Biomedical subjects

T Kawamura

Publications and source records attributed to T Kawamura.

At least 127 records · Page 7Linked to original sources

PubMed2000

Insertion/deletion polymorphism in ACE gene is not associated with renal progression in Japanese patients with IgA nephropathy.

We determined the relationship between the gene polymorphism of angiotensin I-converting enzyme (ACE) and the progression of immunoglobulin A (IgA) nephropathy in a large cohort in a multicenter trial of ethnically homogeneous Japanese patients (n = 527). Patients with biopsy-proven IgA nephropathy were recruited from several clinics in Japan. The mean observation period was 8.4 +/- 4.7 years. ACE insertion/deletion (I/D) genotype was determined by polymerase chain reaction amplification using allele-specific primers. Clinical factors investigated in all patients were date of birth, sex, levels of urinary protein excretion, duration of observation, serum creatinine (sCr) level, and creatinine clearance (CCr). ACE genotype distribution did not differ between patients who maintained normal renal function (II, 41%; ID, 44.7%; DD, 14.3%) and those who progressed to renal impairment (II, 41.7%; ID, 40.4%; DD, 17.9%). Kaplan-Meier analysis did not show a significant difference in renal survival rate among the three groups of each genotype. In multivariate analysis, only two variables, proteinuria greater than 1.0 g/d of protein and impaired renal function (sCr >1.2 mg/dL or CCr <70 mL/min) at the time of renal biopsy, were found to be risk factors for disease progression leading to a poor outcome. No association was observed between these variables and ACE genotype. It appears that ACE I/D polymorphism may not affect the progressive deterioration of renal function in patients with IgA nephropathy from our multicenter trial.

Adult↗

PubMed2000

Purification and characterization of a dipeptidyl carboxypeptidase from the polychaete Neanthes virens resembling angiotensin I converting enzyme.

Dipeptidyl carboxypeptidase (DCP) is well known as a mammalian angiotensin I converting enzyme (ACE) which plays an important role in blood pressure homeostasis. DCP was purified from the whole body of a polychaete, Neanthes virens. The purified enzyme was homogeneous by SDS-PAGE, with a molecular mass of 71 kDa by SDS-PAGE and 69 kDa by gel filtration, indicating that it is monomeric. The isoelectric point was 4.5 and optimum pH for the activity was 8.0. It showed a specific activity of 466.8 U/mg, which is the highest of known DCPs. The enzyme hydrolyzed angiotensin I to angiotensin II and sequentially released Phe-Arg and Ser-Pro from the C-terminus bradykinin, but does not cleave imido-bonds. Activity was completely inhibited by 1 mM EDTA and 5 mM o-phenanthroline, but it was not affected by serine and aspartic protease inhibitors. The original activity of EDTA-inactivated DCP was restored by addition of cobalt, manganese or low concentrations of zinc. The Km and Vmax values of the enzyme for Bz-Gly-His-Leu were 0.56 mM and 600 mumol/min per mg, respectively. The Ki values for specific mammalian ACE inhibitors, such as captopril and lisinopril, were 1.38 and 2.07 nM, respectively. In conclusion, we have shown the existence of a DCP from the polychaete, N. virens, with similar properties to those of mammalian ACE.

Animals↗

PubMed2000

Fas/Fas ligand-mediated apoptosis of murine Langerhans cells.

Epidermal Langerhans cells (LC) are potent antigen-presenting cells (APC), that play a crucial role in initiating cutaneous immune responses. The Fas/Fas ligand pathway has been implicated as an important cellular pathway in the regulation of peripheral immunity. The morphologic, functional and phenotypic characteristics of LC are becoming well-characterized. However, the mechanisms involved in eliminating LC are poorly understood. In this report, we demonstrated that murine epidermal LC constitutively express the Fas antigen (CD95) and the expression was up-regulated by the addition of IFN-gamma in cultures. Interestingly, epidermal LC underwent apoptosis by the addition of both recombinant soluble Fas ligand (FasL) and IFN-gamma, but not by FasL alone. These results suggest that LC may acquire the susceptibility to Fas-mediated apoptosis through up-regulation of the Fas expression by IFN-gamma derived from activated T cells and that the elimination of LC may be important for preventing excess cutaneous inflammatory diseases.

