Updated on 2024/02/01

写真a

 
Kunishige Tomoyuki
 
Affiliation
Nippon Medical School Hospital, Department of Ophthalmology, Associate Professor
Title
Associate Professor
External link

Papers

  • 眼内レンズ縫着術後の縫着糸による壊死性強膜炎の1例

    山岡 正卓, 五十嵐 勉, 有馬 武志, 國重 智之, 岩崎 優子, 高瀬 博, 高橋 浩

    あたらしい眼科   39 ( 2 )   235 - 238   2022.2

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    Language：Japanese   Publisher：(株)メディカル葵出版  

    緒言:左眼黄斑円孔に対して硝子体手術および眼内レンズ縫着術施行後、露出した縫着糸断端による強膜炎および強膜融解を発症した症例に対して強膜移植が有効であった1例を報告する。症例:80歳、女性。2010年、前医にて左黄斑円孔に対して硝子体手術および眼内レンズ縫着術を施行。2018年11月、左眼耳側の縫着糸断端の露出と周囲の強膜充血を認め抗菌薬点眼で加療するも、2019年2月、強膜融解、豚脂様角膜後面沈着物が認められた。抗菌点眼薬2剤、ステロイド点眼でいったん症状改善したが症状再燃し、強膜移植目的に日本医科大学付属病院眼科を紹介受診した。当科初診時、右眼視力(1.0)、左眼視力(0.4)、右眼眼圧14.5mmHg、左眼眼圧13.5mmHg。8月に融解強膜部位に保存強膜移植を施行した。術後、抗菌薬・ステロイド点眼、およびステロイド内服30mgから漸減投与にシクロスポリン100mg内服を併用、1年後シクロスポリン50mgのみでグラフトは生着良好で経過している。結論:眼内レンズ縫着後に発症した強膜融解に保存強膜移植は有効であった。(著者抄録)

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    Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J01784&link_issn=&doc_id=20220224170020&doc_link_id=%2Fah9atgke%2F2022%2F003902%2F021%2F0235b0238%26dl%3D3&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah9atgke%2F2022%2F003902%2F021%2F0235b0238%26dl%3D3&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_4.gif

  • Statistical Analysis of Factors Affecting Surgically Induced Astigmatism Following Trabeculectomy. International journal

    Naka Shiratori, Kenji Nakamoto, Yusuke Nishio, Yasuko Takano, Takeshi Arima, Tomoyuki Kunishige, Hisaharu Suzuki, Tsutomu Igarashi, Hiroshi Takahashi

    Clinical ophthalmology (Auckland, N.Z.)   16   3833 - 3839   2022

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    Language：English   Publishing type：Research paper (scientific journal)  

    PURPOSE: To objectively evaluate surgically induced astigmatism (SIA) after trabeculectomy with mitomycin C and investigate the relationships between SIA and various factors. PATIENTS AND METHODS: This retrospective study included the right eyes of 66 consecutive patients who underwent standard trabeculectomy performed in the superior temporal quadrant for the first time by a single surgeon. Keratometry recordings made before surgery and 3 months after surgery were collected to calculate the SIA in each patient. The arithmetic mean of SIA (M-SIA) and the centroid of SIA (C-SIA) were determined using vector analysis. The relationships between the magnitude of SIA and the following possible related factors were assessed: age, sex, pre-operative corneal astigmatism, pre-operative intraocular pressure (IOP), 3-month postoperative IOP, pre-operative best-corrected visual acuity (BCVA), 3-month postoperative BCVA, the number of total scleral flap sutures (T-SFS), the number of leftover scleral flap sutures without laser suture lysis at 3 months postoperatively (L-SFS), shape of the scleral flap (triangle or trapezoid), and incision type of the conjunctival flap (fornix- or limbal-based). RESULTS: The mean (± standard deviation) M-SIA was 1.00 ± 0.85 D, and the mean C-SIA was 0.34 ± 1.28 D at 104°. The direction of C-SIA showed a trend of corneal steepening to the superior temporal location, in the direction of the scleral flap location. There were significant correlations of the magnitudes of SIA with the number of T-SFS (P = 0.001) and the number of L-SFS (P < 0.001). CONCLUSION: Trabeculectomy induced SIA in the direction of the scleral flap location, and scleral sutures are significantly associated with the SIA. The scleral suture may play a key role in steepening the cornea toward the scleral flap direction in post-trabeculectomy patients.

