2024/04/24 更新

写真a

ミギタ マコト
右田 真
Migita Makoto
所属
武蔵小杉病院 小児科 教授
職名
教授
外部リンク

研究キーワード

  • 造血、遺伝子治療

研究分野

  • ライフサイエンス / 胎児医学、小児成育学

論文

  • Wiskott‐Aldrich syndrome diagnosed after cellulitis at the BCG vaccination site

    Mami Kurihara, Jun Hayakawa, Junya Sugihara, Hikaru Takeshita, Hidehiko Narazaki, Makoto Migita

    Pediatrics International   2023年1月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/ped.15681

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  • Role of a Fetal Ultrasound Clinic in Promoting Multidisciplinary and Inter-Facility Perinatal Care.

    Yoshio Shima, Takehiko Fukami, Tsubasa Takahashi, Takashi Sasaki, Makoto Migita

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   89 ( 3 )   337 - 341   2022年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: With the increasing rate of high-risk pregnancies, there is an increased need for early evaluation of at-risk fetuses. Fetal ultrasound imaging has become a pivotal part of this evaluation. METHODS: To evaluate the role played by a fetal ultrasound clinic in promoting comprehensive perinatal care of patients with high-risk pregnancies, we retrospectively analyzed the indications and findings of fetal scans and the outcomes of the examined fetuses collected over the past 7 years (2014-2020) by our institute, which is reorganized as a perinatal medical center. RESULTS: During the study period, we conducted 345 fetal scans in high-risk pregnancy cases. Of these, 158 cases (46%) were referrals from other institutes. Eighty-nine neonates were admitted to our neonatal intensive care unit (NICU) after being evaluated, of which 10 neonates underwent surgery during their NICU stays. Thirty-nine pregnant women were referred to other tertiary care hospitals mainly due to fetal diagnoses with complex cardiac anomalies. Fourteen cases resulted in intrauterine fetal death or artificial abortion. CONCLUSIONS: Fetal ultrasound clinics have established their role in facilitating sophisticated regional perinatal care via multidisciplinary and inter-facility cooperation for high-risk pregnancy cases. In addition, providing psychological support and counseling for pregnant women whose fetuses are diagnosed with severe congenital anomalies should not be neglected.

    DOI: 10.1272/jnms.JNMS.2022_89-309

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  • 幼児期に腸回転異常症から中腸軸捻転をきたした1例 査読

    濱本 光, 竹下 輝, 佐野 透美, 上春 光司, 橋本 康司, 田嶋 華子, 早川 潤, 宮尾 昌樹, 高橋 翼, 右田 真

    日本医科大学医学会雑誌   17 ( 4 )   186 - 190   2021年10月

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Statistical Evaluation of the First Year of a Neonatal Intensive Care Unit Established in a Medical School Hospital.

    Hidehiko Narazaki, Makoto Watanabe, Makoto Migita, Ryuhei Kurashina, Yoshio Shima, Makiko Mine, Sakae Kumasaka, Gen Ishikawa, Takashi Yamada, Yasuhiko Itoh

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   88 ( 4 )   283 - 290   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: There has been significant progress in reducing perinatal mortality in Japan. However, due to changes in social conditions, the total fertility rate and the number of births are decreasing, whereas the number of low birth weight infants is increasing along with the number of newborn babies that require intensive care. Further, although the number of high-level perinatal medical centers has increased, so has that of infants who need long-term hospitalization. Conversely, the number of regular obstetric facilities has decreased, thus resulting in insufficient beds for neonatal care. To fill this gap, we established a neonatal intensive care unit (NICU) at our hospital. This study aimed to evaluate our new type by comparing the data from ours with that from other facilities. METHODS: The other facilities assessed were two high-level NICU facilities and two regular obstetric facilities. Data, including sex, gestational age, birth weight, Apgar scores at 1 and 5 min, delivery method, and presence of breathing disorders, were extracted from medical records. RESULTS: The birth weight and gestational age distributions were significantly different in the institutions, except in one facility without a NICU. The new NICU saw more infants with low birth weight and respiratory disorders than the regular obstetric facilities. CONCLUSION: The comparison of birth weight and gestational age distributions, cases of respiratory disorders, and delivery methods indicate that our new NICU is positioned as an intermediate facility between a high-level NICU and a regular obstetrics facility.

    DOI: 10.1272/jnms.JNMS.2021_88-403

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  • Interfacility Neonatal Transport for Convalescent Care: Improving Regionalized Care.