Animals↗

PubMed2000

Suppressive effect of antiulcer agents on granulocytes--a role for granulocytes in gastric ulcer formation.

Many clinicians have believed that H2-blockers and proton pump inhibitors ameliorate gastric ulcers via their antacid function. We examined the effects of these antacids on granulocytes. Gastric ulcer patients were administered an H2-blocker or proton pump inhibitor for a week and the number of granulocytes and the superoxide production were examined. To determine the trafficking of granulocytes, mice were exposed to restraint stress for 24 hr. The H2-blocker decreased the number of granulocytes, while the proton pump inhibitor suppressed their superoxide production in humans and mice. The major function of H2-blockers and proton pump inhibitors in curing gastric ulcers seems to be their suppressive effects on granulocytes. In this case, stress accelerates the trafficking of granulocytes from the bone marrow to the gastric mucosa. If we demonstrate a role for granulocytes in gastric ulcer formation, an gap in the acid-pepsin theory and the Helicobacter pylori theory is filled in.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2000

The liver as a crucial organ in the first line of host defense: the roles of Kupffer cells, natural killer (NK) cells and NK1.1 Ag+ T cells in T helper 1 immune responses.

The liver remains a hematopoietic organ after birth and can produce all leukocyte lineages from resident hematopoietic stem cells. Hepatocytes produce acute phase proteins and complement in bacterial infections. Liver Kupffer cells are activated by various bacterial stimuli, including bacterial lipopolysaccharide (LPS) and bacterial superantigens, and produce interleukin (IL)-12. IL-12 and other monokines (IL- 18 etc.) produced by Kupffer cells activate liver natural killer (NK) cells and NK1.1 Ag+ T cells to produce interferon-gamma and thereby acquire cytotoxicity against tumors and microbe-infected cells. These liver leukocytes and the T helper 1 immune responses induced by them thus play a crucial role in the first line of defense against bacterial infections and hematogenous tumor metastases. However, if this defense system is inadequately activated, shock associated with multiple organ failure takes place. Activated liver NK1.1 Ag+ T cells and NK cells also cause hepatocyte injury. NK1.1 Ag+ T cells and another T-cell subset with an intermediate T-cell receptor, CD 122+CD8+ T cells, can develop independently of thymic epithelial cells. Liver NK cells and NK1.1 Ag+ T cells physiologically develop in situ from their precursors, presumably due to bacterial antigens brought from the intestine via the portal vein. NK cells activated by bacterial superantigens or LPS are also probably involved in the vascular endothelial injury in Kawasaki disease.

Animals↗

PubMed2000

Physiological responses of extrathymic T cells in the liver.

The liver has been found to be one of the important hematopoietic organs even after birth. Namely, adult liver still comprises c-kit+ stem cells and gives rise to extrathymic T cells, natural killer (NK) cells, and even granulocytes. Extrathymic T cells generated in the liver of mice are intermediate T-cell receptor (TCR(int)) cells, including the NK1.1+TCR(int) (i.e. NKT cells) and NK1.1-TCR(int) subsets. Although extrathymic T cells are few in number in youth, they gradually increase in number with aging. Even in youth, the number and function of extrathymic T cells are elevated under conditions of stress, infection, malignancy, pregnancy, autoimmune disease, chronic graft-versus-host diseases, etc. Under these conditions, the mainstream of T-cell differentiation in the thymus, which produces conventional T cells, is rather suppressed. Since extrathymic T cells comprise self-reactive forbidden clones and mediate cytotoxicity against abnormal self-cells (e.g. malignant tumor cells, microbially infected hepatocytes, and regenerating hepatocytes), they are beneficial for the elimination of such cells. However, overactivation or continuous activation of extrathymic T cells might be harmful and responsible for the onset of autoimmune diseases. We finally propose the possibility that switching of the immune system from the thymus to the liver might be regulated by the autonomic nervous system as well as by cytokines.