    DOI： 10.2147/OPTH.S389480

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  • Changes in Tear Osmolarity after Cataract Surgery

    Tsutomu Igarashi, Hisatomo Takahashi, Maika Kobayashi, Tomoyuki Kunishige, Takeshi Arima, Chiaki Fujimoto, Hisaharu Suzuki, Takahisa Okuda, Hiroshi Takahashi

    Journal of Nippon Medical School   88 ( 3 )   204 - 208   2021.6

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：Medical Association of Nippon Medical School  

    BACKGROUND: The purpose of this study was to examine changes in the ocular surface before and after phacoemulsification with small incisions and to examine the changes in tear osmolarity. METHODS: This was a prospective, observational study involving 55 eyes of 39 patients (19 male, 20 female patients; average age 72.0±7.3 years) who had cataract surgery at a Nippon Medical School Hospital between December 2013 and June 2018. Compromised tear dynamics were determined by the Schirmer test or the tear break-up time (BUT). An abnormal ocular surface was identified by positive vital staining with fluorescein or lissamine green. Moreover, tear osmolarity (Tosm) and corneal sensitivity were measured. All assessments were done preoperatively and 1 and 4 weeks (P1W and P4W) after the surgery. RESULTS: None of the operations had any complications. Operating time was 17.8±9.3 minutes. BUT was significantly decreased at P1W, and it recovered at P4W. The Schirmer test did not change significantly. The fluorescein staining score (FSS) increased significantly at P1W and recovered at P4W. The Lissamine green score (LSS) did not change significantly. Tear osmolarity increased significantly at P1W and did not recover at P4W. Corneal sensitivity decreased significantly at P1W and recovered at P4W. CONCLUSION: In the present study, there were temporary changes in dry eye-related examinations including tear osmolarity after cataract surgery. In particular, tear osmolarity increased significantly 4 weeks after surgery compared to before surgery, and it showed long-term changes, unlike other factors. After cataract surgery, tear osmolarity, BUT, and FSS increase, resulting in dry eye symptoms. Therefore, it is necessary to pay attention to discomfortable eye symptoms of patients after cataract surgery.

    DOI： 10.1272/jnms.jnms.2021_88-405

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  • iStent術後高眼圧に対して硝子体手術が有効であった落屑緑内障の1例

    加藤 脩太郎, 五十嵐 勉, 中元 兼二, 白鳥 宙, 長野 瑛里子, 新井 淑子, 國重 智之, 小野 眞史, 高橋 浩

    日本緑内障学会抄録集   31回   93 - 93   2020.10

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    Language：Japanese   Publisher：日本緑内障学会  

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  • Evaluation of the Utility of Capsular Stabilization Devices in a Zonular Fiber Defect Model with the Slit Side View System Reviewed

    Tomoyuki Kunishige, Hisaharu Suzuki, Yuji Nakano, Tsutomu Igarashi, Hiroshi Takahashi

    Journal of Ophthalmology   2020   1 - 4   2020.8

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    Publishing type：Research paper (scientific journal)   Publisher：Hindawi Limited  

    Capsular stabilization devices were evaluated in a zonular fiber defect model using the slit side view (SSV) system to confirm their utility for capsular stabilization during phacoemulsification. A zonular fiber defect model was made by cutting Zinn’s zonule under observation with a slit lamp microscope in a porcine eye. Phacoemulsification was performed, and the movement of the lens capsule and the depth of the anterior chamber were observed using the SSV in three groups: control group: no surgical instruments used, CE group: a capsule expander was inserted, and CTR group: a capsular tension ring was inserted. In the control group, the equator of the lens was unstable and was easily suctioned to the port of the ultrasound handpiece. The lens capsule was stable in both in the CE and CTR groups. In the CTR group, the equator responsible for the zonular rupture also returned and closed true to its original position. The utility of the capsular stabilization devices in this zonular fiber defect model was confirmed with the SSV system.

    DOI： 10.1155/2020/5921965

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    Other Link： http://downloads.hindawi.com/journals/joph/2020/5921965.xml

  • Early Experience with Two Techniques of Intrascleral Intraocular Lens Fixation Reviewed

    Tomoyuki Kunishige, Hiroshi Takahashi

    Journal of Nippon Medical School   87 ( 3 )   138 - 141   2020.6

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    Publishing type：Research paper (scientific journal)   Publisher：Medical Association of Nippon Medical School  

    DOI： 10.1272/jnms.jnms.2020_87-304

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  • Immune Checkpoints Contribute Corneal Immune Privilege: Implications for Dry Eye Associated with Checkpoint Inhibitors Reviewed

    Junko Hori, Tomoyuki Kunishige, Yuji Nakano

    Int. J. Mol. Sci.   21 ( 11 )   3962   2020.5

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  • 一卵性双生児のTINUとさらに妹にもぶどう膜炎を発症した小児ぶどう膜炎の3姉妹