    Yoshio Shima, Shohei Matsukawa, Kentaro Yashiro, Makoto Migita

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   87 ( 6 )   334 - 338   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Transfer of infants who no longer need intensive or specialized care from tertiary to community hospitals or clinics contributes to efficient bed utilization in neonatal intensive care units (NICUs). METHODS: We retrospectively analyzed the records of all 1,503 infants admitted to our NICU during the 6-year period from April 2013 through March 2019 to evaluate the impact of interfacility neonatal transport for convalescent care. RESULTS: During the study period, our NICU accepted 33 infants from other tertiary NICUs and transferred 103 infants to other hospitals or clinics before their home discharge for convalescent care. Our NICU covered 39% of the total hospital days of infants accepted from other NICUs. Among infants transferred to other facilities, 81% born at our hospital were born to mothers transported to our obstetrics department as imminent high-risk deliveries; 94% of infants born at other hospitals were moved back to the referring facility. CONCLUSIONS: Interfacility neonatal transport for accepting and transferring infants for convalescent care is now an integral part of NICU practice, to bridge gaps between higher-level care facilities and homes. Establishment of well-defined transfer criteria and appropriate allocation of medical and staff resources among relevant facilities are desirable.

    DOI: 10.1272/jnms.JNMS.2020_87-604

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  • Changes in Cytokine Profile during Initial Treatment of Pediatric Hemophagocytic Lymphohistiocytosis Associated with Epstein-Barr Virus.

    Takahiro Ueda, Toshikazu Itabashi, Shingo Yamanishi, Yujiro Tanabe, Makoto Migita, Yasuhiko Itoh

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   87 ( 3 )   166 - 170   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Hemophagocytic lymphohistiocytosis (HLH) associated with Epstein-Barr virus (EBV) infection can be self-limiting, severe/aggressive, or fatal. We report a case of EBV-HLH with persistent fever, severe pancytopenia, hypertriglyceridemia, and hypofibrinogenemia in a 4-year-old boy. Levels of plasma cytokines and chemokines were measured with a Bio-Plex system at 1, 2, 3, 4, 5, and 8 days after hospital admission. Administration of steroid and high-dose intravenous immunoglobulin (1 g/kg) did not alleviate fever or reduce cytokine production; however, after administration of etoposide (an antineoplastic agent), fever decreased immediately, the patient's general condition improved, and levels of IL-6, IL-10, IL-8, MCP-1, IFN-γ, and TNF-α declined after etoposide administration. In particular, IFN-γ production sharply declined, from 1,104.1 pg/mL to 101.5 pg/mL, and IL-6 level decreased from 229.8 pg/mL to 11.0 pg/mL, on the day after initial etoposide administration. There was no later recurrence of symptoms during treatment with dexamethasone, etoposide, and cyclosporine A. This case suggests that early etoposide administration is critical for treatment success and indicates that etoposide promptly inhibits cytokine production.

    DOI: 10.1272/jnms.JNMS.2020_87-307

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  • Adipose tissue-derived stem cells suppress coronary arteritis of Kawasaki disease in vivo. 国際誌

    Ryoichi Uchimura, Takahiro Ueda, Ryuji Fukazawa, Jun Hayakawa, Ryuji Ohashi, Noriko Nagi-Miura, Naohito Ohno, Makoto Migita, Yasuhiko Itoh

    Pediatrics international : official journal of the Japan Pediatric Society   62 ( 1 )   14 - 21   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Kawasaki disease (KD) is a systemic inflammatory disease resulting in an acute febrile syndrome commonly affecting children younger than 5 years. Coronary arteritis in KD is occasionally non-responsive to several treatments. Recently, adipose tissue-derived stem cells (ADSCs) have been shown to have anti-inflammatory, immunosuppressive, and tissue-repair characteristics and are considered a useful treatment for inflammatory disease. The present study aimed to elucidate whether the administration of ADSCs can suppress KD-associated vasculitis in vivo. METHODS: Candida albicans water-soluble fraction is often used to model KD via the induction of severe coronary arteritis. Kawasaki disease model mice were intravenously administered ADSCs and phosphate-buffered saline (PBS). On day 29, the mice were sacrificed and hearts from mice in each group were dissected. This was followed by serum collection. Cardiac tissue sections were subjected to histopathological examination to evaluate the inflammatory area. The levels of pro-inflammatory cytokines in the serum were analyzed at days 15 and 29. The survival rates of both groups were compared. RESULTS: The mean inflammatory area in coronary arteritis was significantly lower in the ADSC group compared to the PBS group (P < 0.01). Furthermore, the levels of pro-inflammatory cytokines, such as IL-1β, IL-12, IL-17, RANTES, INF-γ, and TNF-α, in the ADSC group were significantly lower than those in the PBS group. Moreover, the ADSC group had a significantly higher survival rate than the PBS group. CONCLUSIONS: These findings highlight that ADSCs have anti-inflammatory and immune regulatory functions that could provide novel cell-based therapeutic strategies for severe KD.

    DOI: 10.1111/ped.14062

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  • Therapy-related Secondary Malignancy After Treatment of Childhood Malignancy: Cases from a Single Center.

