Details of the Researcher

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Tsuyoshi Shirai
Section
Tohoku University Hospital
Job title
Senior Assistant Professor
Degree

  • 博士（医学）（東北大学）

Research History 8

  • 2024/01 - Present
    東北大学病院　リウマチ膠原病内科　講師

  • 2019/10 - 2023/12
    Tohoku University Hospital　Rheumatology

  • 2016/04 - 2019/09
    Tohoku University　Graduate School of Medicine

  • 2013/07 - 2016/03
    Stanford University　Immunology & Rheumatology　Post doctoral fellow

  • 2013/02 - 2013/06
    東北大学メディカルメガバンク機構　助教

  • 2012/10 - 2013/01
    公立志津川病院

  • 2012/04 - 2012/09
    Tohoku University Hospital

  • 2005/04 - 2008/03
    日鋼記念病院

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Education 2

  • Tohoku University　Graduate School of Medicine　Department of Hematology & Rheumatology

    2008/04 - 2012/03

  • Tohoku University　School of Medicine

    1999/04 - 2005/03

Research Interests 8

  • 抗MDA5抗体陽性皮膚筋炎

  • 腸内細菌叢

  • 潰瘍性大腸炎

  • PKM2

  • Cell metabolism

  • Autoantibody

  • Takayasu arteritis

  • Vasculitis

Research Areas 2

  • Life sciences / Gastroenterology /

  • Life sciences / Allergies and connective tissue disease /

Awards 12

  1. Modern Rheumatology Top Reviewer Award

    2023/04　日本リウマチ学会

  2. 医学研究奨励賞

    2022/11　日本医師会

  3. 内科学会ことはじめ 指導教官賞

    2022/04　日本内科学会

  4. 2020年度若手共同研究奨励研究費

    2020/07　東北大学大学院医学系研究科

  5. E-bursary award

    2020/06　EULAR

  6. 内科学会ことはじめ 指導教官賞

    2019/04　日本内科学会

  7. 難病財団医学研究助成金

    2018/01　難病財団

  8. 東北医学会奨学賞A

    2017/01　東北大学

  9. かなえ医薬振興財団助成金

    2016/11

  10. 三浦記念リウマチ学術研究賞

    2013/05　リウマチ財団

  11. 国際ワークショップ賞

    2011/07　日本リウマチ学会

  12. 第4回リトリート最優秀演題賞

    2011/01　東北大学

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Papers 138

  1. Common dysbiosis features between patients of different social environments in Takayasu arteritis: comment on the article by Fan et al International-journal

    Tsuyoshi Shirai, Satoshi Watanabe, Natsuko O. Shinozaki, Kairi Baba, Hiroyuki Yamasaki, Tomonori Ishii, Hiroshi Fujii

    Arthritis & Rheumatology　75　(7)　1291-1292　2023/07

    DOI： 10.1002/art.42438 　

  2. Novel Diagnostic Autoantibodies Against Endothelial Protein C Receptor in Patients With Ulcerative Colitis. International-journal

    Yoichi Kakuta, Tsuyoshi Shirai, Dermot P B McGovern, Jonathan Braun, Hiroshi Fujii, Atsushi Masamune

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association　21　(3)　844-846　2021/12/28

    DOI： 10.1016/j.cgh.2021.12.035 　

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    There have been many reports on serologic autoantibodies in inflammatory bowel diseases (IBD),1 consisting of ulcerative colitis (UC) and Crohn's disease (CD), and recently Kuwada et al2 reported a new autoantibody against integrin αvβ6 with high sensitivity and specificity for UC. Concurrently, we had discovered autoantibodies against endothelial protein C receptor (EPCR) in Takayasu arteritis (TAK), which is sometimes complicated by UC.3 Interestingly, this autoantibody was found in most patients with TAK associated with UC, and we found that the positivity rate in patients with UC without TAK was also high, suggesting that anti-EPCR antibody is a candidate autoantibody useful for the diagnosis of UC.4 To clarify the diagnostic usefulness of anti-EPCR antibodies in patients with IBD and their relationship to several disease subphenotypes and their disease activities, we analyzed the serum samples from patients with IBD and non-IBD control subjects in Japan and the United States.

  3. Distinct autoantibodies against endothelial protein C receptor in ulcerative colitis. International-journal

    Tsuyoshi Shirai, Yoichi Kakuta, Hiroshi Fujii

    Gastroenterology　161　(5)　1724-1725　2021/03/24

    DOI： 10.1053/j.gastro.2021.03.037 　

  4. Identification of two major autoantigens negatively regulating endothelial activation in Takayasu arteritis Peer-reviewed

    Tomoyuki Mutoh, Tsuyoshi Shirai, Tomonori Ishii, Yuko Shirota, Fumiyoshi Fujishima, Fumiaki Takahashi, Yoichi Kakuta, Yoshitake Kanazawa, Atsushi Masamune, Yoshikatsu Saiki, Hideo Harigae, Hiroshi Fujii

    Nature Communications　2020/12

    DOI： 10.1038/s41467-020-15088-0 　

  5. Insufficient Use of Corticosteroids Results in Higher Relapse in Takayasu Arteritis

    Tomoyuki Muto, Tsuyoshi Shirai, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　70　2018/09

    ISSN： 2326-5191

    eISSN： 2326-5205

  6. Pyruvate controls the checkpoint inhibitor PD-L1 and suppresses T cell immunity Peer-reviewed

    Ryu Watanabe, Tsuyoshi Shirai, Hong Namkoong, Hui Zhang, Gerald J. Berry, Barbara B. Wallis, Benedikt Schaefgen, David G. Harrison, Jennifer A. Tremmel, John C. Giacomini, Jorg J. Goronzy, Cornelia M. Weyand

    JOURNAL OF CLINICAL INVESTIGATION　127　(7)　2725-2738　2017/06

    DOI： 10.1172/JCI92167 　

    ISSN： 0021-9738

    eISSN： 1558-8238

  7. NADPH oxidase deficiency underlies dysfunction of aged CD8(+) Tregs Peer-reviewed

    Zhenke Wen, Yasuhiro Shimojima, Tsuyoshi Shirai, Yinyin Li, Jihang Ju, Zhen Yang, Lu Tian, Jorg J. Goronzy, Cornelia M. Weyand

    JOURNAL OF CLINICAL INVESTIGATION　126　(5)　1953-1967　2016/05

    DOI： 10.1172/JCI84181 　

    ISSN： 0021-9738

    eISSN： 1558-8238

  8. The glycolytic enzyme PKM2 bridges metabolic and inflammatory dysfunction in coronary artery disease Peer-reviewed

    Tsuyoshi Shirai, Rafal R. Nazarewicz, Barbara B. Wallis, Rolando E. Yanes, Ryu Watanabe, Marc Hilhorst, Lu Tian, David G. Harrison, John C. Giacomini, Themistocles L. Assimes, Jrg J. Goronzy, Cornelia M. Weyand

    JOURNAL OF EXPERIMENTAL MEDICINE　213　(3)　337-354　2016/03

    DOI： 10.1084/jem.20150900 　

    ISSN： 0022-1007

    eISSN： 1540-9538

  9. A novel autoantibody against ephrin type B receptor 2 in acute necrotizing encephalopathy Peer-reviewed

    Tsuyoshi Shirai, Hiroshi Fujii, Masao Ono, Ryu Watanabe, Yuko Shirota, Shinichiro Saito, Tomonori Ishii, Masato Nose, Hideo Harigae

    JOURNAL OF NEUROINFLAMMATION　10　2013/10

    DOI： 10.1186/1742-2094-10-128 　

    ISSN： 1742-2094

  10. An innovative method to identify autoantigens expressed on the endothelial cell surface: serological identification system for autoantigens using a retroviral vector and flow cytometry (SARF). International-journal Peer-reviewed

    Tsuyoshi Shirai, Hiroshi Fujii, Masao Ono, Ryu Watanabe, Tomonori Ishii, Hideo Harigae

    Clinical & developmental immunology　2013　453058-453058　2013

    DOI： 10.1155/2013/453058 　

  11. A novel autoantibody against fibronectin leucine-rich transmembrane protein 2 expressed on the endothelial cell surface identified by retroviral vector system in systemic lupus erythematosus Peer-reviewed

    Tsuyoshi Shirai, Hiroshi Fujii, Masao Ono, Kyohei Nakamura, Ryu Watanabe, Yumi Tajima, Naruhiko Takasawa, Tomonori Ishii, Hideo Harigae

    ARTHRITIS RESEARCH & THERAPY　14　(4)　2012

    DOI： 10.1186/ar3897 　

    ISSN： 1478-6354

  12. Refractory skin ulcers and afebrile bacteraemia with Staphylococcus aureus in antimelanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report

    Tokio Katakura, Tsuyoshi Shirai, Yusho Ishii, Hiroko Sato, Hiroshi Fujii

    Modern Rheumatology Case Reports　2025/07/25

    DOI： 10.1093/mrcr/rxae082 　

  13. Increased prevalence of gastrointestinal involvement in Behçet’s syndrome patients with gynaecological disorders

    Isso Saito, Yusho Ishii, Hiroko Sato, Tsuyoshi Shirai, Hiroshi Fujii

    Modern Rheumatology　2025/06/02

    DOI： 10.1093/mr/roaf048 　

  14. Drug-induced liver injury related to avacopan therapy

    Kentaro Mori, Tsuyoshi Shirai, Tomoyuki Mutoh, Jun Inoue, Fumiyoshi Fujishima, Satsuki Kubo, Hirofumi Watanabe, Satoko Sato, Mamoru Narita, Yosuke Hoshi, Hiroko Sato, Hiroshi Fujii

    Rheumatology　2025/05/01

    DOI： 10.1093/rheumatology/keae689 　

  15. Positron Emission Tomography in Takayasu Arteritis: A Review Including Patterns of Vascular Involvement Across Modalities and Regions

    Tokio Katakura, Tsuyoshi Shirai

    Journal of Clinical Medicine　2025/04/24

    DOI： 10.3390/jcm14092939 　

  16. Clinical Images: Multiple blisters on the upper and lower extremities in granulomatosis with polyangiitis

    Tokio Katakura, Tsuyoshi Shirai, Hiroshi Fujii, Kenta Oka, Yoshihide Asano

    ACR Open Rheumatology　2025/03

    DOI： 10.1002/acr2.70031 　

  17. Rheumatoid Factor Predicts Long‐Term Retention Associated With Effectiveness of Certolizumab Pegol in Patients With Rheumatoid Arthritis: A Two‐Center Retrospective Study

    Tomoyuki Mutoh, Soshi Okazaki, Tsuyoshi Shirai, Hiroko Sato, Susumu Ohtsu, Tomonori Ishii, Hiroshi Fujii

    International Journal of Rheumatic Diseases　2025/03

    DOI： 10.1111/1756-185X.70173 　

  18. Enthesitis as an initial presentation of vascular Behçet's syndrome: a case-based review. International-journal

    Isso Saito, Tsuyoshi Shirai, Hiroko Sato, Tomonori Ishii, Hiroshi Fujii

    Rheumatology international　44　(11)　2637-2643　2024/11

    DOI： 10.1007/s00296-024-05607-3 　

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    Enthesitis is a characteristic manifestation of spondyloarthropathy (SpA). Historically, Behçet's syndrome (BS) was classified within SpA. Although they are now classified separately, the association between BS and SpA remains controversial. The concept of MHC-I (major histocompatibility complex class I)-opathy has been proposed based on the overlap in immunopathological mechanisms among diseases associated with human leukocyte antigen (HLA) class I. Enthesitis is a frequent complication in patients with BS who also have acne and arthritis. However, information regarding enthesitis in patients with BS without arthritis (BS-WA) is limited. Herein, we report a case of vascular BS complicated by enthesitis. In this case, heel pain was the dominant symptom at presentation. Laboratory tests revealed chlamydia antibody positivity, leading to a tentative diagnosis of reactive arthritis. Despite treatment, C-reactive protein (CRP) levels remained elevated. Imaging revealed numerous aneurysmal lesions in the large vessels. Based on these findings and other symptoms, patient was diagnosed with vascular BS. He tested positive for HLA-B15 and HLA-B46, which are associated with peripheral SpA. Subsequent remission induction therapy for BS was effective and the patient was discharged without complications. Our case and a literature review suggest that there exists a subgroup of BS-WA with a complication of enthesitis, possibly belonging to the spectrum of MHC-I-opathies. It is important to consider BS as a differential diagnosis in patients presenting with enthesitis and to conduct a precise medical history review regarding the symptoms of BS.

  19. Successful management of interstitial lung disease in dermatomyositis complicated by malignancy: a case-based review. International-journal

    Tokio Katakura, Tsuyoshi Shirai, Hiroko Sato, Tomonori Ishii, Hiroshi Fujii

    Rheumatology international　44　(9)　1781-1788　2024/09

    DOI： 10.1007/s00296-023-05442-y 　

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    Dermatomyositis (DM) is associated with interstitial lung disease (ILD) and malignancy. However, the coexistence of ILD and malignancy (DM-ILD-malignancy) is rare, and limited information exists regarding its management. Herein, we report the case of a 70-year-old man who developed DM with rapidly progressive ILD and advanced gastric cancer and provide a literature review of managing DM-ILD-malignancy. The patient presented with typical DM skin rashes and shortness of breath, which worsened within 1 month, without muscular symptoms. Additionally, the patient tested negative for myositis-specific autoantibodies (MSAs). Computed tomography revealed ILD and advanced gastric cancer, which was confirmed on endoscopic examination to be a poorly differentiated adenocarcinoma. Although the patient's ILD progressed rapidly, surgical treatment of the cancer was prioritized. Prednisolone (PSL) 0.5 mg/kg was initiated 3 days before surgery and increased to 1 mg/kg at 7 days postoperative. Remarkable improvement in the skin rash and ILD was observed, and the PSL dose was tapered without immunosuppressants. A literature review revealed that anti-melanoma differentiation-associated gene 5 and anti-aminoacyl transfer RNA synthetase antibodies are the predominant MSAs in DM-ILD-malignancy, and the optimal treatment should be determined based on several factors, including ILD patterns, and malignancy type and stage. In particular, lung cancer may be a risk factor for the acute exacerbation of ILD, and preceding immunosuppression would be useful. Furthermore, prioritizing surgery for gastric cancer is effective because of its paraneoplastic nature.

  20. Development of anti-MDA5 autoantibody-positive dermatomyositis following the use of etanercept biosimilar in rheumatoid arthritis. International-journal

    Soshi Okazaki, Tsuyoshi Shirai, Hiroko Sato, Tomonori Ishii, Hiroshi Fujii

    Modern rheumatology case reports　8　(2)　296-301　2024/07/08

    DOI： 10.1093/mrcr/rxae013 　

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    The induction of autoimmune diseases during tumour necrosis factor-alpha inhibitor (TNFi) usage has been described. Herein, we report a rare case of a 49-year-old woman with antimelanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-positive dermatomyositis (DM), which developed 5 weeks after the introduction of an etanercept biosimilar to rheumatoid arthritis (RA). Four of the five known cases, including ours, of anti-MDA5Ab-positive DM complicated with RA revealed anti-MDA5Ab-positive DM following TNFi usage. When patients with RA are diagnosed with interstitial lung disease during TNFi usage, anti-MDA5 Ab-positive DM could be a differential diagnosis.