Adult↗

PubMed2000

Organ specificity of c-kit+ lymphoid precursors in the liver, thymus, and bone marrow.

c-kit+Lin- cells are present in various immune organs, including the liver, thymus, and bone marrow, where lymphoid, myeloid, or erythroid cells are generated. To compare their properties as lymphoid precursors, c-kit+Lin- cells purified from various organs of B6.Ly5.1 mice were injected into 6.5 Gy-irradiated B6.Ly5.2 mice. Depending on the source of the c-kit cells, the degree of entrance and expansion of lymphoid cells differed in the liver and thymus of recipient mice. c-kit+ cells isolated from the bone marrow entered and expanded prominently in both the liver and thymus, whereas c-kit+ cells from the thymus did not do so at all. On the other hand, c-kit+ cells isolated from the liver and spleen showed an intermediate pattern, namely, they took a long time to enter and expand in the liver and thymus of recipient mice. All of these c-kit+ cells had the potential to give rise to lymphoid cells, which were specific to the liver and thymus, respectively. We previously showed that progenitor cells for extrathymic T cells in the liver and those for conventional T cells in the thymus are not always supplied by the bone marrow, as shown by experiments using parabiosis. Taken together with those previous data, the present results suggest that c-kit+Lin- cells isolated from various immune organs have organ specific properties.

Animals↗

PubMed2000

Induction therapy consisting of alternating cycles of ranimustine, vincristine, melphalan, dexamethasone and interferon alpha (ROAD-IN) and a randomized comparison of interferon alpha maintenance in multiple myeloma: a co-operative study in Japan.

This pilot study evaluated the efficacy of a new combination chemotherapy with a newly developed nitrosourea derivative ranimustine and evaluated the efficacy of interferon alpha (IFN-alpha) maintenance in previously untreated patients with multiple myeloma (MM). The induction therapy (ROAD-IN) was a 6-week regimen consisting of chemotherapy with ranimustine, vincristine (Oncovin), melphalan (Alkeran) and dexamethasone starting on day 1 and IFN-alpha, which was administered three times weekly for 3 weeks starting on day 22. This was repeated for three cycles. The responders were subsequently randomized into two groups that received or did not receive IFN-alpha as maintenance therapy. Of the 164 patients registered, 161 were evaluated. An objective response to induction therapy was seen in 75% of patients; complete remission (CR) in 38 (24%) and partial remission (PR) in 82 (51%). The median survival for all patients was 3.6 years from registration. The survival of responders (CR + PR) was significantly better than that of non-responders (median survival 4.3 years vs. 1.4 years; 7-year survival rate 32% vs. 9%; P < 0.0001). The IFN-alpha maintenance did not show any advantage for either response duration or survival. This pilot study demonstrated that a comparatively short period of induction therapy with the ROAD-IN regimen produced a rather high response rate and a similar survival rate to those achieved with other longer induction regimens, and that good responders to the initial therapy survived significantly longer than non-responders.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2000

The differential effect of stress on natural killer T (NKT) and NK cell function.

When C57Bl/6 mice were exposed to restraint stress for 12 h or 24 h, lymphocytopenia was induced in the liver, spleen, and thymus. We examined which types of lymphocytes were sensitive or resistant to such stress by a immunofluorescence test. T cells of thymic origin were sensitive while NKT and NK cells were resistant. In contrast to the increase in the proportion of NK cells, NK activity of liver lymphocytes against YAC-1 targets decreased at 24 h after stress. On the other hand, their NKT cytotoxicity against syngeneic thymocytes increased in parallel with an increase in their proportion. In perforin -/- B6 mice and B6-gld/gld (Fas ligand-) mice, NK cells were found to mediate cytotoxicity through perforin while NKT cells mediated self-reactive cytotoxicity through Fas ligand. These results suggest that stress increases the proportion of both NK and NKT cells, but that NK cytotoxicity is suppressed while self-reactive NKT cytotoxicity is not, due to a diversity of their functional mechanisms.

Animals↗

PubMed2000

Disparate effect of beige mutation on cytotoxic function between natural killer and natural killer T cells.