    Takahiro Ueda, Makoto Migita, Toshikazu Itabashi, Yujiro Tanabe, Ryoichi Uchimura, Yoshihiro Gocho, Miho Yamanishi, Fumiko Kobayashi, Mio Yoshino, Atsushi Fujita, Shingo Yamanishi, Kiyohiko Kaizu, Jun Hayakawa, Takeshi Asano, Miho Maeda, Yasuhiko Itoh

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   86 ( 4 )   207 - 214   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Therapeutic outcomes for childhood malignancy have dramatically improved. However, secondary malignancies are a major concern, as they greatly affect the quality of life of survivors. This retrospective study evaluated the cumulative incidence, clinical features, and outcomes of secondary malignancies at Nippon Medical School Hospital. METHODS: We examined data from 275 cases of primary childhood malignancy diagnosed between 1980 and 2014. Information regarding treatment of the primary malignancy, including irradiation dose, site, and cumulative dose of anticancer drugs, was assessed. We also collected data on secondary malignancy, including patient sex, age at diagnosis, malignancy site, time from primary to secondary malignancy, and outcomes. RESULTS: Secondary malignancies developed in 11 patients and included acute myeloid leukemia (AML) (4), meningioma (4), Ewing sarcoma (1), germ cell tumor (1), and malignant parotid gland tumor (1). The primary malignancies included acute lymphoblastic leukemia (ALL) (9), non-Hodgkin lymphoma (1) and brain tumor (1). In 7 of the 9 ALL patients, chemoradiotherapy was the primary treatment. The meningiomas and 1 solid tumor developed within the radiation field. All AMLs and meningiomas developed within 5 years and after 20 years, respectively, of the primary diagnosis. The 10- and 20-year cumulative incidence rates for secondary malignancy in our hospital were 1.9% and 5.8%, respectively. CONCLUSIONS: Our results revealed that the type of secondary malignancy depends on the interval after the end of treatment for primary malignancy. Meningioma, notably, develops many years after completion of primary malignancy treatment. Early detection during long-term follow-up is therefore essential.

    DOI: 10.1272/jnms.JNMS.2018_86-401

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  • A case of anhidrotic ectodermal dysplasia presenting with pyrexia, atopic eczema, and food allergy. 国際誌

    Tamaho Suzuki, Hanako Tajima, Makoto Migita, Ruby Pawankar, Takeshi Yanagihara, Atsushi Fujita, Yoshio Shima, Emi Yanai, Yasuhiko Katsube

    Asia Pacific allergy   9 ( 1 )   e3   2019年1月

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    記述言語:英語  

    Anhidrotic ectodermal dysplasia (AED) is a rare hereditary disorder with a triad of sparse hair, dental hypoplasia, and anhidrosis. Here we report a case of AED with food allergy and atopic eczema. The patient was a 11-month-old boy admitted to our hospital with pyrexia for 2 weeks. He presented with a history of dry skin, eczema, and food allergy to egg. On clinical examination, his body temperature was 38.8°C, with dry skin and eczema almost all over the body, sparse eyebrows, and scalp hair. Laboratory investigations and physical examination did not show any evidence of infection. Radioallergosorbent test was positive to egg yolk, egg white, ovomucoid, milk, house dust, and house dust mite. As the child did not sweat despite the high fever, we performed the sweat test which revealed a total lack of sweat glands. Genetic examination revealed a mutation of the EDA gene and he was diagnosed as AED. His pyrexia improved upon cooling with ice and fan. His mother had lost 8 teeth and her sweat test demonstrated low sweating, suggestive of her being a carrier of AED. Atopy and immune deficiencies have been shown to have a higher prevalence in patients with AED. Disruption of the skin barrier in patients with AED make them more prone to allergic diseases such as atopic eczema, bronchial asthma, allergic rhinitis and food allergy. Careful assessment of the familial history is essential to differentiate AED when examining patients with pyrexia of unknown origin and comorbid allergic diseases.

    DOI: 10.5415/apallergy.2019.9.e3

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  • A Case of Congenital Sideroblastic Anemia (CSA) with a Frameshift Mutaion in SLC25A38 査読

    Kiyohiko Kaizu, Makoto Migita, Atsushi Fujita, Yumiko Nakajima, Yasuhiro Katsube, Takeshi Asano, Miho Maeda, Yasuhiko Itoh

    PEDIATRIC BLOOD & CANCER   64   S27 - S28   2017年11月

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    記述言語:英語   出版者・発行元:WILEY  

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  • Prenatal Detection of Peters' Plus Syndrome in a Patient with No Known Family History.