  21. Comment on: A case of vanishing bile duct syndrome during treatment of microscopic polyangiitis with avacopan. International-journal

    Sae Shirota, Tsuyoshi Shirai, Kentaro Mori, Jun Inoue, Hiroko Sato, Tomonori Ishii, Hiroshi Fujii

    Rheumatology (Oxford, England)　63　(4)　e149-e150　2024/04/02

    DOI： 10.1093/rheumatology/kead561 　

  22. 中小型血管炎:治療3 アバコパン導入ANCA関連血管炎における薬物性肝障害の検討

    森 健太郎, 白井 剛志, 武藤 智之, 成田 衛, 星 陽介, 町山 智章, 石井 悠翔, 佐藤 紘子, 石井 智徳, 藤井 博司

    日本リウマチ学会総会・学術集会プログラム・抄録集　68回　582-582　2024/03

    Publisher: (一社)日本リウマチ学会

  23. 中小型血管炎:臨床(治療を除く)2 本邦ANCA関連血管炎患者における2022年ACR/EULAR新分類基準の有用性に関する検討

    桑田 亮, 城田 祐子, 白井 剛志, 山下 裕之, 佐藤 紘子, 岡 友美子, 小寺 隆雄, 本村 杏子, 金子 礼志, 亀岡 淳一, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　68回　584-584　2024/03

    Publisher: (一社)日本リウマチ学会

  24. 全身性エリテマトーデスにおけるベリムマブの有効性と代謝マーカーへの影響

    大和 真弥, 白井 剛志, 佐藤 紘子, 石井 智徳, 藤井 博司

    日本リウマチ学会総会・学術集会プログラム・抄録集　68回　907-907　2024/03

    Publisher: (一社)日本リウマチ学会

  25. 中小型血管炎:治療3 アバコパン導入ANCA関連血管炎における薬物性肝障害の検討

    森 健太郎, 白井 剛志, 武藤 智之, 成田 衛, 星 陽介, 町山 智章, 石井 悠翔, 佐藤 紘子, 石井 智徳, 藤井 博司

    日本リウマチ学会総会・学術集会プログラム・抄録集　68回　582-582　2024/03

    Publisher: (一社)日本リウマチ学会

  26. 中小型血管炎:臨床(治療を除く)2 本邦ANCA関連血管炎患者における2022年ACR/EULAR新分類基準の有用性に関する検討

    桑田 亮, 城田 祐子, 白井 剛志, 山下 裕之, 佐藤 紘子, 岡 友美子, 小寺 隆雄, 本村 杏子, 金子 礼志, 亀岡 淳一, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　68回　584-584　2024/03

    Publisher: (一社)日本リウマチ学会

  27. 全身性エリテマトーデスにおけるベリムマブの有効性と代謝マーカーへの影響

    大和 真弥, 白井 剛志, 佐藤 紘子, 石井 智徳, 藤井 博司

    日本リウマチ学会総会・学術集会プログラム・抄録集　68回　907-907　2024/03

    Publisher: (一社)日本リウマチ学会

  28. Impact of subcutaneous belimumab on disease activity, patient satisfaction, and metabolic profile in long-lasting systemic lupus erythematosus

    Maya Yamato, Tsuyoshi Shirai, Yusho Ishii, Hiroko Sato, Tomonori Ishii, Hiroshi Fujii

    Clinical Rheumatology　2024/02/09

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1007/s10067-024-06904-9 　

    ISSN： 0770-3198

    eISSN： 1434-9949

  29. Active withdrawal of corticosteroids using tocilizumab and its association with autoantibody profiles in relapsed Takayasu arteritis: a multicentre, single-arm, prospective study (the Ab-TAK study). International-journal

    Tsuyoshi Shirai, Tomonori Ishii, Soshi Okazaki, Yuko Shirota, Yusho Ishii, Hiroko Sato, Hiroshi Fujii

    Frontiers in immunology　15　1473100-1473100　2024

    DOI： 10.3389/fimmu.2024.1473100 　

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    OBJECTIVES: The feasibility of corticosteroid withdrawal (CW) for Takayasu arteritis (TAK) remains uncertain. Two autoantibodies (Abs) are identified against endothelial protein C receptor (EPCR) and scavenger receptor class B type 1 (SR-BI) in TAK, determining its three subgroups. This study aimed to evaluate CW using tocilizumab (TCZ) and its association with the Ab profile. METHODS: This prospective study, lasted for 24 weeks, included patients with relapsed but stable TAK. Scheduled tapering of prednisolone (PSL) was performed with subcutaneous TCZ (CW at week 20). The primary endpoint was the difference in type A remission, defined by CW and the absence of inflammatory signs, according to the Ab profile at week 24. RESULTS: Twenty patients were included and 18 patients with a mean PSL dose of 4.9 ± 2.8 mg/day were analysed. Anti-EPCR Ab-positive (E+), anti-SR-BI Ab-positive (S+), and double-negative (DN) groups included four (22.2%), eight (44.4%), and six (33.3%) patients, respectively. At week 24, the mean PSL dose was 2.0 ± 2.7 mg/day. Type A remission was observed in eight patients (44.4%), with significant differences based on the Ab profile: E+ (three patients, 75%), S+ (five patients, 62.5%), and DN (zero patients, 0%) (P=0.018). Besides, age, disease duration, PSL dose, type V arterial lesion, arterial dilation, and C-reactive protein >0.01 mg/dL were identified as risks for CW failure. CONCLUSION: CW using TCZ was achieved in 44.4% of patients with TAK relapse and was significantly higher in E+ and S+ patients. CW can be a feasible target, and the precise selection of patients is critical.

  30. Phospholipase D4 as a signature of toll-like receptor 7 or 9 signaling is expressed on blastic T-bet + B cells in systemic lupus erythematosus. International-journal

    Ken Yasaka, Tomohide Yamazaki, Hiroko Sato, Tsuyoshi Shirai, Minkwon Cho, Koji Ishida, Koyu Ito, Tetsuhiro Tanaka, Kouetsu Ogasawara, Hideo Harigae, Tomonori Ishii, Hiroshi Fujii

    Arthritis research & therapy　25　(1)　200-200　2023/10/16

    DOI： 10.1186/s13075-023-03186-5 　

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    BACKGROUND: In systemic lupus erythematosus (SLE), autoreactive B cells are thought to develop by-passing immune checkpoints and contribute to its pathogenesis. Toll-like receptor (TLR) 7 and 9 signaling have been implicated in their development and differentiation. Although some B cell subpopulations such as T-bet + double negative 2 (DN2) cells have been identified as autoreactive in the past few years, because the upregulated surface markers of those cells are not exclusive to them, it is still challenging to specifically target autoreactive B cells in SLE patients. METHODS: Our preliminary expression analysis revealed that phospholipase D4 (PLD4) is exclusively expressed in plasmacytoid dendritic cells (pDCs) and B cells in peripheral blood mononuclear cells (PBMCs) samples. Monoclonal antibodies against human PLD4 were generated, and flow cytometry analyses were conducted for PBMCs from 23 healthy donors (HDs) and 40 patients with SLE. In vitro cell culture was also performed to study the conditions that induce PLD4 in B cells from HDs. Finally, recombinant antibodies were synthesized from subpopulations of PLD4 + B cells from a patient with SLE, and their antinuclear activity was measured through enzyme-linked immunosorbent assay. RESULTS: pDCs from both groups showed comparable frequency of surface PLD4 expression. PLD4 + B cells accounted for only a few percent of HD B cells, whereas they were significantly expanded in patients with SLE (2.1% ± 0.4% vs. 10.8% ± 1.2%, P < 0.005). A subpopulation within PLD4 + B cells whose cell size was comparable to CD38 + CD43 + plasmablasts was defined as "PLD4 + blasts," and their frequencies were significantly correlated with those of plasmablasts (P < 0.005). PLD4 + blasts phenotypically overlapped with double negative 2 (DN2) cells, and, in line with this, their frequencies were significantly correlated with several clinical markers of SLE. In vitro assay using healthy PBMCs demonstrated that TLR7 or TLR9 stimulation was sufficient to induce PLD4 on the surface of the B cells. Finally, two out of three recombinant antibodies synthesized from PLD4 + blasts showed antinuclear activity. CONCLUSION: PLD4 + B cells, especially "blastic" ones, are likely autoreactive B cells undergoing TLR stimulation. Therefore, PLD4 is a promising target marker in SLE treatment.

  31. 全身性エリテマトーデスに対してステロイド治療開始後、強皮症腎クリーゼの併発が示唆された一例

    成田 衛, 星 陽介, 佐藤 紘子, 白井 剛志, 金銅 妃奈子, 石井 智徳, 田中 哲弘, 藤井 博司

    日本リウマチ学会北海道・東北支部学術集会抄録集　33回　57-57　2023/09

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  32. 若年・成人の境界年齢に発症しマクロファージ活性化症候群を呈したStill病の一例

    松崎 凌佑, 白井 剛志, 佐藤 紘子, 星 陽介, 矢坂 健, 森 健太郎, 成田 衛, 石井 智徳, 藤井 博司

    日本リウマチ学会北海道・東北支部学術集会抄録集　33回　76-76　2023/09

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  33. Efficient detection of somatic UBA1 variants and clinical scoring system predicting patients with variants in VEXAS syndrome. International-journal Peer-reviewed

    Ayaka Maeda, Naomi Tsuchida, Yuri Uchiyama, Nobuyuki Horita, Satoshi Kobayashi, Mitsumasa Kishimoto, Daisuke Kobayashi, Haruki Matsumoto, Tomoyuki Asano, Kiyoshi Migita, Ayaka Kato, Ichiro Mori, Hiroyuki Morita, Akihiro Matsubara, Yoshiaki Marumo, Yuji Ito, Tomoaki Machiyama, Tsuyoshi Shirai, Tomonori Ishii, Mari Kishibe, Yusuke Yoshida, Shintaro Hirata, Satoshi Akao, Akitsu Higuchi, Ryo Rokutanda, Ken Nagahata, Hiroki Takahashi, Koske Katsuo, Toshio Ohtani, Hiroshi Fujiwara, Hiromichi Nagano, Takashi Hosokawa, Takanori Ito, Yoichiro Haji, Hiroyuki Yamaguchi, Noboru Hagino, Toshimasa Shimizu, Tomohiro Koga, Atsushi Kawakami, Goichi Kageyama, Hiroshi Kobayashi, Akiko Aoki, Akinari Mizokami, Yoichi Takeuchi, Rena Motohashi, Hiroyuki Hagiyama, Masaki Itagane, Hiroyuki Teruya, Tomohiro Kato, Yuji Miyoshi, Takayasu Kise, Naoto Yokogawa, Takako Ishida, Naoki Umeda, Shuntaro Isogai, Taio Naniwa, Toru Yamabe, Kaori Uchino, Jo Kanasugi, Akiyoshi Takami, Yasushi Kondo, Kazunori Furuhashi, Koichi Saito, Shigeru Ohno, Daiga Kishimoto, Mari Yamamoto, Yoshiro Fujita, Yuichiro Fujieda, Sachiko Araki, Hiroshi Tsushima, Kyohei Misawa, Akira Katagiri, Takahiro Kobayashi, Kenichi Hashimoto, Takehiro Sone, Yukiko Hidaka, Hiroaki Ida, Ryuta Nishikomori, Hiroshi Doi, Katsumichi Fujimaki, Keiichi Akasaka, Masako Amano, Hidekazu Matsushima, Kaori Kashino, Hidenori Ohnishi, Yuki Miwa, Noriyuki Takahashi, Kaoru Takase-Minegishi, Ryusuke Yoshimi, Yohei Kirino, Hideaki Nakajima, Naomichi Matsumoto

    Rheumatology (Oxford, England)　2023/08/22

    DOI： 10.1093/rheumatology/kead425 　

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    OBJECTIVES: To efficiently detect somatic UBA1 variants and establish a clinical scoring system predicting patients with pathogenic variants in VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome. METHODS: Eighty-nine Japanese patients with clinically suspected VEXAS syndrome were recruited [81 males and 8 females; median onset age (IQR) 69.3 years (62.1-77.6)]. Peptide nucleic acid-clamping PCR (PNA-PCR), regular PCR targeting exon 3 clustering UBA1 variants, and subsequent Sanger sequencing were conducted for variant screening. Partitioning digital PCR (pdPCR) or targeted amplicon deep sequencing (TAS) was also performed to evaluate the variant allele frequency (VAF). We developed our clinical scoring system to predict UBA1 variant-positive and ‑negative patients and assessed the diagnostic value of our system using receiver operating characteristic (ROC) curve analysis. RESULTS: Forty patients with reported pathogenic UBA1 variants (40/89, 44.9%) were identified, including a case having a variant with VAF of 1.7%, using a highly sensitive method. Our clinical scoring system considering >50 years of age, cutaneous lesions, lung involvement, chondritis, and macrocytic anaemia efficiently predicted patients with UBA1 variants (the area under the curve for the scoring total was 0.908). CONCLUSIONS: Genetic screening with the combination of regular PCR and PNA-PCR detected somatic UBA1 variants with high sensitivity and specificity. Our scoring system could efficiently predict patients with UBA1 variants.

  34. First reported case of pulmonary arteritis in patients with relapsing polychondritis International-journal

    Maya Yamato, Tsuyoshi Shirai, Hiroko Sato, Tomonori Ishii, Hiroshi Fujii

    Rheumatology　2023/06/16

    DOI： 10.1093/rheumatology/kead300 　

  35. 【分類不能腸炎(IBDU)の現状と将来展望】炎症性腸疾患における血清学的バイオマーカー診断の現状

    角田 洋一, 岡崎 創司, 澤橋 基, 猪股 優志, 下山 雄丞, 内藤 健夫, 諸井 林太郎, 志賀 永嗣, 木内 喜孝, 白井 剛志, 藤井 博司, 正宗 淳

    胃と腸　58　(6)　783-788　2023/06

    Publisher: (株)医学書院

    ISSN： 0536-2180

    eISSN： 1882-1219

  36. Severe Bone Marrow Aplasia Following Macrophage Activation Syndrome in Systemic Lupus Erythematosus.

    Hirona Ichimura, Satoshi Ichikawa, Koya Ono, Kyoko Inokura, Yosuke Hoshi, Tsuyoshi Shirai, Noriko Fukuhara, Hisayuki Yokoyama, Hiroshi Fujii, Hideo Harigae

    The Tohoku journal of experimental medicine　260　(4)　301-304　2023/05/11

    DOI： 10.1620/tjem.2023.J037 　

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    Macrophage activation syndrome (MAS) is a potentially fatal complication of rheumatic diseases, characterized by activated macrophages with hemophagocytosis and multiple organ damage. We report a case of MAS associated with systemic lupus erythematosus that initially presented with severe liver dysfunction. Although it was improved with steroids and plasmapheresis, severe pancytopenia was subsequently experienced, and the bone marrow showed severe aplasia similar to aplastic anemia. Nevertheless, the administration of immunosuppressants resulted in the recovery of blood counts within two weeks. When severe MAS results in cytokine overproduction, bone marrow aplasia may occur, for which immunosuppressive therapy may be highly effective.