Beige mice lack natural killer (NK) cytotoxicity, although NK cells are normally present. In recent studies, NK T cells have been newly identified. We therefore examined the number and function of NK T cells in beige mice. The number of NK T cells was at a normal level in the liver of beige mice. NK cytotoxicity was decreased in the liver of these mice, whereas NK T cytotoxicity was intact. When immunochemical staining for perforin was conducted, the majority of NK cells and the minority of NK T cells in beige mice carried a giant granule, containing perforin, in the cytoplasm. In the case of control B6 mice, the majority of NK cells and the minority of NK T cells had multiple, dispersed granules containing perforin. These results suggest that NK T cytotoxicity is unaffected by the beige mutation, owing to their cytotoxicity being mediated without the secretion system of perforin.

Animals↗

PubMed2000

Resistance of extrathymic T cells to stress and the role of endogenous glucocorticoids in stress associated immunosuppression.

When mice were exposed to restraint stress for 12 or 24 h, severe lymphopenia was induced in all immune system organs, including the liver and the thymus. However, in adrenalectomized mice, this response was completely absent. Phenotypic characterization revealed that interleukin (IL)-2Rbeta+CD3int cells (i.e. extrathymic T cells) with CD4+ phenotype and the NK1.1+ subset of CD3int cells (i.e. NKT cells) in the liver as well as the mature conventional T cells in the thymus were resistant to such stress. In adrenalectomized mice, there was no significant change in the distribution of lymphocyte subsets in all tested organs before stress. Interestingly, the number of lymphocytes in the liver and spleen and the proportion of NKT cells in the liver rather increased after stress in these adrenalectomized mice. Therefore, endogenous steroid hormones were indicated to be important in the induction of immunosuppressive states after stress. Among stress associated cytokines, the secretion of tumour necrosis factor (TNF)-alpha was completely suppressed while that of IL-6 was partially suppressed in adrenalectomized mice. These results suggest that endogenous steroid hormones are important for the induction of the stress associated immunosuppression and that NKT cells are resistant to stress, namely, resistant to exposure to endogenous steroid hormones.

Adrenalectomy↗

PubMed2000

Plasma brain natriuretic peptide concentrations in patients with Kawasaki disease.

BACKGROUND: Brain natriuretic peptide (BNP) is a cardiac hormone and plasma levels of it increase in patients with congestive heart failure and in those with acute myocardial infarction. Kawasaki disease (KD) is a well-known generalized vasculitis and the most prominent features of this disease are the cardiovascular manifestations, which involve the pericardium, myocardium, endocardium and coronary arteries. It was hypothesized that the plasma concentrations of BNP in patients with KD might be increased and that plasma BNP might be a useful biological marker of cardiovascular manifestations in patients with KD. METHODS: Blood was obtained to measure and compare plasma BNP concentrations in the acute (n = 32) and convalescent (n = 35) phases of KD and in the acute phase of the patients with viral infection (n = 26), which included adenovirus, influenza, measles and herpes group virus infection. In patients with KD, two-dimensional echocardiography was performed to check for pericardial effusion and coronary arterial lesions and to measure the dimensions of the left ventricle at diastole and the shortening fraction of the left ventricle (LVSF). RESULTS: The mean plasma BNP concentration in patients with KD in the acute phase was 55.0 +/- 39.5 pg/mL, but was 6.8 +/- 7.3 pg/mL in patients with viral infection. The plasma BNP concentration in patients with KD in the acute phase was significantly higher than in patients with viral infection (P < 0.0001). In 31 cases of KD, the plasma BNP concentrations were measured both in the acute and convalescent phases. The mean plasma BNP concentration in the acute phase of KD was 55.3 +/- 40.1 pg/mL and in the convalescent phase was 5.9 +/- 5.7 pg/mL. The level of plasma BNP decreased significantly in the convalescent phase (P < 0.0001). The mean BNP level in patients with KD with pericardial effusion (n = 8) in the acute phase was 80.3 +/- 43.4 pg/mL and that in patients without pericardial effusion (n = 24) was 46.5 +/- 35.1 pg/mL. The BNP level in patients with pericardial effusion was significantly higher than that of patients without pericardial effusion (P < 0.05). There was no significant correlation between the plasma concentrations of BNP in the acute phase of KD and LVSF (r = -0.161, P = 0.39, n = 31). CONCLUSION: It was shown that the plasma BNP concentration increased in the acute phase of KD and decreased to within normal range in the convalescent phase. Further examinations are needed to clarify the mechanism by which the elevated levels of plasma BNP occur in the acute phase of KD. However, plasma BNP might be a useful biological marker of the cardiovascular manifestations in patients with KD.

