosphorylation of histone-H3 in the entire cell cycle may up-regulate the entry of HCC into the cell cycle to enhance their proliferation.

Adult↗