  37. Dysbiosis in Takayasu arteritis complicated with infectious endocarditis following tocilizumab administration

    T Shirai, H Sato, T Ishii, H Fujii

    Scandinavian Journal of Rheumatology　2023/03/04

    DOI： 10.1080/03009742.2022.2124620 　

  38. ANCA関連血管炎の診断 従来法で診断された本邦多発血管炎性肉芽症患者における2022年アメリカリウマチ学会/ヨーロッパリウマチ学会新分類基準の有用性に関する検討

    桑田 亮, 城田 祐子, 白井 剛志, 山下 裕之, 佐藤 紘子, 武田 朋樹, 岡 友美子, 小寺 隆雄, 金子 礼志, 亀岡 淳一, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　67回　524-524　2023/03

    Publisher: (一社)日本リウマチ学会

  39. 多発性筋炎・皮膚筋炎1:抗MDA5抗体陽性症例のアウトカム 抗MDA5抗体陽性皮膚筋炎の中長期的予後の検討

    白井 剛志, 片倉 世雄, 森 健太郎, 井樋 創, 星 陽介, 高橋 秀典, 町山 智章, 佐藤 紘子, 石井 智徳, 藤井 博司

    日本リウマチ学会総会・学術集会プログラム・抄録集　67回　535-535　2023/03

    Publisher: (一社)日本リウマチ学会

  40. 多発性筋炎・皮膚筋炎4:抗MDA5抗体/抗ARS抗体陰性の多発性筋炎/皮膚筋炎 抗TIF-1γ抗体陽性皮膚筋炎の臨床的特徴と再燃率の検討

    片倉 世雄, 森 健太郎, 高橋 幹弘, 矢坂 健, 井樋 創, 星 陽介, 高橋 秀典, 佐藤 紘子, 白井 剛志, 石井 智徳, 藤井 博司

    日本リウマチ学会総会・学術集会プログラム・抄録集　67回　641-641　2023/03

    Publisher: (一社)日本リウマチ学会

  41. 馬蹄腎に発症し,尿所見と腎病理像に乖離を認めたANCA関連腎炎の一例

    森 健太郎, 片倉 世雄, 高橋 幹弘, 井樋 創, 星 陽介, 高橋 秀典, 町山 智章, 佐藤 紘子, 白井 剛志, 石井 智徳, 藤井 博司

    日本リウマチ学会総会・学術集会プログラム・抄録集　67回　842-842　2023/03

    Publisher: (一社)日本リウマチ学会

  42. Intensive induction therapy combining tofacitinib, rituximab and plasma exchange in severe anti-melanoma differentiation-associatedprotein-5 antibody-positive dermatomyositis. International-journal

    Tsuyoshi Shirai, Tomoaki Machiyama, Hiroko Sato, Tomonori Ishii, Hiroshi Fujii

    Clinical and experimental rheumatology　41　(2)　291-300　2023/03

    DOI： 10.55563/clinexprheumatol/8kulbf 　

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    OBJECTIVES: Anti-melanoma differentiation-associated protein-5 (MDA5) autoantibodies (Abs) are associated with rapidly progressive interstitial lung disease (RP-ILD) in dermatomyositis (DM). Because the addition of plasma exchange (PE) and rituximab (RTX) to triple therapy is inadequate in severe cases, we treat such cases with intensive induction therapy (IIT) combining all these options with tofacitinib (TOF). In this study, we investigated the poor prognostic factors and the efficacy and safety of IIT. METHODS: Thirty-three patients diagnosed with anti-MDA5 Ab-positive DM in our institution between 2014 and 2021 were included. The clinical characteristics of poor prognosis were retrospectively analysed using principal component analysis (PCA), and the outcomes of IIT were analysed in terms of survival, assessed using the Kaplan-Meier test, and adverse events. RESULTS: Although triple therapy with RTX, PE, or intravenous immunoglobulin was administered before the introduction of IIT, eight of 12 RP-ILD cases with a ferritin level >400 ng/mL (mean, 2,342) died within a median of 2.5 months. PCA revealed distinct clusters for prognosis, and age and serum ferritin were leading predictors of the prognosis. IIT, consisting of combinations of triple therapy with higher doses of methylprednisolone, PE, RTX, and TOF, was applied to eight patients (mean ferritin, 3,558). Although two patients died even with these regimens, a significant improvement in survival was documented. Several IIT-related adverse events were observed, including viral and fungal infections and cytopenia. CONCLUSIONS: IIT significantly improved the survival of patients with severe anti-MDA5 Ab-positive RP-ILD. Although infections are noted, their benefits outweigh the risks in younger patients with high serum ferritin levels.

  43. Common Autoantibody among Takayasu Arteritis and Ulcerative Colitis: A Possible Pathophysiology That Includes Gut-Vessel Connection in Vascular Inflammation Peer-reviewed

    Tsuyoshi Shirai

    JMA Journal　6　(3)　2023

    Publisher: Japan Medical Association

    DOI： 10.31662/jmaj.2023-0038 　

    ISSN： 2433-3298 2433-328X

  44. Sjögren's Syndrome Presenting with Temporary Hemiplegia Mimicking Transient Ischemic Attack.

    Yukiko Kamogawa, Kanae Akita, Hiroko Sato, Tsuyoshi Shirai, Tomonori Ishii, Hideo Harigae, Hiroshi Fujii

    The Tohoku journal of experimental medicine　258　(3)　207-211　2022/10/26

    DOI： 10.1620/tjem.2022.J079 　

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    Sjögren's syndrome manifests with a wide variety of neurologic symptoms. This case report presents a 53-year-old woman with Sjögren's syndrome associated with temporal hemiplegia, which was suspected to be a transient ischemic attack. After induction of immunosuppressive therapies [high-dose prednisolone (1 mg/kg/day) and intravenous cyclophosphamide (total 5 g)], the hemiplegia did not reappear and the blood flow abnormalities remarkably improved as depicted on electroencephalography and single photon emission computed tomography. This case suggests that temporal hemiplegia presenting with transient ischemia-like attack symptoms may be a neurologic manifestation of Sjögren's syndrome and responsive to immunosuppressive therapy.

  45. IBD病態を踏まえた今後の治療ストラテジー 抗EPCR抗体価と潰瘍性大腸炎の病態および治療反応性との関連に関する検討

    角田 洋一, 白井 剛志, 正宗 淳

    Gastroenterological Endoscopy　64　(Suppl.2)　2023-2023　2022/10

    Publisher: (一社)日本消化器内視鏡学会

    ISSN： 0387-1207

    eISSN： 1884-5738

  46. 腰痛で発症,経過中洞停止をきたし,シクロフォスファミドパルスが奏功した抗ミトコンドリア抗体陽性皮膚筋炎の一例

    高橋 幹弘, 武藤 智之, 永井 泰地, 佐藤 紘子, 白井 剛志, 石井 智徳, 藤井 博司

    日本リウマチ学会北海道・東北支部学術集会抄録集　32回　43-43　2022/09

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  47. 限局皮膚硬化型全身性強皮症に合併しinhibitor boostingによる血漿交換不応が疑われた血栓性血小板減少性紫斑病の一例

    森 健太郎, 片倉 世雄, 高橋 幹弘, 高橋 秀典, 星 陽介, 佐藤 紘子, 白井 剛志, 石井 智徳, 藤井 博司

    日本リウマチ学会北海道・東北支部学術集会抄録集　32回　52-52　2022/09

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  48. Phospholipase D 4 Is a Novel Surface Marker of a Distinctive B Cell Population Overlapping with Double Negative 2 B Cells

    Ken Yasaka, Tomohide Yamazaki, Hiroko Sato, Tsuyoshi Shirai, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　74　3240-3242　2022/09

    ISSN： 2326-5191

    eISSN： 2326-5205

  49. 今月の症例 自己免疫性膵炎に対するステロイド維持療法中にIgG4関連下垂体炎を発症した1例

    大黒 顕佑, 尾股 慧, 手塚 雄太, 小野 美澄, 森本 玲, 白井 剛志, 宮崎 真理子, 張替 秀郎, 佐藤 文俊

    日本内科学会雑誌　111　(8)　1588-1593　2022/08

    Publisher: (一社)日本内科学会

    ISSN： 0021-5384

    eISSN： 1883-2083

  50. Establishing clinical remission criteria and the framework of a treat-to-target algorithm for Takayasu arteritis: Results of a Delphi exercise carried out by an expert panel of the Japan Research Committee of the Ministry of Health, Labour and Welfare for intractable vasculitis

    Takahiko Sugihara, Yoshikazu Nakaoka, Haruhito A. Uchida, Hajime Yoshifuji, Yasuhiro Maejima, Yoshiko Watanabe, Eisuke Amiya, Kazuo Tanemoto, Tetsuro Miyata, Natsuka Umezawa, Yusuke Manabe, Jun Ishizaki, Tsuyoshi Shirai, Hiroko Nagafuchi, Hitoshi Hasegawa, Takako Miyamae, Hiroaki Niiro, Shuichi Ito, Tomonori Ishii, Mitsuaki Isobe, Masayoshi Harigai

    MODERN RHEUMATOLOGY　32　(5)　930-937　2022/08

    DOI： 10.1093/mr/roab081 　

    ISSN： 1439-7595

    eISSN： 1439-7609

  51. Development of severe colitis in Takayasu arteritis treated with tocilizumab. International-journal

    Kae Ishii, Tsuyoshi Shirai, Yoichi Kakuta, Tomoaki Machiyama, Hiroko Sato, Tomonori Ishii, Hideo Harigae, Hiroshi Fujii

    Clinical rheumatology　41　(6)　1911-1918　2022/06

    DOI： 10.1007/s10067-022-06108-z 　

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    Relapse of Takayasu arteritis (TAK) is frequent, and the use of biologics is required in refractory cases. Tocilizumab (TCZ), a biological agent used in TAK, is known to increase the incidence of diverticulitis in patients with rheumatoid arthritis. Adverse events of TCZ in TAK have been poorly recognised. This study aimed to investigate the occurrence of severe colitis among patients with TAK receiving TCZ. We enrolled 116 patients with TAK who met the criteria of the American College of Rheumatology and visited our department between 2018 and 2020. The occurrence of severe colitis and its clinical characteristics were retrospectively evaluated. TCZ was introduced in 34 of 116 patients (29.3%). Severe colitis that required hospitalisation was observed in three of the 34 patients receiving TCZ (8.8%). All patients were female and had Numano type V artery lesions, and the ascending colon was commonly affected. Wide lesions that reached the sigmoid colon, colonic perforation, bacteraemia, or positive stool cultures were observed in some patients. All patients received antibiotics and intestinal rest, and TCZ was resumed in one patient. IL-6 plays a physiological role in the intestine, including recovery from ischaemic damage. In addition to infectious aetiology, blocking the physiological roles of IL-6 by TCZ is considered important for the development of colitis in TAK. Severe colitis is an important adverse event in patients with TAK who receive TCZ. The risk of bloodstream infection associated with colitis should be recognised, especially in patients who have undergone vascular surgery. Key Points • Severe colitis was observed in 8.8% of patients with TAK receiving tocilizumab • Patients had type V artery lesions and ascending colon involvement and were under long-term use of corticosteroids • Inhibition of the physiological roles of IL-6 in the intestinal tract might also be involved.

  52. Granulomatosis with Polyangiitis Following Pfizer-BioNTech COVID-19 Vaccination. International-journal

    Tsuyoshi Shirai, Jun Suzuki, Shimpei Kuniyoshi, Yuito Tanno, Hiroshi Fujii

    Modern rheumatology case reports　7　(1)　127-129　2022/03/04

    DOI： 10.1093/mrcr/rxac016 　

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    We report the first case of proteinase 3 (PR3)- antineutrophil cytoplasmic antibody (ANCA)-positive granulomatosis with polyangiitis (GPA) with predominant ears, nose, and throat (ENT) manifestations following COVID-19 vaccination. A 63-year-old woman presented with aural fullness three days after vaccination. She presented with progressive rhinosinusitis and otitis media leading to profound hearing loss within three weeks. Clinical imaging revealed soft-tissue shadows in the paranasal sinuses with multiple pulmonary nodules, and histopathology was consistent with a diagnosis of GPA. It is crucial to be wary of the possibility of GPA in patients who received COVID-19 vaccines due to its rapid disease progression.

  53. 高安動脈炎の臨床 高安動脈炎における生物学的製剤の長期的有効性と継続率の検討

    白井 剛志, 町山 智章, 佐藤 紘子, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　66回　337-337　2022/03

    Publisher: (一社)日本リウマチ学会

  54. ANCA関連血管炎:コホート研究・ケースシリーズ 多発血管炎性肉芽腫症患者におけるANCAサブタイプの臨床的意義と免疫抑制療法効果の検討 多施設共同後方視的観察研究

    桑田 亮, 城田 祐子, 白井 剛志, 山下 裕之, 小林 俊昭, 本村 杏子, 金子 駿太, 高橋 裕子, 佐藤 紘子, 武田 朋樹, 堤 智美, 岡 友美子, 小寺 隆雄, 金子 礼志, 亀岡 淳一, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　66回　415-415　2022/03

    Publisher: (一社)日本リウマチ学会

  55. 多発性筋炎・皮膚筋炎の治療 抗MDA5抗体陽性皮膚筋炎に対するトファシチニブ、血漿交換、リツキシマブを併用した高強度寛解導入療法の治療成績

    白井 剛志, 丹野 唯人, 星 陽介, 秋田 佳奈恵, 町山 智章, 佐藤 紘子, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　66回　471-471　2022/03

    Publisher: (一社)日本リウマチ学会

  56. Predictive factors for retention of golimumab over a median 4-year duration in Japanese patients with rheumatoid arthritis in a real-world setting: A retrospective study and literature review. International-journal

    Tomoyuki Mutoh, Taichi Nagai, Tsuyoshi Shirai, Soshi Okazaki, Hiroko Sato, Hiroshi Fujii

    International journal of rheumatic diseases　25　(3)　335-343　2022/03

    DOI： 10.1111/1756-185X.14281 　

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    OBJECTIVES: To investigate 6-year drug survival (median: 48.5 months) of golimumab and predictors for lack of efficacy leading to golimumab discontinuation in Japanese patients with rheumatoid arthritis (RA) in routine practice. METHODS: This retrospective single-center study included 60 patients with RA treated with golimumab from November 2011 to August 2020. Patients were divided into 2 groups (retention, n = 28; withdrawal due to lack of efficacy, n = 24). The retention rate was assessed using the Kaplan-Meier method, and variables associated with golimumab discontinuation were identified using the Cox proportional hazard model. RESULTS: The prevalence of concomitant methotrexate and no biologics use was significantly higher in the retention than in the withdrawal group. Overall drug survival of golimumab was 66.3%, 48.3%, and 24.5% at 12, 36, and 72 months, respectively. There were statistical differences in retention rates among groups stratified by initiation dose, methotrexate, and biologics use. Multivariate analysis revealed the factor associated with golimumab discontinuation as history of 1 (hazards ratio: 4.42, 95% CI: 1.35-19.93, P = .012) and ≥2 biologics use (7.49, 1.97-36.27, P = .003). CONCLUSIONS: Prior exposure of increasing number of biologics was identified as the most important factor negatively affecting long-term golimumab retention in Japanese patients with RA.