    武田 彩佳, 國重 智之, 山崎 将志, 木村 彩香, 西尾 侑祐, 仲野 裕一郎, 堀 純子

    日本眼科学会雑誌   124 ( 臨増 )   243 - 243   2020.3

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    Language：Japanese   Publisher：(公財)日本眼科学会  

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  • VISTA Is Crucial for Corneal Allograft Survival and Maintenance of Immune Privilege. Reviewed International journal

    Kunishige T, Taniguchi H, Ohno T, Azuma M, Hori J

    Investigative Ophthalmology & Visual Science   60 ( 15 )   4958 - 4965   2019.12

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    Language：English   Publishing type：Research paper (scientific journal)  

    PURPOSE: V-domain immunoglobulin suppressor of T cell activation (VISTA) is a novel immune checkpoint receptor and ligand for regulating T cell proliferation and cytokine production. The purpose of the present study was to determine the role of VISTA in the immune privilege of corneal allografts. METHODS: Expression of VISTA mRNA in mouse eyes was assessed with reverse-transcription PCR. Corneas of C57BL/6 mice were orthotopically transplanted into the eyes of BALB/c wild-type recipients treated with anti-VISTA mAb, and graft survival was assessed. A separate set of BALB/c mice treated with anti-VISTA mAb or rat IgG received injection of C57BL/6 splenocytes into the anterior chamber, and induction of allospecific anterior chamber-associated immune deviation (ACAID) was assessed. CD4+ and CD8+ T cells in the spleen were assessed with flow cytometry. RESULTS: VISTA mRNA was constitutively expressed in the cornea, and the expression of VISTA was localized to CD11b+ cells on the corneal stroma. Survival of allografts treated with anti-VISTA mAb was less than that of the control. ACAID was induced less efficiently in BALB/c mice treated with VISTA mAb. The proportions of CD8+ T cells and CD8+ CD103+ T cells (CD8+ T regulatory cells) in the spleen of BALB/c mice treated with anti-VISTA mAb were significantly lower than those of the control. CONCLUSIONS: VISTA may play an essential role in the acceptance of corneal allografts via involvement with allospecific ACAID, which suppresses T cell infiltration into the cornea.

    DOI： 10.1167/iovs.19-27322

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  • Vogt-小柳-原田病の再発と治療内容に関する検討 Reviewed

    白鳥 宙, 国重 智之, 由井 智子, 堀 純子

    あたらしい眼科   35 ( 5 )   698 - 702   2018.5

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    Language：Japanese   Publisher：(株)メディカル葵出版  

    Vogt-小柳-原田病(VKH)の再発率、再発部位、再発時の治療内容について観察した。2008年1月〜2016年8月に日本医科大学付属病院眼科を受診したVKH患者(n=33)を対象に、診療録より後ろ向きに検討した。初診時の状態は、初発例が24例、再発例が1例、遷延例が4例、他院で加療後の経過観察が4例であった。治療経過中の再発は初発例の24例中6例(25.0%)、再発・遷延例の5例中4例(80%)に認め、再発・遷延例では再発を繰り返す症例が高頻度であった。再発部位は前眼部型6例、後眼部型4例であった。前眼部型に対しては2例を除いてステロイドの眼局所療法が有効であった。後眼部型に対してはステロイドとシクロシポリンの併用や、アダリムマブが有効であった。(著者抄録)

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    Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01784&link_issn=&doc_id=20180605200028&doc_link_id=%2Fah9atgke%2F2018%2F003505%2F027%2F0698-0702%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah9atgke%2F2018%2F003505%2F027%2F0698-0702%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 硝子体液IL-6の高値により診断に苦慮した眼内原発悪性リンパ腫の一例

    窪倉 真樹子, 由井 智子, 國重 智之, 堀 純子

    日本眼科学会雑誌   122 ( 臨増 )   290 - 290   2018.3

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    Language：Japanese   Publisher：(公財)日本眼科学会  

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  • Protective Role of ICOS and ICOS Ligand in Corneal Transplantation and in Maintenance of Immune Privilege Reviewed

    Tomoyuki Kunishige, Hiroko Taniguchi, Misao Terada, Hisaya Akiba, Hideo Yagita, Ryo Abe, Junko Hori

    INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   57 ( 15 )   6815 - 6823   2016.12