Acute Disease↗

PubMed2000

Congenital vesicovaginal fistula.

Congenital vesicovaginal fistula is a very rare entity, the etiology of which has not been clearly elucidated because pathologic features have not been mentioned in previous reports. The case of a 4-year-old girl having incontinence resulting from a congenital vesicovaginal fistula joining with the left ectopic ureter from the hypoplastic kidney is described. This is thought to be the first presentation of congenital vesicovaginal fistula joining with ectopic ureter. A microscopic examination revealed the fistula consisting of transitional cell epithelium, suggesting an abnormal fusion of the ureteral bud and caudal end of the müllerian duct with the urogenital sinus.

Child, Preschool↗

PubMed2000

Inflammatory pseudotumor of the bladder in neonates.

Inflammatory pseudotumors of the bladder are rare in children. We describe a 7-day-old male neonate with inflammatory pseudotumor of the bladder. He presented with a 3-day history of macroscopic hematuria. Ultrasonography, computed tomography and cystoscopy showed an intravesical mass arising from the right lateral wall. Pathologic findings obtained by open excision revealed that the tumor had spindle-shaped cells without significant atypia infiltrating into submucosal fibrous tissue. There has been no evidence of recurrent tumor 12 months post-operatively. To our knowledge our case is the first presentation in a neonate among the reported pediatric cases.

Granuloma, Plasma Cell↗

PubMed2000

Selective upregulation of fibroblast Fas ligand expression, and prolongation of Fas/Fas ligand-mediated skin allograft survival, by retinoic acid: the skin as a retinoide-inducible immune privilege site.

Fas/Fas ligand-mediated lymphocyte apoptosis has been implicated in the suppression of immune responses and may cause immune privilege. Human corneas exhibit immune privilege and can be transplanted across allogeneic barriers without immunosuppressive therapy, perhaps, because corneal keratinocytes express Fas ligand. To characterize Fas and Fas ligand expression in skin, we examined expression by murine keratinocytes, dermal fibroblasts, melanocytes, and human umbilical endothelial cells. We also studied the regulation of Fas and Fas ligand in skin cells by retinoic acid, vitamin D3, and dexamethasone as well as various cytokines. Among the molecules and cells tested, retinoic acid selectively upregulated the expression of Fas ligand molecule by fibroblasts. Retinoic acid-induced Fas ligand+ fibroblasts killed Fas+ target cells, and this killing was blocked by anti-Fas ligand antibody. The function of Fas ligand on dermal fibroblasts in vivo was tested in a cutaneous allograft system. Histoincompatible BALB/C mouse (H-2d) donor skin was grafted on to allogeneic C57BL/6 mice (H-2b). Daily local injection of retinoic acid blocked inflammation and extended graft survival for more than 10 d. Injection of retinoic acid into Fas ligand mutated gld/gld donor skin did not prevent leukocyte infiltration into the allograft or prolong graft survival. These experiments indicate that, in skin, retinoic acid selectively increases Fas ligand expression by fibroblasts and that retinoic acid has potent Fas/Fas ligand-dependent immunosuppressive activity.

Animals↗

PubMed2000

Three-dimensional matrix suppresses E2F-controlled gene expression in glomerular mesangial cells.