  57. Hypertrophic Pachymeningitis Development in Eosinophilic Granulomatosis with Polyangiitis at Relapse of Disease: A Case-Based Review.

    Machi Kiyohara, Tsuyoshi Shirai, Shuhei Nishiyama, Hiroko Sato, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    The Tohoku journal of experimental medicine　256　(3)　241-247　2022/03

    DOI： 10.1620/tjem.256.241 　

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    Hypertrophic pachymeningitis (HP) presents with thickening of the dura mater in the cerebrum and spine, and its symptoms vary depending on the affected location. The association of HP with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been recognized, and most cases are complicated by granulomatosis with polyangiitis. We report the case of a 47-year-old man who presented with HP upon relapse of eosinophilic granulomatosis with polyangiitis (EGPA), with literature review. He presented with disturbance of consciousness, and magnetic resonance imaging (MRI) revealed thickening of the dura mater around the left parietal lobe. Although myeloperoxidase (MPO)-ANCA was positive on EGPA diagnosis, the elevation of MPO-ANCA was not documented at the onset of HP. Brain perfusion scintigraphy showed an increase in blood flow in the left parietal lobe and temporal lobe, and electroencephalogram (EEG) revealed slow waves in the left parietal lobe. He was treated with a high dose of corticosteroid and rituximab, and the slow waves on EEG and brain perfusion were normalized. Although the most frequent symptom of HP is headache, disturbance of consciousness can be the manifestation of HP, and inflammation of HP could affect the cerebral parenchyma, which can be documented as abnormal EEG and perfusion scintigraphy. Literature review revealed that most of the HP in EGPA developed when EGPA relapsed, and was observed in patients with MPO-ANCA positivity. HP develops without evidence of other clinical features of EGPA; therefore, adequate imaging, including contrast-enhanced MRI, is necessary. Rituximab may be effective for treating HP complicated with EGPA.

  58. "Coexistence of IgA nephropathy and renal artery stenosis in Takayasu arteritis: case report and literature review". International-journal

    Nono Ito, Tsuyoshi Shirai, Takafumi Toyohara, Hideaki Hashimoto, Hiroko Sato, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    Rheumatology international　43　(2)　391-398　2022/01/11

    DOI： 10.1007/s00296-021-05066-0 　

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    Although Takayasu arteritis (TAK) is a form of large vessel vasculitis, complications of glomerulonephritis have occasionally been observed, with mesangial proliferative glomerulonephritis as the most common. The aim of this work was to present a case-based review regarding the association of glomerulonephritis and IgA nephropathy (IgAN) with TAK. A literature search was carried out using the PubMed and Scopus databases for articles published in English, and the Ichu-shi Web for Japanese. A 34-year-old Japanese man was evaluated for proteinuria, and IgAN was diagnosed by renal biopsy. Simultaneously, aortic wall thickening and right renal artery stenosis confirmed a coexisting TAK. Prednisolone and methotrexate improved both diseases, and percutaneous transluminal renal angioplasty resulted in right renal artery reopening. Our case and literature review revealed that membranous proliferative glomerulonephritis and IgAN are common in eastern Asia, while focal segmental glomerulosclerosis and mesangial proliferative glomerulonephritis are common in other regions. The incidence of IgAN is higher in TAK cases and is mostly reported in Asia. Abdominal aortic involvement and renal artery stenosis are common in cases with preceding TAK. IgAN could be related to the cytokine network involving interleukin-6, suggesting the usefulness of tocilizumab in patients with TAK accompanied by IgAN. The type of glomerulonephritis complicated with TAK differs among regions, and patients with TAK are more likely to experience IgAN than the healthy population.

  59. 播種性クリプトコッカス症発症後に血球貪食症候群を呈したループス腎患者の一例

    成田 衛, 丹野 唯人, 秋田 佳奈恵, 星 陽介, 佐藤 紘子, 白井 剛志, 藤井 博司, 石井 智徳

    日本リウマチ学会北海道・東北支部学術集会抄録集　31回　49-49　2022/01

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  60. 全身性エリテマトーデスに合併した後天性第XI因子欠乏症の帝王切開に際して血漿交換を施行した1例

    丹野 唯人, 石井 智徳, 成田 衛, 星 陽介, 秋田 佳奈恵, 町山 智章, 佐藤 紘子, 白井 剛志, 藤井 博司, 張替 俊郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　31回　52-52　2022/01

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  61. 巨細胞性動脈炎に対するトシリズマブ導入後にサルモネラ敗血症を来した1例

    星 陽介, 成田 衛, 丹野 唯人, 秋田 佳奈恵, 佐藤 紘子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　31回　54-54　2022/01

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  62. エタネルセプト開始後に抗MDA5抗体陽性皮膚筋炎を発症した関節リウマチの一例

    岡崎 創司, 白井 剛志, 高橋 幹弘, 石井 悠翔, 秋田 佳奈恵, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　31回　45-45　2022/01

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  63. エタネルセプト開始後に抗MDA5抗体陽性皮膚筋炎を発症した関節リウマチの一例

    岡崎 創司, 白井 剛志, 高橋 幹弘, 石井 悠翔, 秋田 佳奈恵, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　31回　45-45　2022/01

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  64. 巨細胞性動脈炎に対するトシリズマブ導入後にサルモネラ敗血症を来した1例

    星 陽介, 成田 衛, 丹野 唯人, 秋田 佳奈恵, 佐藤 紘子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　31回　54-54　2022/01

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  65. Multi-targeted therapy for refractory eosinophilic granulomatosis with polyangiitis characterized by intracerebral hemorrhage and cardiomyopathy: a case-based review. International-journal

    Tomoyuki Mutoh, Tsuyoshi Shirai, Hiroko Sato, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    Rheumatology international　42　(11)　2069-2076　2021/07/21

    DOI： 10.1007/s00296-021-04950-z 　

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    Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic autoimmune disorder classified under anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, predominantly affecting small- to medium-sized vessels, characterized by asthma, eosinophilia, and necrotizing granulomatous inflammation. Most patients with EGPA experience peripheral neuropathy, whereas intracerebral hemorrhage is rare as EGPA-related presentation in central nervous system involvement, causing severe morbidity and mortality. Here, we present a 45-year-old man with refractory EGPA who developed intracerebral hemorrhage as the first manifestation, followed by cardiac involvement. This patient with a history of bronchial asthma developed a right putaminal hemorrhage caused by EGPA. Although intravenous cyclophosphamide (IVCY) and mepolizumab (MPZ) induced remission, relapse was frequently observed. Subsequently, he developed cardiomyopathy despite administration of rituximab (RTX) substituted from IVCY and MPZ. Combined immunosuppressive therapy, including IVCY, MPZ, and RTX was required to inhibit vascular inflammation, leading to sustained remission. We review previously published literature while focusing on the clinical features of patients with intracerebral hemorrhage caused by EGPA and describe clinical characteristics for detecting EGPA in patients with intracerebral hemorrhage, emphasizing rapid evaluation and recognition of EGPA and adequate intervention in the early vasculitic phase of this disease. We also refer to the immunological aspects of this case. It is important to consider "multi-targeted therapy" through interleukin-5 suppression and B cell depletion in the management of refractory EGPA.

  66. 【ステロイドからの離脱を目指す膠原病診療】高安動脈炎にtocilizumabが保険適用となって、ステロイドの使い方は変わるか?

    白井 剛志, 石井 智徳

    リウマチ科　65　(6)　642-648　2021/06

    Publisher: (有)科学評論社

    ISSN： 0915-227X

  67. Cyclophosphamide-associated enteritis presenting with severe protein-losing enteropathy in granulomatosis with polyangiitis: A case report. International-journal

    Hiroko Sato, Tsuyoshi Shirai, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    World journal of gastroenterology　27　(20)　2657-2663　2021/05/28

    DOI： 10.3748/wjg.v27.i20.2657 　

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    BACKGROUND: Although cyclophosphamide (CPA) is the key drug for the treatment of autoimmune diseases including vasculitides, it has some well-known adverse effects, such as myelosuppression, hemorrhagic cystitis, infertility, and infection. However, CPA-associated severe enteritis is a rare adverse effect, and only one case with a lethal clinical course has been reported. Therefore, the appropriate management of patients with CPA-associated severe enteritis is unclear. CASE SUMMARY: We present the case of a 61-year-old woman diagnosed with granulomatosis with polyangiitis based on the presence of symptoms in ear, lung, and, kidney with positive myeloperoxidase-antineutrophil cytoplasmic antibody. She received pulsed methylprednisolone followed by prednisolone 55 mg/d and intravenous CPA at a dose of 500 mg/mo. Ten days after the second course of intravenous CPA, she developed nausea, vomiting, and diarrhea, and was admitted to the hospital. Laboratory testing revealed hypoalbuminemia, suggesting protein-losing enteropathy. Computed tomography revealed wall thickening of the stomach, small intestine, and colon with contrast enhancement on the lumen side. Antibiotics and immunosuppressive therapy were not effective, and the patient's enteritis did not improve for > 4 mo. Because her condition became seriously exhausted, corticosteroids were tapered and supportive therapies including intravenous hyperalimentation, replenishment of albumin and gamma globulin, plasma exchange, and infection control were continued. These supportive therapies improved her condition, and her enteritis gradually regressed. She was finally discharged 7 mo later. CONCLUSION: Immediate discontinuation of CPA and intensive supportive therapy are crucial for the survival of patients with CPA-associated severe enteritis.

  68. CTD関連 非強皮症合併肺動脈性肺高血圧症の臨床

    石井 智徳, 藤井 博司, 白井 剛志, 佐藤 紘子, 星 陽介, 秋田 佳奈恵

    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集　6回・27回　17-17　2021/05

    Publisher: 日本肺高血圧・肺循環学会・日本小児肺循環研究会

  69. Association of various myositis-specific autoantibodies with dermatomyositis and polymyositis triggered by pregnancy. International-journal

    Chikaho Akiyama, Tsuyoshi Shirai, Hiroko Sato, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    Rheumatology international　42　(7)　1271-1280　2021/04/10

    DOI： 10.1007/s00296-021-04851-1 　

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    Although pregnancy is an important risk factor for autoimmune rheumatic diseases, little is known regarding the association between pregnancy and dermatomyositis (DM) or polymyositis (PM). Herein, we present two patients with DM that developed during the perinatal period. The first patient was positive for anti-aminoacyl synthetase (ARS) antibody and developed DM in the 14th week of pregnancy. Despite treatment, her foetus died of intrauterine growth restriction in the 27th week. The second patient was positive for anti-melanoma differentiation-associated gene 5 (MDA-5) antibody and developed DM 1 week after miscarriage at 9 weeks of gestation. The patient developed severe interstitial pneumonia, and intensive therapy including tofacitinib and rituximab administration was required. Our cases and a literature review revealed that various myositis-specific autoantibodies, including anti-ARS, anti-Mi-2, anti-TIF-1γ, and anti-MDA-5, are associated with DM and PM triggered by pregnancy. We also found that delay in commencing treatment in case of active disease including myositis and interstitial pneumonia, and poor response to corticosteroids were related to poor foetal outcomes in DM and PM. Although rare in pregnant women, it is critical to consider the possibility of DM and PM in patients presenting with rash, fever, weakness, and cough, and testing for myositis-specific autoantibodies is recommended.

  70. 血管炎診療の進歩 高安動脈炎における自己抗体の意義

    石井 智徳, 白井 剛志, 武藤 智之, 藤井 博司, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　183-183　2021/03

    Publisher: (一社)日本リウマチ学会

  71. Cutting-edge knowledge on pathogenic autoantibodies and immune tolerance SARFによる高安動脈炎の新規自己抗原の同定とその病的意義について

    藤井 博司, 白井 剛志, 武藤 智之, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　229-229　2021/03

    Publisher: (一社)日本リウマチ学会

  72. 多発性筋炎・皮膚筋炎:治療 抗MDA5抗体陽性皮膚筋炎に伴う急速進行性間質性肺炎に対するトファシチニブ、血漿交換、リツキシマブを併用した高強度寛解導入療法の有効性

    白井 剛志, 丹野 唯人, 高橋 美岐, 岡崎 創司, 星 陽介, 町山 智章, 秋田 佳奈恵, 佐藤 紘子, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　390-390　2021/03

    Publisher: (一社)日本リウマチ学会

  73. ベーチェット病 ベーチェット病における血管病変の特徴と再燃に関連する因子の検討

    佐藤 紘子, 丹野 唯人, 高橋 美岐, 岡崎 創司, 星 陽介, 町山 智章, 秋田 佳奈恵, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　425-425　2021/03

    Publisher: (一社)日本リウマチ学会

  74. リウマチ性疾患の合併症 当院の関節リウマチ患者におけるMTX関連リンパ増殖性疾患40例の診断契機に関する検討

    高橋 美岐, 丹野 唯人, 岡崎 創司, 町山 智章, 星 陽介, 秋田 佳奈恵, 佐藤 紘子, 白井 剛志, 石井 智徳, 藤井 博司, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　4.37-4.37　2021/03

    Publisher: (一社)日本リウマチ学会

  75. 当科における関節リウマチに対するゴリムマブの長期継続率の検討

    武藤 智之, 永井 泰地, 佐藤 紘子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　569-569　2021/03

    Publisher: (一社)日本リウマチ学会

  76. 腹部大動脈周囲炎を合併した好酸球性多発血管炎性肉芽腫症の一例

    秋田 佳奈恵, 藤井 博司, 丹野 唯人, 高橋 美岐, 岡崎 創司, 星 陽介, 佐藤 紘子, 白井 剛志, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　662-662　2021/03

    Publisher: (一社)日本リウマチ学会

  77. 再燃を繰り返した治療抵抗性好酸球性多発血管炎性肉芽腫症に対してシクロホスファミド、リツキシマブ、メポリズマブ併用療法が有効であった1例

    武藤 智之, 白井 剛志, 永井 泰地, 佐藤 紘子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　663-663　2021/03

    Publisher: (一社)日本リウマチ学会

  78. 妊娠に関連し発症した抗ARS抗体陽性と抗MDA5抗体陽性皮膚筋炎の2例

    秋山 悠歩, 白井 剛志, 佐藤 紘子, 高橋 幹弘, 丹野 唯人, 高橋 美岐, 岡崎 創司, 星 陽介, 秋田 佳奈恵, 藤井 博司, 石井 智徳

    日本リウマチ学会総会・学術集会プログラム・抄録集　65回　725-725　2021/03

    Publisher: (一社)日本リウマチ学会

  79. シクロホスファミドとアザチオプリンによる寛解維持が困難でインフリキシマブが有効であった再発性多発軟骨炎の一例

    秋田 佳奈恵, 白井 剛志, 丹野 唯人, 高橋 美岐, 岡崎 創司, 星 陽介, 佐藤 紘子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　30回　41-41　2021/02

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  80. トシリズマブ、サリルマブで加療を行ったTAFRO症候群の一例

    丹野 唯人, 高橋 美岐, 岡崎 創司, 星 陽介, 秋田 佳奈恵, 町山 智章, 佐藤 紘子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　30回　53-53　2021/02

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  81. SLE、Sjogren症候群を伴う肺多発結節影を来した肺MALT lymphomaの一例

    高橋 幹弘, 岡崎 創司, 秋田 佳奈恵, 石井 悠翔, 丹野 唯人, 高橋 美岐, 星 陽介, 白井 剛志, 石井 智宏, 藤井 博司, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　30回　65-65　2021/02

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  82. SLE、Sjogren症候群を伴う肺多発結節影を来した肺MALT lymphomaの一例

    高橋 幹弘, 岡崎 創司, 秋田 佳奈恵, 石井 悠翔, 丹野 唯人, 高橋 美岐, 星 陽介, 白井 剛志, 石井 智宏, 藤井 博司, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　30回　65-65　2021/02

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  83. The feasible maintenance dose of corticosteroid in Takayasu arteritis in the era of biologic therapy

    T. Shirai, H. Sato, H. Fujii, T. Ishii, H. Harigae

    Scandinavian Journal of Rheumatology　50　(6)　462-468　2021

    Publisher: Taylor and Francis Ltd.