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

    PURPOSE. The interaction between the inducible costimulatory molecule (ICOS) and ICOS ligand (ICOSL) has been implicated in the differentiation and functions of T cells. The purpose of the present study was to determine the role of ICOS-ICOSL in the immune privilege of corneal allografts.
    METHODS. Expression of ICOS and ICOSL mRNA from mouse eyes was assessed by RT-PCR. Corneas of C57BL/6 mice were orthotopically transplanted into the eyes of ICOS-/- BALB/c recipients and BALB/c wild-type (WT) recipients treated with anti-ICOSL mAb, and graft survival was assessed. A separate set of WT and ICOS-/- BALB/c mice received an anterior chamber injection of C57BL/6 splenocytes, and induction of allospecific anterior chamber-associated immune deviation (ACAID) was assessed. In vitro, cornea was incubated with T cells from WT and ICOS-/- BALB/c mice, and destruction of corneal endothelial cells (CECs) and the population of Foxp3(+) CD25(+) CD4(+) T cells was assessed.
    RESULTS. Inducible costimulatory molecule ligand mRNA was constitutively expressed in the cornea, iris-ciliary body, and retina. Allograft survival in ICOS-/- recipients and WT recipients treated with anti-ICOSL mAb was significantly shorter than in control recipients. Anterior chamber-associated immune deviation was induced less efficiently in ICOS-/- mice. Destruction of CECs by alloreactive ICOS-/- T cells was enhanced compared with WT T cells. After coincubation with allogeneic corneal tissue, the proportion of regulatory T cells was significantly greater among WT T cells than in ICOS-/- T cells.
    CONCLUSIONS. The expression of ICOSL in the cornea and the ICOS-mediated induction of Foxp3(+) CD4(+) regulatory T cells may contribute to successful corneal allograft survival.

    DOI： 10.1167/iovs.16-20644

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  • 【眼の免疫学】 角膜移植後免疫応答にみる眼内微小環境の特殊性

    國重 智之, 堀 純子

    医学のあゆみ   256 ( 13 )   1259 - 1261   2016.3

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    Language：Japanese   Publisher：医歯薬出版(株)  

    眼には過剰な炎症を自動制御し組織の恒常性を維持する免疫特性があり、この性質は従来から免疫特権(immune privilege)とよばれている。角膜移植の高い生着率も免疫特権の恩恵である。近年、角膜移植モデルを用いることで、免疫特権の分子機構が解明されつつある。角膜から前房、虹彩にかけて多くの免疫制御因子が発現し、免疫抑制性眼内微小環境が維持されていることは、免疫特権の重要な機序のひとつと考えられている。免疫抑制性眼内微小環境を維持する分子のなかでもFas ligand、B7H1、GITR ligand、Galectin-9などは、エフェクターT細胞へのアポトーシス、制御性T細胞の誘導などを介して、それぞれ眼内の免疫抑制に大きく寄与し、角膜移植片の生着に必須な分子と考えられている。(著者抄録)

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  • [Incidence of endogenous intraocular inflammation patients who visited Nippon Medical School Hospital during the 8 years from 2004 to 2012]. Reviewed

    Serizawa M, Kunishige T, Ito Y, Tsukada R, Hori J

    Nippon Ganka Gakkai zasshi   119 ( 5 )   347 - 353   2015.5

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  • 眼内浸潤と脳播種を生じた眼窩先端部原発多クローン性リンパ増殖性腫瘍の1例 Reviewed

    久保田大紀, 國重智之, 芹澤元子, 山口文雄, 濱田泰子, 福永景子, 山口博樹, 堀 純子

    Journal of the Eye   32 ( 5 )   733 - 737   2015

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  • Immune privilege as new therapeutic strategies for success of corneal transplantation. Invited Reviewed

    Tomoyuki Kunishige

    Inflammation and Regeneration   2013.11

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    Language：English   Publishing type：Research paper (scientific journal)  

    DOI： 10.2492/inflammregen.33.274

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  • 感染症と免疫 眼表面の免疫特権 Reviewed

    Kunishige T, Hori J

    臨床眼科   66 ( 11 )   346 - 350   2012.10

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    Language：Japanese  

    DOI： 10.11477/mf.1410104491

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  • Mometasone Furoate Nasal Spray Relieves the Ocular Symptoms of Seasonal Allergic Rhinoconjunctivitis Reviewed

    Tsutomu Igarashi, Yuri Nakazato, Tomoyuki Kunishige, Miho Fujita, Yumi Yamada, Chiaki Fujimoto, Kimihiro Okubo, Hiroshi Takahashi