BACKGROUND: Extracellular matrix (ECM) regulates mitogenesis of glomerular mesangial cells. Currently, however, the molecular mechanisms that mediate the control of cell growth by ECM are not fully elucidated. METHODS: The effects of structurally distinct forms of type I collagen matrix on mesangial cell proliferation and cell cycle distribution were examined. Expressions of the cell cycle-regulatory transcription factor E2F and retinoblastoma susceptibility gene family proteins were also investigated. RESULTS: Mesangial cells cultured on monomeric collagen matrix showed a substantial growth response to serum. In contrast, mesangial cells cultured on polymerized collagen matrix exhibited arrest of the cell cycle in the G0/G1 phase. The induction of the quiescent phenotype was correlated with down-regulation of E2F-1, the prototypal transcription factor that controls cell cycle progression. The suppression of E2F-1 was associated with (1) dephosphorylation of retinoblastoma susceptibility gene proteins, pRB and p130, and (2) accumulation of E2F-pRB and E2F-p130 DNA binding complexes that bind to the E2F consensus sequence located in the E2F-1 promoter. Other E2F regulatory genes, including c-myc, cyclin A, and cdc 2, were also down-regulated in mesangial cells cultured on polymerized collagen matrix. CONCLUSION: These results suggest that a three-dimensional collagen induces cell cycle arrest via suppression of E2F-controlled gene expression in mesangial cells. Dephosphorylation of pRB and p130 and subsequent generation of transrepressor complexes, E2F-pRB and E2F-p130, may be involved in this process.

Carrier Proteins↗

PubMed2000

Mesangial factor V expression colocalized with fibrin deposition in IgA nephropathy.

BACKGROUND: Factor V in its active form (Va) plays a key role at the termination of the intrinsic coagulation pathway, serving as a membrane-bound cofactor for the conversion of prothrombin to thrombin by factor Xa. Cross-linked fibrin (XFb) is often observed in mesangial areas in active types of human glomerulonephritis. In this study, to clarify contribution of factor V in intramesangial coagulation, mesangial factor V expression and its relationship to mesangial proliferation and fibrin deposition in IgA nephropathy (IgAN) were investigated. METHODS: Twenty-two patients with IgAN were studied. XFb was detected in renal biopsy specimens using anti-d-dimer antibody combined with plasmin exposure, and factor V was detected with rabbit antibody against human factor V. Double-labeling immunohistochemistry was used to investigate the relationship of the glomerular distribution of factor V to XFb. The relationship of factor V staining to the activity index or XFb deposition was evaluated. The expression of factor V mRNA was assessed by in situ hybridization in relationship to the antigen staining of alpha-smooth muscle actin (alpha-SMA). The ultrastructural distribution of factor V in glomeruli was studied by immunoelectron microscopy. RESULTS: XFb and factor V were observed in the mesangium and along capillary loops in seven and nine specimens, respectively. Factor V had intense, frequent expression in the proliferating and necrotizing areas, showing a significant relationship to XFb (P < 0.05). Furthermore, XFb deposition and factor V expression were markedly correlated with disease activity (P = 0.005 and P = 0.008, respectively). By double-labeling experiments, XFb and factor V were often seen colocalized in mesangial areas of the glomeruli, which showed necrotizing lesions and/or intense cellular proliferation. By in situ hybridization, factor V mRNA was detected mainly in the mesangial cells, which were positive for alpha-SMA, and partly in the endothelial cells. By immunoelectron microscopy, factor V presence was confirmed in the mesangium and endothelium. CONCLUSION: The present findings suggest that factor V is strongly expressed in mesangial cells in active IgAN accompanied with mesangial proliferation and may exert procoagulant activity, leading to intramesangial coagulation.

Actins↗

PubMed2000

Hepatic blood flow and function in elderly patients undergoing laparoscopic cholecystectomy.

Laparoscopic cholecystectomy (LC) has been widely accepted as an alternative to laparotomy and has many advantages, including short hospital stay and very limited surgical invasion. However, this procedure may impair hepatic function in elderly patients because high pressure is maintained in the peritoneal cavity for an extended period. We observed the effect of pneumoperitoneum on the middle hepatic venous blood flow (MHVBF) in elderly patients undergoing LC. LC patients were anesthesized with inhaled and epidural anesthesia, after which MHVBF was continuously measured by transesophageal echocardiography. MHVBF decreased significantly during a period of high intraperitoneal pressure, and recovery of MHVBF after deflation was significantly lower in elderly patients (65-75 yr), but not in younger patients (24-62 yr). In contrast, MHVBF remained almost constant in elderly patients during open cholecystectomy, and thus was significantly different from that in patients who underwent LC with pneumoperitoneum. Laparoscopic cholecystectomy may impair hepatic function in elderly patients because high pressure is maintained in the peritoneal cavity for an extended period.

Adult↗