    DOI： 10.1080/03009742.2021.1881155 　

    ISSN： 1502-7732 0300-9742

  84. 【リウマチ性疾患のリスク因子・予後予測因子】大型血管炎の予後予測因子と寛解維持

    白井 剛志, 石井 智徳

    リウマチ科　64　(4)　461-468　2020/10

    Publisher: (有)科学評論社

    ISSN： 0915-227X

  85. Extranasal extranodal NK/T-cell lymphoma associated with systemic lupus erythematosus.

    Satoshi Ichikawa, Noriko Fukuhara, Tsuyoshi Shirai, Tomonori Ishii, Ryo Ichinohasama, Hideo Harigae

    International journal of hematology　112　(4)　592-596　2020/10

    DOI： 10.1007/s12185-020-02914-w 　

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    Increased incidence of lymphoproliferative disorders is reported in patients with autoimmune diseases, majority of which have a B-cell phenotype and are pathogenetically associated with the reactivation of Epstein-Barr virus (EBV). However, EBV-associated T/NK-cell lymphoma has hardly been reported. We present the case of a 68-year-old-woman, who had been diagnosed with systemic lupus erythematosus (SLE) 28 years back and was treated with various immunosuppressive agents including steroids, cyclophosphamide, and tacrolimus. She presented with a progressively worsening swelling of the right thigh for the last few months. Radiological examination revealed an intramuscular bulky tumor without any other lesions and the biopsy results led to a diagnosis of extranodal NK/T-cell lymphoma, nasal type (ENKL). Concurrent chemoradiotherapy resulted in a complete response, which has been sustained for more than 2 years without requiring additional therapy. After the initiation of chemotherapy, SLE did not worsen with the administration of low-dose corticosteroids. To the best of our knowledge, this is the first case report of a localized extranasal ENKL developing in a patient with SLE.

  86. 全身性結合織疾患の難治性病態 SLEに合併したADAMTS13インヒビター陰性二次性血栓性血小板減少性紫斑病の一例

    佐藤 紘子, 永井 泰地, 武藤 智之, 町山 智章, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　64回　390-390　2020/08

    Publisher: (一社)日本リウマチ学会

  87. 大型血管炎 大型血管炎におけるステロイド寛解維持量の検討

    白井 剛志, 佐藤 紘子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　64回　451-451　2020/08

    Publisher: (一社)日本リウマチ学会

  88. 中小型血管炎(ANCA関連血管炎) 多発血管炎性肉芽腫症における臓器別にみた治療反応性についての検討

    城田 祐子, 白井 剛志, 藤井 博司, 佐藤 紘子, 町山 智章, 堤 智美, 武田 朋樹, 岡 友美子, 小寺 隆雄, 桑田 亮, 石井 智徳, 張替 秀郎, 亀岡 淳一

    日本リウマチ学会総会・学術集会プログラム・抄録集　64回　511-511　2020/08

    Publisher: (一社)日本リウマチ学会

  89. 中小型血管炎(ANCA関連血管炎) 多発血管炎性肉芽腫症における臓器別にみた治療反応性についての検討

    城田 祐子, 白井 剛志, 藤井 博司, 佐藤 紘子, 町山 智章, 堤 智美, 武田 朋樹, 岡 友美子, 小寺 隆雄, 桑田 亮, 石井 智徳, 張替 秀郎, 亀岡 淳一

    日本リウマチ学会総会・学術集会プログラム・抄録集　64回　511-511　2020/08

    Publisher: (一社)日本リウマチ学会

  90. Rheumatoid Arthritis After Cord Blood Cell Transplantation. International-journal Peer-reviewed

    Tsuyoshi Shirai, Yu Mori, Takuya Izumiyama, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases　27　(7)　e276-e277　2020/06/12

    DOI： 10.1097/RHU.0000000000001430 　

  91. Successful treatment of methotrexate-associated classical Hodgkin lymphoma with brentuximab vedotin-combined chemotherapy: a case series. Peer-reviewed

    Satoshi Ichikawa, Noriko Fukuhara, Kei Saito, Koichi Onodera, Tsuyoshi Shirai, Yasushi Onishi, Hisayuki Yokoyama, Hiroshi Fujii, Ryo Ichinohasama, Hideo Harigae

    International journal of hematology　111　(5)　667-672　2020/05

    DOI： 10.1007/s12185-020-02822-z 　

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    Methotrexate (MTX)-associated classical Hodgkin lymphoma (CHL) is unlikely to regress following discontinuation of MTX, and its treatment usually requires chemotherapy. Standard chemotherapy for CHL is the ABVD regimen, which contains pneumotoxic bleomycin. This can be problematic in MTX-CHL patients suffering from an autoimmune disease (AID), such as rheumatoid arthritis (RA), as they frequently have pulmonary complications. However, brentuximab vedotin (BV)-containing chemotherapy without bleomycin (A + AVD regimen) was recently reported to show favorable efficacy for CHL, and could therefore be beneficial in MTX-CHL. We treated three cases of MTX-CHL using the A + AVD regimen. All were female and had received MTX for more than 15 years. Underlying AIDs in these patients were RA in two patients, and overlap syndrome with systemic lupus erythematosus and dermatomyositis in one patient. The A + AVD regimen resulted in a complete response in all patients. Peripheral neuropathy developed in two patients, necessitating reduction of the BV dose. All three patients experienced hematological toxicity necessitating dose reduction; however, no severe adverse effects, including infection or pulmonary complication, were documented. RA was well-controlled without additional immunosuppressants. The A + AVD regimen is a promising chemotherapy for MTX-CHL with favorable efficacy and tolerable toxicity profiles.

  92. Successful Treatment of Pulmonary Arterial Hypertension in Systemic Sclerosis with Anticentriole Antibody Peer-reviewed

    Yusho Ishii, Hiroshi Fujii, Koichiro Sugimura, Tsuyoshi Shirai, Yosuke Hoshi, Yoko Fujita, Yuko Shirota, Tomonori Ishii, Hiroaki Shimokawa, Hideo Harigae

    Case Reports in Rheumatology　2020/02/26

    DOI： 10.1155/2020/1926908 　

  93. Comment on: Aortarctia: a rare manifestation of relapsing polychondrits Peer-reviewed

    Tsuyoshi Shirai, Koji Murakami, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    Rheumatology　2020/02/05

    Publisher: Oxford University Press ({OUP})

    DOI： 10.1093/rheumatology/keaa019 　

  94. Interferon α Enhances B Cell Activation Associated With FOXM1 Induction: Potential Novel Therapeutic Strategy for Targeting the Plasmablasts of Systemic Lupus Erythematosus. International-journal

    Kanae Akita, Ken Yasaka, Tsuyoshi Shirai, Tomonori Ishii, Hideo Harigae, Hiroshi Fujii

    Frontiers in immunology　11　498703-498703　2020

    DOI： 10.3389/fimmu.2020.498703 　

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    Systemic lupus erythematosus (SLE) is an autoimmune disease. It is characterized by the production of various pathogenic autoantibodies and is suggested to be triggered by increased type I interferon (IFN) signature. Previous studies have identified increased plasmablasts in the peripheral blood of SLE patients. The biological characteristics of SLE plasmablasts remain unknown, and few treatments that target SLE plasmablasts have been applied despite the unique cellular properties of plasmablasts compared with other B cell subsets and plasma cells. We conducted microarray analysis of naïve and memory B cells and plasmablasts (CD38+CD43+ B cells) that were freshly isolated from healthy controls and active SLE (n = 4, each) to clarify the unique biological properties of SLE plasmablasts. The results revealed that all B cell subsets of SLE expressed more type I IFN-stimulated genes. In addition, SLE plasmablasts upregulated the expression of cell cycle-related genes associated with higher FOXM1 and FOXM1-regulated gene expression levels than that in healthy controls. This suggests that a causative relationship exists between type I IFN priming and enhanced proliferative capacity through FOXM1. The effects of pretreatment of IFNα on B cell activation and FOXM1 inhibitor FDI-6 on B cell proliferation and survival were investigated. Pretreatment with IFNα promoted B cell activation after stimulation with anti-IgG/IgM antibody. Flow cytometry revealed that pretreatment with IFNα preferentially enhanced the Atk and p38 pathways after triggering B cell receptors. FDI-6 inhibited cell division and induced apoptosis in activated B cells. These effects were pronounced in activated B cells pretreated with interferon α. This study can provide better understanding of the pathogenic mechanism of interferon-stimulated genes on SLE B cells and an insight into the development of novel therapeutic strategies.

  95. Migratory Aortitis Associated with Granulocyte-colony-stimulating Factor

    Tsuyoshi Shirai, Hiroka Komatsu, Hiroko Sato, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    INTERNAL MEDICINE　59　(12)　1559-1563　2020

    DOI： 10.2169/internalmedicine.4331-19 　

    ISSN： 0918-2918

    eISSN： 1349-7235

  96. Protein-losing gastroenteropathy with severe hypoalbuminemia associated with Sjögren's syndrome: A case report and review of the literature. Peer-reviewed

    Tetsuya Akaishi, Ken Yasaka, Michiaki Abe, Hiroshi Fujii, Mika Watanabe, Tsuyoshi Shirai, Kota Ishizawa, Shin Takayama, Yutaka Kagaya, Hideo Harigae, Tadashi Ishii

    Journal of general and family medicine　21　(1)　24-28　2020/01

    DOI： 10.1002/jgf2.281 　

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    A 30-year-old man with severe hypoalbuminemia (serum albumin: 0.9 g/dL) was admitted with severe bilateral leg edema and unilateral pleural effusion. Serum anti-SS-A and SS-B antibody levels were abnormally elevated, and his symptoms fulfilled the diagnostic criteria for Sjögren's syndrome. Technetium-99m albumin scintigraphy revealed protein leakage from a large area of the small intestine. Immunohistochemistry revealed perivascular deposition of C1q, C3d, and immunoglobulin G in the duodenal mucosa. The patient was diagnosed with protein-losing gastroenteropathy associated with Sjögren's syndrome. Within 2 months of treatment with oral prednisolone and mycophenolate mofetil, the clinical symptoms of hypoalbuminemia and Sjögren's syndrome disappeared completely.

  97. Endothelial Protein C Receptor and Scavenger Receptor Class B Type 1 Negatively Regulate Vascular Inflammation and Are Major Autoantigens in Takayasu Arteritis

    Tomoyuki Mutoh, Tsuyoshi Shirai, Tomonori Ishii, Yuko Shirota, Hideo Harigae, Hiroshi Fujii

    ARTHRITIS & RHEUMATOLOGY　71　2019/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  98. Refractory Takayasu arteritis successfully treated with rituximab: case-based review. International-journal Peer-reviewed

    Mutoh T, Ishii T, Shirai T, Akita K, Kamogawa Y, Fujita Y, Sato H, Shirota Y, Fujii H, Harigae H

    Rheumatology international　39　(11)　1989-1994　2019/08

    DOI： 10.1007/s00296-019-04390-w 　

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    Takayasu arteritis (TAK) is a subtype of the large-vessel vasculitis, affecting the aorta and its major branches. Although T cell-mediated autoimmunity is mainly involved in vascular inflammation, in recent years, accumulating evidence suggests the important role of B cells in the pathogenesis and effectiveness of B-cell-targeted therapy with rituximab (RTX), a chimeric anti-CD20 monoclonal antibody in refractory TAK. Herein, we report for the first time a case involving a 34-year-old man with TAK who was refractory to four different biologic agents, such as one selective T-cell co-stimulation modulator (abatacept), one anti-interleukin-6 receptor monoclonal antibody (tocilizumab), and two tumor necrosis factor-α inhibitors (infliximab and etanercept), but eventually achieved remission with RTX. He received a total of six courses of RTX, and doses of prednisolone and methotrexate were tapered without relapse. The current case provided further evidence to the potential role of RTX therapy in patients with refractory TAK, and its efficacy needs to be validated in a controlled trial.

  99. Insufficient use of corticosteroids without immunosuppressants results in higher relapse in Takayasu arteritis. International-journal Peer-reviewed

    Mutoh T, Shirai T, Fujii H, Ishii T, Harigae H

    The Journal of rheumatology　47　(2)　255-263　2019/05

    DOI： 10.3899/jrheum.181219 　

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    OBJECTIVE:Although prednisolone (PSL) and immunosuppressants are key drugs for Takayasu arteritis (TAK) treatment, there is limited evidence on the optimal PSL dose. The aim of this study was to investigate the correlation between the initial PSL dose and relapse in TAK. METHODS:We enrolled 105 patients with TAK who satisfied the criteria of the Japanese Circulation Society and American College of Rheumatology from 1990 to 2015. The clinical characteristics and outcomes of patients with TAK were retrospectively evaluated. The relapse-free period was assessed according to the difference in initial treatments. RESULTS:Relapse was observed in 57 (59.4%) of 96 patients treated with immunosuppressive therapy at diagnosis during a median follow-up of 56 months. Male sex and younger age of onset were significantly associated with relapse. Although ≤30-mg/day PSL monotherapy was preferably prescribed for patients with lower inflammatory markers, compared with &gt;30 mg/day (87.2% vs. 52.6%), a significantly higher relapse rate was observed in the ≤30-mg/day group (hazard ratio, 1.78, P = 0.047). Furthermore, the relapse-free period was longer in patients treated with ≥50-mg/day PSL compared with those treated with ≤40-mg/day PSL. Combination therapy improved the relapse-free period compared with PSL monotherapy in the short term. The initial PSL dose was not associated with adverse events. CONCLUSION:A higher dose of PSL was associated with a significant decrease in the relapse rate. The effect of combination therapy on relapse needs to be further investigated. Lower-dose PSL monotherapy is an undesirable strategy for remission induction in TAK, despite low disease activity.