    JOURNAL OF NIPPON MEDICAL SCHOOL   79 ( 3 )   182 - 189   2012.6

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

    Background: Recent studies have examined the effects of intranasal corticosteroids (INSs) in relieving the ocular symptoms of seasonal allergic rhinoconjunctivitis (SAR) and perennial allergic rhinitis. However, because most of these studies were based on subjective assessments by patients, the associated factors and mechanism of action are unknown.
    Methods: A single-center, randomized, double-blind, parallel-group study was carried out in which patients with SAR were randomly assigned to an INS mometasone furoate nasal spray (MFNS) group or to a placebo group and treated once daily for 4 weeks. Substance P concentrations in tears were measured, ocular and nasal symptoms were recorded by patients in an allergy diary, and findings were recorded by an ophthalmologist.
    Results: There was no significant difference between treatment groups in the mean change from baseline of substance P concentration in tears after 4 weeks of treatment, but the mean change tended to increase in the placebo group and tended to decrease in the MFNS group (P = 0.089). All ocular and nasal symptom scores, except eye tearing, were significantly lower in the MFNS group than in the placebo group. Furthermore. substance P concentrations were strongly correlated with ocular and nasal symptom scores.
    Conclusions: In patients with SAR. INSs tend to decrease the substance P concentration in tears, which is correlated with the severity of ocular and nasal symptoms. (J Nippon Med Sch 2012; 79: 182-189)

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  • HLA-A26陽性であったBehcet病の1例

    亦野 蓉子, 船坂 陽子, 国重 智之, 堀 純子, 川名 誠司

    皮膚臨床   54 ( 5 )   707 - 711   2012.5

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  • Cortical blindness caused by hypoxemia following an asthma attack Reviewed

    Tomoyuki Kunishige, Ataru Omori, Amane Tateno, Noriaki Yahata, Junko Hori

    JAPANESE JOURNAL OF OPHTHALMOLOGY   55 ( 5 )   588 - 590   2011.9

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    Language：English   Publishing type：Thesis (other)   Publisher：SPRINGER TOKYO  

    DOI： 10.1007/s10384-011-0058-7

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Misc.

  • Expression of T cell/transmembrane, immunoglobulin, and mucin (TIM)-4 in normal cornea and corneal grafts Reviewed

    Takeda Ayaka, Taniguchi Hiroko, Kunishige Tomoyuki, Akiba Hisaya, Yagita Hideo, Hori Junko

    INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   59 ( 9 )   2018.7

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  • アダリムマブが著効した間質性腎炎ぶどう膜炎症候群の一卵性双生児

    武田 彩佳, 国重 智之, 五十嵐 徹, 堀 純子

    日本眼科学会雑誌   122 ( 臨増 )   258 - 258   2018.3

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    Language：Japanese   Publisher：(公財)日本眼科学会  

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  • Clinical statistics for recurrence of Vogt-Koyanagi-Harada disease

    Naka Shiratori, Tomoyuki Kunishige, Junko Hori

    INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   57 ( 12 )   2016.9

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    Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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  • Expression of ICOS and Foxp3 on T cells infiltrating in corneal allografts Reviewed

    Taniguchi Hiroko, Kunishige Tomoyuki, Akiba Hisaya, Yagita Hideo, Abe Ryo, Hori Junko

    INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   57 ( 12 )   2016.9

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  • Role of V-domain Ig suppressor of T cell activation (VISTA) in Anterior Chamber Associated Immune Deviation

    Tomoyuki Kunishige, Hiroko Taniguchi, Tatsukuni Ohno, Mlyuki Azuma, Junko Hori

    INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   57 ( 12 )   2016.9

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    Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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  • 間質性腎炎ぶどう膜炎症候群(TINU)を同時期に発症した一卵性双生児の症例

    南 想, 国重 智之, 五十嵐 徹, 堀 純子

    日本眼科学会雑誌   120 ( 臨増 )   283 - 283   2016.3

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  • 難治性強膜炎における免疫抑制剤と生物学的製剤の治療成績

    白鳥宙, 由井智子, 国重智之, 堀純子

    日本眼感染症学会・日本眼炎症学会・日本コンタクトレンズ学会総会・日本涙道・涙液学会プログラム・講演抄録集   53rd-50th-59th-5th   2016

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  • 半円式CCCマーカーの教育的効果の検討

    有馬 武志, 鈴木 久晴, 岩間 真由美, 國重 智之, 志和 利彦, 高橋 浩

    IOL & RS   29 ( 4 )   533 - 538   2015.12

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    Language：Japanese   Publisher：(株)杏林舎内「IOL&RS」編集事務局  