  100. Muehrcke lines on fingers and toenails. International-journal Peer-reviewed

    Takeshi Kozaru, Takeshi Fukumoto, Tsuyoshi Shirai, Naruhiko Takasawa, Jun-Ichi Kameoka, Masahiro Oka

    European journal of dermatology : EJD　29　(1)　87-88　2019/02

    DOI： 10.1684/ejd.2018.3439 　

  101. Four distinct clinical phenotypes of vasculitis affecting medium-sized arteries. Peer-reviewed

    Tsuyoshi Shirai

    Scandinavian journal of rheumatology　48　(4)　308-314　2019/01/23

    DOI： 10.1080/03009742.2018.1551965 　

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    OBJECTIVE:Within the spectrum of polyarteritis nodosa (PAN), cutaneous PAN (cPAN) is further classified into mild cPAN and severe cPAN which presents with ulcers, necrosis, or neuritis. As distinguishing between severe cPAN and systemic PAN can be difficult, this study evaluated the clinical characteristics of patients with necrotizing arteritis of medium-sized arteries. METHODS:Forty-one patients diagnosed with necrotizing arteritis of medium-sized arteries between 2008 and 2017 at our institution were enrolled in this study. Clinical background, laboratory findings, treatments, and rates of relapse and death were evaluated. RESULTS:Thirty-six patients were classified as having cPAN (mild, 15; ulcer, nine; neuritis, eight; both, four), and five cases manifested systemic vasculitis. Clinical characteristics of mild cPAN included female predominance (84.6%) and younger age (median 31 years); those of systemic PAN included older age (median 71 years) and higher levels of inflammatory markers. Severe cPAN manifested with intermediate phenotypes. The median doses of prednisolone used to treat mild cPAN, severe cPAN, and systemic PAN were 20.0, 40.0, and 40.0 mg/day, respectively. Immunosuppressants were used in 20.0% of mild cPAN, 90.5% of severe cPAN, and 80.0% of systemic PAN patients. Although the mortality rates were indistinguishable, the relapse rates of severe cPAN (ulcer type) were significantly higher than those of other types (88.9%). CONCLUSION:The clinical characteristics of mild cPAN, severe cPAN (ulcer type), severe cPAN (neuritis type), and systemic PAN were distinct from each other. In particular, patients with severe cPAN (ulcer type) had higher relapse rates, indicating the importance of combination therapy.

  102. Multicenter double-blind randomized controlled trial to evaluate the effectiveness and safety of bortezomib as a treatment for refractory systemic lupus erythematosus. International-journal Peer-reviewed

    Tomonori Ishii, Yoshiya Tanaka, Atsushi Kawakami, Kazuyoshi Saito, Kunihiro Ichinose, Hiroshi Fujii, Yuko Shirota, Tsuyoshi Shirai, Yoko Fujita, Ryu Watanabe, Shih-Wei Chiu, Takuhiro Yamaguchi, Hideo Harigae

    Modern rheumatology　28　(6)　986-992　2018/11

    DOI： 10.1080/14397595.2018.1432331 　

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    OBJECTIVES: The objective of this study is to evaluate the efficacy and safety of bortezomib for treating systemic lupus erythematosus (SLE), in patients whose disease activity could not be controlled. METHODS: Fourteen SLE patients with persistent disease activity were selected, who required prednisolone doses of >10 mg/d despite concomitant immunosuppressive therapy. Patients were randomly administered either bortezomib or a placebo, eight times. The primary and secondary end-points were a change in anti-dsDNA antibody titer at week 24 and the SLE Responder Index (SRI), respectively. RESULTS: In the bortezomib group, four out of eight patients discontinued the trial; three others failed to complete the minimum protocol treatment due to adverse reactions. The changes in anti-dsDNA antibody titers at week 24 were 4.24% and -1.96%, for the bortezomib and placebo groups, respectively, disconfirming bortezomib's efficacy. In contrast, the corresponding SRI at week 12 was 75% and 40%. CONCLUSIONS: As bortezomib therapy for SLE is associated with many adverse reactions, treatment indications should be selected carefully, and protocols should aim to prevent these occurrences. Although the change in anti-dsDNA antibody titer did not support the efficacy of bortezomib as a treatment for SLE, high SRI in the treatment group suggests bortezomib may utilize mechanisms other than inhibition of anti-dsDNA antibody production.

  103. 【わかりやすいANCA関連血管炎性中耳炎(OMAAV)-早期診断と治療-】全身疾患におけるANCA測定の意義 Peer-reviewed

    白井 剛志, 石井 智徳

    ENTONI　(217)　17-22　2018/04

    Publisher: (株)全日本病院出版会

    ISSN： 1346-2067

  104. Immunosuppressive therapy ameliorates refractory vasospastic angina, severe pulmonary hypertension, and bronchiolitis in a patient with eosinophilic granulomatosis with polyangiitis: a case report Peer-reviewed

    Ryo Konno, Shunsuke Tatebe, Tsuyoshi Shirai, Hiroaki Shimokawa

    European Heart Journal - Case Reports　2　(2)　1-5　2018/04

    Publisher: Oxford University Press ({OUP})

    DOI： 10.1093/ehjcr/yty050 　

    ISSN： 2514-2119

  105. Nasal Septal Perforation in Propylthiouracil-Induced Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis International-journal Peer-reviewed

    Yusho Ishii, Tsuyoshi Shirai, Yousuke Hoshi, Yoko Fujita, Yuko Shirota, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    Case Reports in Rheumatology　2018　1-8192021　2018

    Publisher: Hindawi Limited

    DOI： 10.1155/2018/8192021 　

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    Here, we present the case of a 29-year-old woman with nasal septal perforation and positive myeloperoxidase- (MPO-) anti-neutrophil cytoplasmic antibody (ANCA). She had been diagnosed with Graves' disease and had been treated with propylthiouracil (PTU) for 14 months. A biopsy of the nasal septum revealed an infiltration of inflammatory cells, with no evidence of malignancy or granulomatous change. Because of the use of PTU, destructive nasal lesion, and positive MPO-ANCA, she was diagnosed with drug-induced ANCA-associated vasculitis (AAV) and was treated with prednisolone and methotrexate after the cessation of PTU. Although PTU is known to be the medicine that induces drug-induced AAV, the manifestation of nasal septal perforation in drug-induced AAV is poorly identified. This is the rare case of drug-induced AAV which manifested only nasal septal perforation.

  106. Takayasu arteritis coexisting with sclerosing osteomyelitis Peer-reviewed

    Tsuyoshi Shirai, Riiza Hanaoka, Yusuke Goto, Ikuho Kojima, Yusho Ishii, Yousuke Hoshi, Yoko Fujita, Yuko Shirota, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    Internal Medicine　57　(13)　1929-1934　2018

    DOI： 10.2169/internalmedicine.0329-17 　

    ISSN： 0918-2918

    eISSN： 1349-7235

  107. Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) restricted to the limbs Peer-reviewed

    Yoshie Ojima, Kinya Sawada, Hiroshi Fujii, Tsuyoshi Shirai, Ayako Saito, Saeko Kagaya, Satoshi Aoki, Yoichi Takeuchi, Tomonori Ishii, Tasuku Nagasawa

    Internal Medicine　57　(9)　1301-1308　2018

    Publisher: Japanese Society of Internal Medicine

    DOI： 10.2169/internalmedicine.9848-17 　

    ISSN： 1349-7235 0918-2918

  108. Bortezomib treatment induces a higher mortality rate in lupus model mice with a higher disease activity Peer-reviewed

    Tomoko Ikeda, Hiroshi Fujii, Masato Nose, Yukiko Kamogawa, Tsuyoshi Shirai, Yuko Shirota, Tomonori Ishii, Hideo Harigae

    Arthritis Research & Therapy　19　(1)　2017/08/11

    Publisher: Springer Nature

    DOI： 10.1186/s13075-017-1397-7 　

    ISSN： 1478-6362

  109. Bortezomib treatment induces a higher mortality rate in lupus model mice with a higher disease activity Peer-reviewed

    Tomoko Ikeda, Hiroshi Fujii, Masato Nose, Yukiko Kamogawa, Tsuyoshi Shirai, Yuko Shirota, Tomonori Ishii, Hideo Harigae

    ARTHRITIS RESEARCH & THERAPY　19　(1)　187　2017/08

    DOI： 10.1186/s13075-017-1397-7 　

    ISSN： 1478-6354

    eISSN： 1478-6362

  110. リウマチ性疾患の合併症 11C-BF-227-PETによる全身アミロイド計測を試みたアミロイドーシス6症例の検討

    城田 祐子, 石井 悠翔, 星 陽介, 藤田 洋子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　61回　585-585　2017/03

    Publisher: (一社)日本リウマチ学会

  111. 心臓MRIで遅延造影なく心臓生検で心筋炎の診断がついた全身性エリテマトーデス(SLE)の一例

    藤田 洋子, 星 陽介, 石井 悠翔, 武藤 智之, 町山 智章, 秋田 佳奈恵, 鴨川 由起子, 白井 剛志, 城田 祐子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　61回　674-674　2017/03

    Publisher: (一社)日本リウマチ学会

  112. 免疫抑療法制が奏効した抗セントリオール抗体陽性全身性強皮症関連肺動脈性肺高血圧症の1例

    石井 悠翔, 藤田 洋子, 白井 剛志, 城田 祐子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　61回　748-748　2017/03

    Publisher: (一社)日本リウマチ学会

  113. Relapsing Polychondritis Complicated by Myelodysplastic Syndrome Is Resistant to Immunosuppression: Comment on the Article by Dion et al Peer-reviewed

    Tsuyoshi Shirai, Hiroshi Fujii, Ryoko Saito, Kentaro Nasu, Yukiko Kamogawa, Noriko Fukuhara, Yoko Fujita, Yuko Shirota, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　69　(3)　682-683　2017/03

    DOI： 10.1002/art.39969 　

    ISSN： 2326-5191

    eISSN： 2326-5205

  114. Extracorporeal Shock Wave Therapy for Digital Ulcers of Systemic Sclerosis: A Phase 2 Pilot Study Peer-reviewed

    Shinichiro Saito, Tomonori Ishii, Yukiko Kamogawa, Ryu Watanabe, Tsuyoshi Shirai, Yoko Fujita, Yuko Shirota, Hiroshi Fujii, Kenta Ito, Hiroaki Shimokawa, Takuhiro Yamaguchi, Yasushi Kawaguchi, Hideo Harigae

    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE　238　(1)　39-47　2016/01

    DOI： 10.1620/tjem.238.39 　

    ISSN： 0040-8727

    eISSN： 1349-3329

  115. Macrophages in vascular inflammation - From atherosclerosis to vasculitis Peer-reviewed

    Tsuyoshi Shirai, Marc Hilhorst, David G. Harrison, Joerg J. Goronzy, Cornelia M. Weyand

    AUTOIMMUNITY　48　(3)　139-151　2015/05

    DOI： 10.3109/08916934.2015.1027815 　

    ISSN： 0891-6934

    eISSN： 1607-842X

  116. Chronic Lupus Peritonitis Is Characterized by the Ascites with a Large Content of Interleukin-6 Peer-reviewed

    Ryu Watanabe, Hiroshi Fujii, Yukiko Kamogawa, Kyohei Nakamura, Tsuyoshi Shirai, Tomonori Ishii, Hideo Harigae

    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE　235　(4)　289-294　2015/04

    DOI： 10.1620/tjem.235.289 　

    ISSN： 0040-8727

    eISSN： 1349-3329

  117. Accelerated atherosclerosis in patients with chronic inflammatory rheumatologic conditions Peer-reviewed

    Hong, J., Maron, D.J., Shirai, T., Weyand, C.M.

    International Journal of Clinical Rheumatology　10　(5)　365-381　2015

    DOI： 10.2217/ijr.15.33 　

  118. T cell-macrophage interactions and granuloma formation in vasculitis Peer-reviewed

    Marc Hilhorst, Tsuyoshi Shirai, Gerald Berry, Joerg J. Goronzy, Cornelia M. Weyand

    FRONTIERS IN IMMUNOLOGY　5　(SEP)　1-14　2014/09

    DOI： 10.3389/fimmu.2014.00432 　

    ISSN： 1664-3224

  119. Autophagy plays a protective role as an anti-oxidant system in human T cells and represents a novel strategy for induction of T-cell apoptosis Peer-reviewed

    Ryu Watanabe, Hiroshi Fujii, Tsuyoshi Shirai, Shinichiro Saito, Tomonori Ishii, Hideo Harigae

    EUROPEAN JOURNAL OF IMMUNOLOGY　44　(8)　2508-2520　2014/08

    DOI： 10.1002/eji.201344248 　

    ISSN： 0014-2980

    eISSN： 1521-4141

  120. Ulcerative colitis is not a rare complication of Takayasu arteritis Peer-reviewed

    Ryu Watanabe, Tomonori Ishii, Kyohei Nakamura, Tsuyoshi Shirai, Hiroshi Fujii, Shinichiro Saito, Hideo Harigae

    MODERN RHEUMATOLOGY　24　(2)　372-373　2014/03

    DOI： 10.3109/14397595.2013.854045 　

    ISSN： 1439-7595

    eISSN： 1439-7609

  121. Successful Use of Intensive Immunosuppressive Therapy for Treating Simultaneously Occurring Cerebral Lesions and Pulmonary Arterial Hypertension in a Patient with Systemic Lupus Erythematosus Peer-reviewed

    Ryu Watanabe, Hiroshi Fujii, Tsuyoshi Shirai, Shinichiro Saito, Akira Hatakeyama, Koichiro Sugimura, Yoshihiro Fukumoto, Tomonori Ishii, Hideo Harigae

    INTERNAL MEDICINE　53　(6)　627-631　2014

    DOI： 10.2169/internalmedicine.53.0514 　

    ISSN： 0918-2918

    eISSN： 1349-7235

  122. Prevalence and time course of hepatitis B virus infection in patients with systemic lupus erythematosus under immunosuppressive therapy Peer-reviewed

    Ryu Watanabe, Tomonori Ishii, Kyohei Nakamura, Tsuyoshi Shirai, Yumi Tajima, Hiroshi Fujii, Hideo Harigae

    MODERN RHEUMATOLOGY　23　(6)　1094-1100　2013/11

    DOI： 10.1007/s10165-012-0797-4 　

    ISSN： 1439-7595

    eISSN： 1439-7609

  123. Polyarteritis nodosa clinically mimicking nonocclusive mesenteric ischemia Peer-reviewed

    Tsuyoshi Shirai, Hiroshi Fujii, Shinichiro Saito, Tomonori Ishii, Hideyuki Yamaya, Shigehito Miyagi, Satoshi Sekiguchi, Naoki Kawagishi, Masato Nose, Hideo Harigae

    WORLD JOURNAL OF GASTROENTEROLOGY　19　(23)　3693-3698　2013/06

    DOI： 10.3748/wjg.v19.i23.3693 　

    ISSN： 1007-9327

  124. 【血管炎-基礎と臨床のクロストーク-】 最新の研究トピックス AP-VAS 2012から 血管炎の基礎研究 血管内皮細胞表面に対する抗FLRT2自己抗体 Peer-reviewed

    白井 剛志, 藤井, 博司, 小野, 栄夫, 石井, 智徳, 張替 秀郎

    日本臨床　71　(増刊1 血管炎)　497-501　2013/02

  125. 自己抗体 顕著な脳炎を呈した中枢神経ループス患者における新規抗EphB2自己抗体の同定 Peer-reviewed

    白井剛志, 藤井博司, 中村恭平, 渡部龍, 田島結実, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　56回・21回　452-452　2012/03

  126. 腎機能障害と血小板減少を呈し、レボレード投与、エンドキサンパルス療法が奏功した強皮症の一例 Peer-reviewed

    佐々木結実, 中村恭平, 渡部龍, 白井剛志, 藤井博司, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会学術集会国際リウマチシンポジウムプログラム抄録集56回・21回　663　2012/03

  127. 血管炎に合併した肥厚性硬膜炎の３例 Peer-reviewed

    中村恭平, 渡部龍, 白井剛志, 田島結実, 藤井博司, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会学術集会国際リウマチシンポジウムプログラム抄録集56回・21回　615　2012/03

  128. ANCA関連血管炎が疑われた非結核性抗酸菌症と考えられる１例 Peer-reviewed

    高澤徳彦, 中村恭平, 渡部龍, 白井剛志, 佐々木結実, 藤井博司, 石井智徳, 張替秀郎

    日本リウマチ学会総会学術集会国際リウマチシンポジウムプログラム抄録集56回・21回　543　2012/03

  129. 大量ガンマグロブリン療法が奏功した視神経周囲炎を伴うChurg-Strauss症候群の一例 Peer-reviewed

    渡部龍, 石井智徳, 中村恭平, 白井剛志, 田島結実, 藤井博司, 高澤徳彦, 張替秀郎

    末梢神経　22　(2)　264-265　2011/12

    ISSN： 0917-6772

  130. リコンビナント抗原を使用したELISA法によるANCA測定キット(コスミック社)の基礎的・臨床的検討 Peer-reviewed

    白井剛志, 石井智徳, 中村恭平, 渡部龍, 田島結実, 藤井博司, 高澤徳彦, 張替秀郎

    医学と薬学　65　(4)　517-523　2011/04

  131. Thrombotic Microangiopathy Presenting with a Considerable Accumulation of Ascites: A Case Report Peer-reviewed

    Tsuyoshi Shirai, Tomonori Ishii, Ryu Watanabe, Yumi Tajima, Hiroshi Fujii, Naruhiko Takasawa, Hiroshi Sato, Hideo Harigae

    INTERNAL MEDICINE　50　(1)　53-57　2011

    DOI： 10.2169/internalmedicine.50.4330 　

    ISSN： 0918-2918

  132. The use of tacrolimus for recurrent lupus enteritis: a case report. International-journal Peer-reviewed

    Tsuyoshi Shirai, Yasuhiko Hirabayashi, Ryu Watanabe, Yumi Tajima, Hiroshi Fujii, Naruhiko Takasawa, Tomonori Ishii, Hideo Harigae

    Journal of medical case reports　4　150-150　2010/05/24

    DOI： 10.1186/1752-1947-4-150 　

  133. 多量腹水、下腿浮腫、血小板減少を呈した血栓性微小血管障害症(TMA)の一例 Peer-reviewed

    白井剛志, 渡部龍, 田島結実, 藤井博司, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　54回・19回　612-612　2010/03

  134. Pregnancy-Associated Thrombotic Thrombocytopenic Purpura with Anti-Centromere Antibody-Positive Raynaud's Syndrome Peer-reviewed

    Ryu Watanabe, Tsuyoshi Shirai, Yumi Tajima, Hiroto Ohguchi, Yasushi Onishi, Hiroshi Fujii, Naruhiko Takasawa, Tomonori Ishii, Hideo Harigae

    INTERNAL MEDICINE　49　(12)　1229-1232　2010

    DOI： 10.2169/internalmedicine.49.3465 　

    ISSN： 0918-2918

    eISSN： 1349-7235

  135. 眼球突出、PR3-ANCA高値を呈しWegener肉芽腫との鑑別を要したT細胞リンパ腫の一例

    白井 剛志, 田島 結実, 高橋 令子, 藤井 博司, 高澤 徳彦, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　53回・18回　320-320　2009/03

    Publisher: (一社)日本リウマチ学会

  136. Peripheral T Cell Lymphoma with a High Titer of Proteinase-3-Antineutrophil Cytoplasmic Antibodies that Resembled Wegener&apos;s Granulomatosis Peer-reviewed

    Tsuyoshi Shirai, Reiko Takahashi, Yumi Tajima, Katsura Kohata, Joji Yamamoto, Hiroshi Fujii, Naruhiko Takasawa, Kenichi Ishizawa, Ryo Ichinohasama, Tomonori Ishii, Hideo Harigae

    INTERNAL MEDICINE　48　(23)　2041-2045　2009

    DOI： 10.2169/internalmedicine.48.2600 　

    ISSN： 0918-2918

  137. アンチゲネミア陰性を示した汎血球減少を伴うサイトメガロウイルス感染症の一例

    白井 剛志, 高橋 令子, 平林 泰彦, 石井 智徳, 高澤 徳彦, 田島 結実, 張替 秀郎

    日本臨床免疫学会会誌　31　(4)　335-335　2008/08

    Publisher: (一社)日本臨床免疫学会

    ISSN： 0911-4300

    eISSN： 1349-7413

  138. Percutaneous endoscopic cecostomy (PEC) for ileus in aged patients Peer-reviewed

    Uno, Y., Nagaoka, Y., Shirai, T.

    Gastroenterological Endoscopy　50　(3)　408-416　2008

Show all ︎Show first 5

Misc. 34

  1. IBD病態を踏まえた今後の治療ストラテジー 抗EPCR抗体価と潰瘍性大腸炎の病態および治療反応性との関連に関する検討

    角田 洋一, 白井 剛志, 正宗 淳

    Gastroenterological Endoscopy　64　(Suppl.2)　2023-2023　2022/10

    Publisher: (一社)日本消化器内視鏡学会

    ISSN： 0387-1207

    eISSN： 1884-5738

  2. 重症な急速進行性間質性肺炎を合併した抗MDA5抗体陽性皮膚筋炎に対して多剤併用療法が奏効した一例 Peer-reviewed

    町山 智章, 白井 剛志, 藤田 洋子, 鴨川 由紀子, 佐藤 紘子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　29回　74-74　2019/11

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  3. 後部虚血性視神経症による急性視力障害を来たした小型血管炎の1例 Peer-reviewed

    李 邱平, 白井 剛志, 永井 泰地, 町山 智章, 鴨川 由起子, 佐藤 紘子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会北海道・東北支部学術集会抄録集　29回　78-78　2019/11

    Publisher: (一社)日本リウマチ学会-北海道・東北支部

  4. IDENTIFICATION OF ENDOTHELIAL PROTEIN C RECEPTOR AND SCAVENGER RECEPTOR CLASS B TYPE 1 AS MAJOR AUTOANTIGENS IN TAKAYASU ARTERITIS

    Tsuyoshi Shirai, Tomoyuki Mutoh, Tomonori Ishii, Hiroshi Fujii, Hideo Harigae

    ANNALS OF THE RHEUMATIC DISEASES　78　437-438　2019/06

    DOI： 10.1136/annrheumdis-2019-eular.602 　

    ISSN： 0003-4967

    eISSN： 1468-2060

  5. 血管炎(大型血管炎)-3 生物学的製剤を使用した大型血管炎患者の検討 Peer-reviewed

    白井 剛志, 武藤 智之, 藤田 洋子, 藤井 博司, 石井 智徳, 平林 泰彦, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　63回　452-452　2019/03

    Publisher: (一社)日本リウマチ学会

  6. リウマチ性疾患の合併症-1 膠原病関連肺動脈性肺高血圧症における各種自己抗体別にみた長期予後の違いについての検討 Peer-reviewed

    城田 祐子, 白井 剛志, 藤井 博司, 小寺 隆雄, 亀岡 淳一, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　63回　465-465　2019/03

    Publisher: (一社)日本リウマチ学会

  7. ベーチェット病 血管ベーチェット病の臨床的特徴と治療内容の検討 Peer-reviewed

    佐藤 紘子, 星 陽介, 町山 智章, 鴨川 由起子, 藤田 洋子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　63回　561-561　2019/03

    Publisher: (一社)日本リウマチ学会

  8. 血管炎(大型血管炎)-3 生物学的製剤を使用した大型血管炎患者の検討

    白井 剛志, 武藤 智之, 藤田 洋子, 藤井 博司, 石井 智徳, 平林 泰彦, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　63回　452-452　2019/03

    Publisher: (一社)日本リウマチ学会

  9. リウマチ性疾患の合併症-1 膠原病関連肺動脈性肺高血圧症における各種自己抗体別にみた長期予後の違いについての検討

    城田 祐子, 白井 剛志, 藤井 博司, 小寺 隆雄, 亀岡 淳一, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　63回　465-465　2019/03

    Publisher: (一社)日本リウマチ学会

  10. ベーチェット病 血管ベーチェット病の臨床的特徴と治療内容の検討

    佐藤 紘子, 星 陽介, 町山 智章, 鴨川 由起子, 藤田 洋子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　63回　561-561　2019/03

    Publisher: (一社)日本リウマチ学会

  11. High Prevalence of Vascular Surgery and Autoimmune Comorbidity in Takayasu Arteritis

    Tsuyoshi Shirai, Tomoyuki Muto, Yuko Shirota, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　70　2018/09

    ISSN： 2326-5191

    eISSN： 2326-5205

  12. Autoantibodies and Clinical Outcomes in Pulmonary Arterial Hypertension Associated with Connective Tissue Diseases

    Yuko Shirota, Tomonori Ishii, Tsuyoshi Shirai, Hiroshi Fujii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　70　2018/09

    ISSN： 2326-5191

    eISSN： 2326-5205

  13. Comparative Analysis of the Macrophage Glycolytic Machinery in Giant Cell Arteritis (GCA) and in Coronary Artery Disease (CAD)

    Cornelia M. Weyand, Ryu Watanabe, Tsuyoshi Shirai, Hui Zhang, Gerald Berry, Jorg Goronzy

    ARTHRITIS & RHEUMATOLOGY　69　2017/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  14. Non-Randomized Controlled Trial to Evaluate the Effect of Extracorporeal Shock Wave Therapy on Digital Ulcers in Systemic Sclerosis

    Tomonori Ishii, Yasushi Kawaguchi, Osamu Ishikawa, Naruhiko Takasaawa, Takao Kodera, Hidekata Yasuoka, Yuichi Takahashi, Osamu Takai, Izaya Nakaya, Hiroshi Fujii, Yukiko Kamogawa, Yuko Shirota, Tsuyoshi Shirai, Yoko Fujita, Shinichiro Saito, Hiroaki Shimokawa, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　69　2017/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  15. Molecular Mechanism for the Therapeutic Effect of Extracorporeal Shock Wave Therapy on Digital Ulcers of Systemic Sclerosis

    Yukiko Kamogawa, Hiroshi Fujii, Tsuyoshi Shirai, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　69　2017/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  16. Four-Distinct Phenotypes of Patients with Necrotizing Arteritis of Medium and Small Arteries

    Tsuyoshi Shirai, Hiroshi Fujii, Yoko Fujita, Yuko Shirota, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　69　2017/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  17. 下顎骨骨炎が先行して発症した高安動脈炎の1例

    小嶋 郁穂, 阪本 真弥, 飯久保 正弘, 白井 剛志, 大田 英揮, 常陸 真, 村田 隆紀, 明石 敏昭, 笹野 高嗣

    歯科放射線　57　(増刊)　57-57　2017/05

    Publisher: (NPO)日本歯科放射線学会

    ISSN： 0389-9705

    eISSN： 2185-6311

  18. Establishment of a Powerful Method to Identify Autoantigens Expressed on the Cell Surface

    Tsuyoshi Shirai, Hiroshi Fujii, Tomoyuki Muto, Yuko Shirota, Yoko Fujita, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　68　2016/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  19. Bortezomib Treatment Induces Higher Mortality Rate in Lupus Model Mice with High Disease Activity

    Hiroshi Fujii, Tomoko Ikeda, Masato Nose, Tomoyuki Muto, Kanae Akita, Yukiko Kamogawa, Tsuyoshi Shirai, Yuko Shirota, Tomonori Ishii, Hideo Harigae

    ARTHRITIS & RHEUMATOLOGY　68　2016/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  20. 心室細動で発症し冠攣縮性狭心症と肺高血圧症を合併した好酸球性多発血管炎性肉芽腫症(EGPA)の1例

    紺野亮, 建部俊介, 杉村宏一郎, 青木竜男, 山本沙織, 矢尾板信裕, 佐藤遥, 神津克也, 羽尾清貴, 高橋潤, 中野誠, 福田浩二, 白井剛志, 杉浦久敏, 中嶋壮太, 石井智徳, 下川宏明

    日本循環器学会東北地方会(Web)　163rd　TOHOKU163,4 (WEB ONLY)　2016

  21. Enhanced Oxidant Signaling in Inflammatory Macrophages in Rheumatoid Arthritis (RA) and in Coronary Artery Disease (CAD)

    Tsuyoshi Shirai, Benedikt Schaefgen, Barbara Wallis, Eric L. Matteson, Themistocles L. Assimes, David G. Harrison, Jorg Goronzy, Cornelia M. Weyand

    ARTHRITIS & RHEUMATOLOGY　67　2015/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  22. Distinct Profiles of Proinflammatory Macrophages in Rheumatoid Arthritis and Coronary Artery Disease.

    Tsuyoshi Shirai, Eric L. Matteson, David G. Harrison, Barbara B. Wallis, Themistocles L. Assimes, Jorg J. Goronzy, Cornelia M. Weyand

    ARTHRITIS & RHEUMATOLOGY　66　S187-S187　2014/10

    ISSN： 2326-5191

    eISSN： 2326-5205

  23. FATE OF COLLAGEN DISEASE RELATED DIGITAL SKIN ULCERS TREATED ONLY UNDER CURRENTLY APPROVED THERAPIES: A CONTROL STUDY COMPARING WITH THE NEW SHOCKWAVE THERAPY TOWARD DIGITAL ULCERS OF SCLERODERMA

    S. Saito, Y. Kamogawa, K. Nakamura, R. Watanabe, Y. Fujita, T. Shirai, Y. Shirota, H. Fuji, T. Ishii, K. Ito, H. Shimokawa, H. Takemori, T. Konta, A. Komatsuda, T. Izumiyama, Y. Hirabayashi, Y. Sato, Y. Urata, Y. Kawaguchi, H. Harigae

    ANNALS OF THE RHEUMATIC DISEASES　73　568-569　2014/06

    DOI： 10.1136/annrheumdis-2014-eular.3064 　

    ISSN： 0003-4967

    eISSN： 1468-2060

  24. 9. 多剤併用療法に抵抗性のループス腎炎に免疫吸着法(Immunoadsorption Plasmapheresis)を施行した2例(一般演題,日本アフェレシス学会第23回東北アフェレーシス研究会抄録)

    鈴木 舞, 鴨川 由起子, 中村 恭平, 渡部 龍, 白井 剛志, 藤田 洋子, 城田 祐子, 藤井 博司, 齋藤 真一郎, 石井 智徳, 張替 秀郎

    日本アフェレシス学会雑誌　32　(3)　241-241　2013

    Publisher: 日本アフェレシス学会

    ISSN： 1340-5888

  25. A Novel Method for Quantitative and Functional Analysis of Autophagy Using Flow Cytometry in Activated Human Primary T Cells

    Ryu Watanabe, Hiroshi Fujii, Yukiko Kamogawa, Kyohei Nakamura, Tsuyoshi Shirai, Yumi Tajima, Shinichiro Saito, Tomonori Ishii, Hideo Harigae

    ARTHRITIS AND RHEUMATISM　64　(10)　S982-S983　2012/10

    ISSN： 0004-3591

  26. Retroviral Vector System Identified FLRT2 As a Novel Cell Surface Autoantigen Against Anti-Endothelial Cell Antibodies in Systemic Lupus Erythematosus.