    目的:白内障手術を習得中のレジデントにとってcontinuous curvilinear capsulorhexis(CCC)の作成は大きな関門である。今回、我々はCCC作成時に半円式CCCマーカーを用いてレジデントに対する教育的効果を比較検討した。対象と方法:白内障手術経験100例程度である術者Aおよび20例程度である術者Bが手術を施行した。CCC作成の前に半円式CCCマーカーを用いて水晶体に直接圧痕をつけることでマーキングした場合をM群、用いなかった場合をN群とした。症例数はAでM群:12眼、N群:12眼、BでM群23眼、N群25眼とした。評価法としてはマーカーの有無によるCCCの直径、ばらつき、眼内レンズ(IOL)に対するコンプリートカバー率をそれぞれ比較した。直径の計測は手術画面よりIOL直径との比率により算出した。結果:CCCの直径平均は術者AにおいてM群:5.02±0.20mm、N群:5.14±0.41mm、術者BではM群:4.72±0.33mm、N群:4.71±0.49mmであり両術者ともに両群間で直径に有意差はなかったが、M群の方が、有意にばらつきが少なかった(F検定:p&lt;0.05)。コンプリートカバー率では術者A、Bともに有意差は認めなかったが、M群の方が高い傾向を認めた。結論:半円式CCCマーカーは安定したCCC作成に有用であり、教育面でも有用であることが示唆された。(著者抄録)

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  • 尿細管間質性腎炎ぶどう膜炎症候群にHLA A26とB51陽性及びMEFV遺伝子変異とCIAS1遺伝子変異をもつ姉妹例

    五十嵐 徹, 清水 章, 山西 慎吾, 田辺 雄次郎, 竹下 輝, 尾崎 優介, 堀 純子, 小野 眞史, 國重 智之, 宮前 多佳子, 川本 学, 猪狩 直之, 柳原 剛, 伊藤 保彦

    日本小児リウマチ学会総会・学術集会プログラム・抄録集   25回   114 - 114   2015.10

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  • Mechanisms of V-domain Ig suppressor of T cell activation (VISTA)-mediated acceptance of corneal allografts

    Tomoyuki Kunishige, Hiroko Taniguchi, Tatsukuni Ohno, Miyuki Azuma, Junko Hori

    INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   56 ( 7 )   2015.6

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    Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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  • V-domain Ig Suppressor of T Cell Activation (VISTA) is Necessary for Corneal Allograft Survival

    Tomoyuki Kunishige, Hiroko Taniguchi, Tatsukuni Ohno, Miyuki Azuma, Junko Hori

    INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE   54 ( 15 )   2013.6

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  • 線維柱帯切除術後の毛様体解離が疑われた低眼圧黄斑症の1例

    仲里 ゆり, 南野 麻美, 鈴木 久晴, 国重 智之, 若山 久仁子, 高橋 浩

    眼科手術   25 ( 4 )   583 - 586   2012.10

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    Language：Japanese   Publisher：(公社)日本眼科手術学会  

    背景:線維柱帯切除術直後からの難治性低眼圧により低眼圧黄斑症を生じ、強膜毛様体縫合術により改善した1例を経験した。症例:原発開放隅角緑内障の40歳、男性。薬物治療にて眼圧コントロール不良(術前眼圧39mmHg)となり、線維柱帯切除術を施行した。術後、前房は深く濾過胞形成は良好で漏出も認めなかったが、術後3日目より低眼圧(2mmHg)となり低眼圧黄斑症を呈するに至った。強膜弁再縫合術を2回施行したが眼圧は上昇せず、毛様体解離を疑い線維柱帯切除術後33日目に強膜弁下の周辺虹彩切除部から、直視下で通糸して強膜毛様体縫合術を行った。翌日より眼圧は10mmHgと安定し、低眼圧黄斑症は徐々に改善した。結論:線維柱帯切除術後の毛様体解離が原因と考えられる遷延性低眼圧に対し、強膜弁下の虹彩切除部から直視下で通糸する強膜毛様体縫合術は有効である可能性がある。(著者抄録)

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  • 白内障術後のNocardia感染による結膜下膿瘍の1例

    芹澤 元子, 國重 智之, 高橋 浩

    臨床眼科   66 ( 10 )   1515 - 1518   2012.10

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    Language：Japanese   Publisher：(株)医学書院  

    目的:白内障手術後にNocardia属放線菌により球結膜下膿瘍が発症した症例の報告。症例:64歳男性が5週前に近医で右眼の白内障手術を受けた。強角膜切開,超音波乳化吸引術,眼内レンズ挿入が行われ,経過は良好であったという。3週後に充血,眼脂,疼痛が右眼に生じ,その2週後に当科に紹介された。所見と経過:矯正視力は右1.0,左1.2で,右眼に充血と眼脂のほか,手術切開創が離解し,結膜下膿瘍が多発していた。前房には炎症の所見がなく,眼底も正常であった。術後感染症を疑い,4種類の抗菌薬の点眼と,抗真菌薬の点眼と内服を開始した。初診から9日後に手術創から採取した検体からNocardia spp.が培養された。トブラマイシンに感受性があり,これを中心とする治療に切り替えた。初診から14日後に結膜下膿瘍は消退をはじめ,手術切開創は閉鎖し,2ヵ月後に治癒した。結論:白内障術後に,放線菌であるNocardiaによる球結膜下膿瘍が発症することがある。(著者抄録)

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  • CASE REPORTS : HLA-A26-Positive Behcet's Disease

    54 ( 6 )   859 - 862   2012.6

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  • 季節性アレルギー性鼻結膜炎患者に対するMometasone Furoateの眼症状改善効果の検討

    仲里 ゆり, 五十嵐 勉, 國重 智之, 藤田 美穂, 山田 佑美, 藤本 千明, 大久保 公裕, 高橋 浩

    アレルギー   60 ( 3-4 )   485 - 485   2011.4

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  • 白内障手術後のPaecilomyces lilacinus角膜炎・眼内炎の1例

    稲毛 道憲, 鈴木 久晴, 國重 智之, 小野 眞史, 高橋 浩

    あたらしい眼科   26 ( 8 )   1108 - 1112   2009.8

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    Language：Japanese   Publisher：(株)メディカル葵出版  

    緒言:白内障手術後のPaecilomyces lilacinus角膜炎・眼内炎の1例を経験した。症例:74歳、女性。平成19年9月19日、近医にて左眼超音波乳化吸引術+眼内レンズ挿入術を施行した。翌日より虹彩炎を認め、ステロイド、抗菌薬の投与にて一時的に改善した。その後再燃し、角膜炎も出現し増悪したため、11月15日に当科紹介入院となった。初診時、左眼視力5cm指数弁、角膜潰瘍、角膜混濁、前房蓄膿を認め、抗菌薬、抗ヘルペス薬、抗真菌薬を投与したが角膜潰瘍は拡大した。入院12日目、手術創部擦過標本の培養検査よりPaecilomyces lilacinusが検出されたため、ボリコナゾールの全身、局所投与したが改善せず、創部付近の強膜菲薄化も進んだため、入院33日目、全層角膜移植、眼内レンズ摘出、硝子体手術、眼内洗浄、強膜被覆術を施行した。その後、感染は鎮静化し移植片は生着したが、眼球癆の状態となった。結論:Paecilomyces lilacinus角膜炎・眼内炎はきわめて難治であり、速やかな診断と手術的治療が必要である。(著者抄録)

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  • 正常眼圧白内障手術における角膜侵襲評価

    鈴木 久晴, 大木 孝太郎, 国重 智之, 稲毛 道憲, 若山 久仁子, 志和 利彦, 高橋 浩

    日本眼科学会雑誌   112 ( 9 )   815 - 815   2008.9

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  • 角膜移植後ヘルペスウイルス感染による遷延性角膜上皮欠損を繰り返した1例

    國重 智之, 鈴木 久晴, 小野 眞史, 高橋 永幸, 平岡 美紀, 高橋 浩

    臨床眼科   62 ( 8 )   1323 - 1326   2008.8

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    Language：Japanese   Publisher：(株)医学書院  

    目的:遷延性角膜上皮欠損に対し複数回の全層角膜移植が行われ,最終的にヘルペスの治療で治癒した症例の報告。症例:78歳男性が,4年前の白内障手術後に生じた右眼の水疱性角膜症で受診した。矯正視力は右指数弁,左1.0であった。右眼に水疱性角膜症,角膜の上皮欠損と混濁があった。経過:全層角膜移植を行ったが移植片が融解し,4ヵ月後に再移植が行われた。再び移植片が融解し,その2ヵ月後に3回目の移植,さらにその5ヵ月後に表層角膜移植が行われた。角膜上皮欠損に対する羊膜被覆術は奏効せず,羊膜が融解した。ヘルペス感染を疑い,初診から23ヵ月後にアシクロビル点眼を開始し,4回目の角膜全層移植を行った。上皮欠損はなく,角膜は透明で,視力は0.05に回復した。結論:角膜全層移植に抵抗する遷延性角膜上皮欠損にはヘルペス感染が関与している可能性がある。(著者抄録)

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Research Projects

  • 眼免疫特権に寄与する分子群と制御性T細胞の解析および移植と眼炎症疾患治療への展開

    Grant number：20K09813  2020.4 - 2023.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    堀 純子, 武田 彩佳, 國重 智之

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    Grant amount：\4290000 （ Direct Cost: \3300000 、 Indirect Cost：\990000 ）