    Tsuyoshi Shirai, Hiroshi Fujii, Masao Ono, Kyohei Nakamura, Ryu Watanabe, Yumi Sasaki, Naruhiko Takasawa, Tomonori Ishii, Hideo Harigae

    ARTHRITIS AND RHEUMATISM　63　(10)　S560-S561　2011/10

    ISSN： 0004-3591

  27. シェーグレン症候群 原発性シェーグレン症候群に合併した肺動脈性肺高血圧症(PAH)に対する免疫抑制療法 (日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集)

    中村恭平, 石井智徳, 田島結実, 白井剛志, 渡部龍, 藤井博司, 高澤徳彦, 張替秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　55回・20回　450-450　2011/06

  28. SLE SLEにおけるHBs抗体及びHBc抗体の保有率と免疫抑制療法の安全性 (日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集)

    渡部龍, 中村恭平, 白井剛志, 田島結実, 藤井博司, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　55回・20回　446-446　2011/06

  29. SLE SLE患者リンパ球におけるアンギオテンシンIIの作用解析 (日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集)

    田島結実, 中村恭平, 渡部龍, 白井剛志, 藤井博司, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　55回・20回　341-341　2011/06

  30. 自己抗体 レトロウイルスベクターシステムを用いた抗血管内皮細胞抗体対応自己抗原FLRT2の同定 (日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集)

    白井剛志, 藤井博司, 中村恭平, 渡部龍, 田島結実, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　55回・20回　320-320　2011/06

  31. Clinicopathological study of 12 cases with Churg-Strauss syndrome

    渡部龍, 白井剛志, 田島結実, 藤井博司, 高澤徳彦, 石井智徳, 張替秀郎, 鈴木直輝, 竪山真規, 糸山泰人

    臨床リウマチ　23　(1)　62-67　2011/03/30

    Publisher: The Japanese Society for Clinical Rheumatology and Related Research

    DOI： 10.14961/cra.23.62 　

    ISSN： 0914-8760

    More details Close

    To clarify the clinicopathological features of Churg-Strauss syndrome (CSS), we examined 12 cases that presented with clinical features described by Churg and Strauss and also fulfilled the cristeria of American college of rheumatology. Patients, 5 male and 7 female, were 51.8 years of mean age. Anti-neutrophil cytoplasmic antibody (ANCA) was positive in 7 cases (58%, MPOANCA in 6, PR3-ANCA in1). All patients had a medical history of bronchial asthma (BA). Various organ involvements such as mononeuritis multiplex (12 cases), skin (9 cases), sinusitis (8 cases), lung and heart (5 cases, respectively), sensory organ (4 cases), central nervous system (2 cases), and gastrointestinal tract and kidney (1case, respectively) were observed. ANCA positive patients had significantly higher prevalence of skin involvement than ANCA negative patients. We also observed a tendency of ANCA negative patients having a higher frequency of lung and heart lesion.<br>    Skin biopsy was performed in6cases.Extravascular infiltration of eosinophils was observed in all of them, but necrotizing vasculitis and extravascular granuloma, which is thought to be characteristic to CSS, was observed in only1case, respectively. Neural biopsy was done in 4 cases. Almost all the cases showed axonal degeneration and decrease of nerve fiber density, but no cases showed necrotizing vasculitis and extravascular granuloma.<br>    In conclusion, various types of organ involvement were observed in12cases with CSS, but typical pathological changes such as necrotizing vasculitis and extravascular granuloma were not common in CSS.

  32. 当科におけるChurg‐Strauss症候群12例の臨床病理学的検討

    渡部龍, 白井剛志, 田島結実, 藤井博司, 高澤徳彦, 鈴木直輝, 竪山真規, 糸山泰人, 石井智徳, 張替秀郎

    末梢神経　21　(2)　247-248　2010/12/01

    ISSN： 0917-6772

  33. 血管炎・APS 当科膠原病診療におけるPR3-ANCA陽性患者の検討 (日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集)

    白井剛志, 渡部龍, 田島結実, 藤井博司, 高澤徳彦, 石井智徳, 張替秀郎

    日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集　54回・19回　544-544　2010/03

  34. 当科におけるChurg‐Strauss症候群12例の臨床病理学的検討

    渡部龍, 白井剛志, 田島結実, 藤井博司, 高澤徳彦, 鈴木直輝, 竪山真規, 糸山泰人, 石井智徳, 張替秀郎

    日本末梢神経学会学術集会プログラム・抄録　21st　48　2010

Show all ︎Show first 5

Presentations 20

  1. Identification of two major autoantigens negatively regulating endothelial activation in Takayasu arteritis

    Tomoyuki Mutoh, Tsuyoshi Shirai, Tomonori Ishii, Yuko Shirota, Fumiyoshi Fujishima, Fumiaki Takahashi, Yoichi Kakuta, Yoshitake Kanazawa, Atsushi Masamune, Yoshikatsu Saiki, Hideo Harigae, Hiroshi Fujii

    Nature Communications　2020/12

  2. Serum and genetic biomarkers of Takayasu arteritis–which are truly useful? Invited

    Tsuyoshi Shirai

    26th Asia-Pacific League of Associations for Rheumatology Congress　2024/08/24

  3. Novel Autoantibodies in Takayasu Arteritis Suggest Gut-vessel Connection in Vascular Inflammation Invited

    Tsuyoshi Shirai

    The 88th Annual Scientific Meeting of the Japanese Circulation Society　2024/03/09

  4. 自己抗体から紐解く疾患の病理形態 Invited

    白井 剛志

    第112回日本病理学会総会　2023/04/14

  5. Endothelial Protein C Receptor and Scavenger Receptor Class B Type 1 Negatively Regulate Vascular Inflammation and Are Major Autoantigens in Takayasu Arteritis International-presentation

    Tomoyuki Mutoh, Tsuyoshi Shirai, Tomonori Ishii, Yuko Shirota, Hideo Harigae, Hiroshi Fujii

    American College of Rheumatology Annual Meeting 2019　2019/11/14

  6. 著明な倦怠感を認め、血小板低下を来した一例

    佐藤紘子, 永井泰地, 武藤智之, 町山智章, 鴨川由起子, 白井剛志, 藤井博司, 石井智徳, 張替秀郎

    第18回東北臨床免疫研究会　2019/08/24

  7. 膠原病関連肺動脈性高血圧症における各種自己抗体別にみた長期予後の違いについての検討

    城田祐子, 白井剛志, 藤井博司, 小寺隆雄, 亀岡淳一, 石井智徳, 張替秀郎

    2019/04/16

  8. 血管ベーチェット病の臨床的特徴と治療内容の検討

    佐藤紘子、星陽介、町山智章、鴨川由起子、藤田洋子、白井剛志、藤井博司、石井智徳、張替秀郎　2019/04/16

  9. 生物学的製剤を使用した大型血管炎患者の検討

    白井剛志, 武藤智之, 藤田洋子, 藤井博司, 石井智徳, 平林泰彦, 張替秀郎

    第63回日本リウマチ学会総会・学術集会 ワークショップ　2019/04/16

  10. Identification of endothelial protein C receptor and scavenger receptor class B type 1 as major autoantigens in Takayasu arteritis International-presentation

    Shirai T, Mutoh T, Fujii H, Ishii T, Harigae H

    EULAR 2019　2019

  11. Insufficient Use of Corticosteroids Results in Higher Relapse in Takayasu Arteritis International-presentation

    Tomoyuki Muto, Tsuyoshi Shirai, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    American College of Rheumatology Annual Meeting 2018　2018/10/23

  12. High Prevalence of Vascular Surgery and Autoimmune Comorbidity in Takayasu Arteritis International-presentation

    Tsuyoshi Shirai, Tomoyuki Muto, Yuko Shirota, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae

    American College of Rheumatology Annual Meeting 2018　2018/10/23

  13. 眼窩内腫瘤による視力及び眼球運動障害を呈した難治性多発血管炎性肉芽腫症(GPA)の一例

    桑田 亮, 城田 祐子, 石井 悠翔, 星 陽介, 藤田 洋子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　2018/03

  14. ベーチェット病における抗TNF製剤の有効性の検討

    佐藤 紘子, 星 陽介, 藤田 洋子, 白井 剛志, 城田 祐子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　2018/03

  15. 高安動脈炎における再燃率とリスク因子の検討

    武藤 智之, 白井 剛志, 藤田 洋子, 城田 祐子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　2018/03

  16. リウマチ性疾患の合併症(感染症以外・アミロイドーシス・その他)3:その他2 膠原病性肺動脈性肺高血圧症(CTD-PAH)における予後予測因子と死因について

    城田 祐子, 星 陽介, 佐藤 紘子, 藤田 洋子, 白井 剛志, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　2018/03

  17. 強皮症・MCTD・重複症候群1 全身性強皮症に伴う難治性皮膚潰瘍に対する低出力衝撃波療法の有効性・安全性検証試験

    石井 智徳, 川口 鎮司, 石川 治, 竹森 弘光, 高澤 徳彦, 小林 仁, 安岡 秀剛, 高橋 裕一, 小寺 隆雄, 高井 修, 中屋 来哉, 泉山 朋政, 齋藤 真一郎, 鴨川 由起子, 藤田 洋子, 白井 剛志, 城田 祐子, 藤井 博司, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　2018/03

  18. 血管炎2:大型血管炎の臨床研究 大型血管炎における合併症・併存症の検討

    白井 剛志, 武藤 智之, 城田 祐子, 藤井 博司, 石井 智徳, 張替 秀郎

    日本リウマチ学会総会・学術集会プログラム・抄録集　2018/03

  19. Four-Distinct Phenotypes of Patients with Necrotizing Arteritis of Medium and Small Arteries International-presentation

    Tsuyoshi Shirai, Hiroshi Fujii, Yoko Fujita, Yuko Shirota, Tomonori Ishii, Hideo Harigae

    American College of Rheumatology Annual Meeting 2017　2017/11/07

  20. Establishment of a Powerful Method to Identify Autoantigens Expressed on the Cell Surface International-presentation

    Tsuyoshi Shirai, Hiroshi Fujii, Tomoyuki Muto, Yuko Shirota, Yoko Fujita, Tomonori Ishii, Hideo Harigae

    American College of Rheumatology Annual Meeting 2016　2016/11/13

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Industrial Property Rights 2

  1. 炎症性腸疾患の診断方法、診断プローブ及び診断キット

    白井剛志, 藤井博司, 石井智徳, 張替秀郎ら

    Property Type: Patent

  2. 高安動脈炎の診断方法、診断マーカー及び診断キット

    白井剛志, 藤井博司, 石井智徳, 張替秀郎

    Property Type: Patent

Research Projects 5

  1. 共通病態を基盤とした高安動脈炎と潰瘍性大腸炎を包括する新規症候群の検討

    白井 剛志

    Offer Organization: 日本学術振興会

    System: 科学研究費助成事業

    Category: 基盤研究(C)

    Institution: 東北大学

    2021/04/01 - 2024/03/31

    More details Close

    高安動脈炎における腸内細菌叢異常の解析として、腸内細菌叢の次世代シークエンサーを用いたメタゲノム解析を行った。高安動脈炎患者からの糞便を検体とし、糞便よりDNAを抽出し精製、次世代シークエンサーを用いて、16S rDNA V3・4領域のシークエンスを行った。20検体を用いて、シークエンス解析を行い、Ribosomal database project (RDP)による帰属分類群の推定を行った。この結果を用いて、高安動脈炎における腸内細菌叢の解析を進めている。臨床検体との比較では、腸内細菌叢異常を伴う症例では、bacterial translocationが考慮される、血流感染を起こしやすい可能性が考慮された。 抗EPCR抗体の臨床的意義の解析のために、消化管疾患を対象とし、潰瘍性大腸炎、Crohn病をはじめとする炎症性腸疾患や大腸がんを含む非炎症性疾患での抗体価測定を行った。抗EPCR抗体は潰瘍性大腸炎の70%以上で認められ、Crohn病では大腸炎を呈する症例に認められれたが、他の非炎症性疾患では出現せず、大腸炎に関連する事が明らかになった。また、疾患活動性との相関も一部で認められている。 自己抗体の向炎症能解析として、抗EPCR/SR-BI抗体を血管内皮細胞と共培養することにより、血管内皮細胞機能への影響、直接的な細胞傷害性、アポトーシス誘導、免疫担当細胞への機能修飾を検討した。内皮細胞機能への影響として、血管内皮細胞に抗EPCR/SR-BI抗体を添加し、接着分子や前炎症性サイトカインを定量した。EPCRによる炎症抑制作用は様々な細胞においてみとめられ、組織特異的な現象について検討している。

  2. Development of a new rheumatoid arthritis monitoring method by analysis of anti-CCP antibody-producing B cell repertoire

    ISHII Tomonori

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (C)

    Institution: Tohoku University

    2017/04/01 - 2020/03/31

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    Abatacept was administered to 15 patients with rheumatoid arthritis who did not lose their activity despite existing treatment. Before treatment, peripheral blood was collected from patients and lymphocytes were separated from peripheral blood. Repertoire analysis of B cell receptor and T cell receptor was performed on the obtained lymphocytes. Abatacept was treated for more than three months in these patients. After treatment, a second repertoire analysis of B cells and T cells was performed and compared with the repertoire before treatment. Abatacept treatment was effective in 70% of patients. Specific T cell repertoire decreased before and after treatment in lymphocytes obtained from patients who responded to these treatments

  3. 解糖系酵素ピルビン酸キナーゼM2による炎症性疾患の制御 Competitive

    白井 剛志

    Offer Organization: 科研費

    System: 若手研究

    2018 - 2020

  4. 新規自己抗体による高安動脈炎の病態解明と臨床応用 Competitive

    白井 剛志

    Offer Organization: 科研費

    System: 研究活動スタート支援

    2016 - 2017

  5. 脳症を呈する膠原病患者における抗EphB2抗体の臨床的・病原的意義の解明 Competitive

    白井 剛志

    Offer Organization: 科研費

    System: 若手研究(B)

    2013 - 2015