    眼内免疫抑制性微少環境の維持と制御性 T細胞の誘導に関与する可能性のある免疫チェックポイントであるTIM4分子とICOS分子の眼炎症制御機構の解析を計画どおりに実施した。
    TIM4については、昨年度に引き続きマウス角膜アログラフトモデルを用いた宿主免疫応答の解析として、アログラフト生着曲線とアロ抗原特異的末消性免疫寛容（前房関連免疫偏位：ACAID）誘導について抗TIM４抗体投与群と対照群で比較した。その結果、アログラフト生着は抗TIM４抗体投与群において低下する傾向があった。
    ICOSについては、ICOS-KOマウスと野生型マウスのマウス角膜に11-0ナイロン糸を縫合し血管リンパ管新生を誘導するモデルを用いて、共焦点顕微鏡下で角膜血管リンパ管の増生、Foxp3陽性CD4陽性T細胞（制御性T細胞）の浸潤を解析したほか、角膜内の血管新生誘導因子やサイトカインを網羅的にタンパク量解析し、ICOS-KOマウスと野生型マウスで比較した。その結果、ICOS-KOマウスの角膜は、野生型マウスの角膜に比較して、角膜血管リンパ管の増生が有意に多く、一方、制御性T細胞の浸潤は少なかった。また、ICOS-KOマウスの角膜は、野生型マウスの角膜に比較して、VEGF-A, CCR2など血管新生誘導因子のタンパクが多く発現していた。

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  • Contribution of VISTA molecules to corneal transplantation and immune privilege

    Grant number：20K18362  2020.4 - 2023.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Early-Career Scientists

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    Grant amount：\4030000 （ Direct Cost: \3100000 、 Indirect Cost：\930000 ）

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  • Analysis of ocular immune checkpoints to develop new therapy for transplantation and inflammatory diseases in the eye

    Grant number：17K11493  2017.4 - 2020.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    Hori Junko

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    Grant amount：\4680000 （ Direct Cost: \3600000 、 Indirect Cost：\1080000 ）

    V-domain immunoglobulin suppressor of T-cell activation (VISTA) is a novel immune checkpoint receptor and ligand for regulating T cell proliferation and cytokine production. VISTA mRNA was constitutively expressed in the cornea, and the expression of VISTA was localized to CD11b+ cells on the corneal stroma. Corneas of C57BL/6 mice were orthotopically transplanted into the eyes of BALB/c wild-type recipients treated with anti-VISTA mAb. Survival of allografts treated with anti-VISTA mAb was less than that of the control. ACAID was induced less efficiently in BALB/c mice treated with VISTA mAb. The proportions of CD8+ T cells and CD8+ CD103+ T cells (CD8+ T regulatory cells) in the spleen of BALB/c mice treated with anti-VISTA mAb were significantly lower than those of the control. Thus, VISTA play an essential role in the acceptance of corneal allografts via involvement with allo-specific ACAID, which suppresses T cell infiltration into the cornea.

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  • Role of ICOS on Corneal Lymphangiogenesis

    Grant number：15K20290  2015.4 - 2017.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Young Scientists (B)

    Kunishige Tomoyuki

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    Grant amount：\3770000 （ Direct Cost: \2900000 、 Indirect Cost：\870000 ）

    Interaction between the inducible costimulatory molecule (ICOS) and its ligand, B7-related protein (B7RP-1), has been reported to have an impact on differentiation and functions of various T regulatory cells. The purpose of the present study is to further investigate the role of ICOS on inflammatory lymphoangiogeneisis in the cornea and its mechanisms.

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  • Immune regulation for tissue transplantation and regeneration in the eye

    Grant number：26462700  2014.4 - 2017.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    Hori Junko, Azuma Miyuki, Abe Ryo, Yagita Hideo, Akiba Hisaya

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    Grant amount：\4810000 （ Direct Cost: \3700000 、 Indirect Cost：\1110000 ）

    ICOS and ICOS-ligand (ICOSL) have been reported to have an impact on differentiation and functions of various T cells. ICOSL mRNA is constitutively expressed in the cornea. Blockade of ICOSL and ICOS deficiency in the recipients accelerated rejection of corneal allografts. ICOSL mRNA is kept to express on the survived allograft. ICOS deficiency induced alloantigen-specific anterior chamber associated immune deviation (ACAID) weaklly. ICOS/ICOSL is necessary for leading immune privilege of corneal allografts. The expression of ICOSL and ICOS-mediated Foxp3+CD4+ regulatory T cells may contribute to success corneal allograft survival.
    VISTA is a novel and structurally distinct Ig superfamily inhibitory ligand.VISTA was constitutively expressed in the cornea of normal eyes. VISTA may play an important role in the acceptance of corneal allografts and inducing aloo-specific ACAID.

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