    Yoshio Shima, Makoto Migita

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   83 ( 3 )   130 - 2   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Peters' plus syndrome is a rare autosomal recessive condition characterized by a combination of typical ocular defects and other systemic abnormalities. We present a case of this uncommon syndrome that we diagnosed during a fetal ultrasonographical examination. Because the patient exhibited microcephaly and anterior staphyloma of the right eye and because impending rupture was feared, we performed ophthalmectomy during the neonatal period. Fetal ophthalmological anomalies are often detected during ultrasonographic examination targeting other systemic abnormalities, with positive family histories providing important diagnostic clues. This case is, to our knowledge, the first to be reported of prenatally diagnosed Peters' plus syndrome in a patient with no known family history in whom total blindness was prevented with an early referral to specialists.

    DOI: 10.1272/jnms.83.130

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  • Comprehensive and quantitative multilocus methylation analysis reveals the susceptibility of specific imprinted differentially methylated regions to aberrant methylation in Beckwith-Wiedemann syndrome with epimutations. 国際誌

    Toshiyuki Maeda, Ken Higashimoto, Kosuke Jozaki, Hitomi Yatsuki, Kazuhiko Nakabayashi, Yoshio Makita, Hidefumi Tonoki, Nobuhiko Okamoto, Fumio Takada, Hirofumi Ohashi, Makoto Migita, Rika Kosaki, Keiko Matsubara, Tsutomu Ogata, Muneaki Matsuo, Yuhei Hamasaki, Yasufumi Ohtsuka, Kenichi Nishioka, Keiichiro Joh, Tsunehiro Mukai, Kenichiro Hata, Hidenobu Soejima

    Genetics in medicine : official journal of the American College of Medical Genetics   16 ( 12 )   903 - 12   2014年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Expression of imprinted genes is regulated by DNA methylation of differentially methylated regions (DMRs). Beckwith-Wiedemann syndrome is an imprinting disorder caused by epimutations of DMRs at 11p15.5. To date, multiple methylation defects have been reported in Beckwith-Wiedemann syndrome patients with epimutations; however, limited numbers of DMRs have been analyzed. The susceptibility of DMRs to aberrant methylation, alteration of gene expression due to aberrant methylation, and causative factors for multiple methylation defects remain undetermined. METHODS: Comprehensive methylation analysis with two quantitative methods, matrix-assisted laser desorption/ionization mass spectrometry and bisulfite pyrosequencing, was conducted across 29 DMRs in 54 Beckwith-Wiedemann syndrome patients with epimutations. Allelic expressions of three genes with aberrant methylation were analyzed. All DMRs with aberrant methylation were sequenced. RESULTS: Thirty-four percent of KvDMR1-loss of methylation patients and 30% of H19DMR-gain of methylation patients showed multiple methylation defects. Maternally methylated DMRs were susceptible to aberrant hypomethylation in KvDMR1-loss of methylation patients. Biallelic expression of the genes was associated with aberrant methylation. Cis-acting pathological variations were not found in any aberrantly methylated DMR. CONCLUSION: Maternally methylated DMRs may be vulnerable to DNA demethylation during the preimplantation stage, when hypomethylation of KvDMR1 occurs, and aberrant methylation of DMRs affects imprinted gene expression. Cis-acting variations of the DMRs are not involved in the multiple methylation defects.

    DOI: 10.1038/gim.2014.46

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  • Adipose-derived stromal cells grown on a hydroxyapatite scaffold can support hematopoiesis in regenerated bone marrow in vivo. 国際誌

    Takahiro Ueda, Atsushi Fujita, Rei Ogawa, Yasuhiko Itoh, Yoshitaka Fukunaga, Takashi Shimada, Makoto Migita

    Cell biology international   38 ( 6 )   790 - 8   2014年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Osteoblastic cells are a key component of the bone marrow (BM) stem cell niche and help regulate hematopoietic stem cells (HSCs). We have previously demonstrated that adipose-derived stromal cells (ADSCs) can differentiate into both osteogenic and chondrogenic cells in vitro. The current study examined whether the anatomical architecture of the BM could be regenerated in vivo by using ADSCs cultured on a hydroxyapatite (HA) scaffold. ADSCs from GFP transgenic mice were cultured in vitro on an HA scaffold. The scaffold with the attached cells was implanted subcutaneously onto the backs of C57/BL6 (Ly5.2) recipient mice. Lineage-negative (Lin-) Ly5.1 BM cells transduced with a lentiviral vector containing the luciferase (Luc) gene were intravenously administered to the recipient mice after lethal irradiation. Eight weeks after BM transplantation, the scaffolds were removed from the first recipient mice and subcutaneously implanted into lethally irradiated second recipient mice. The biodistribution and kinetics of Luc(+) Ly5.1 cells were monitored by bioluminescence imaging and flow cytometry. Luc(+) hematopoietic cells were present in the scaffolds of the secondary implanted mice for at least 8 months. Subcutaneous injection of G-CSF resulted in wide distribution of bioluminescence signals from the original scaffolds to the whole body. Therefore, BM regenerated using ADSCs grown on an HA scaffold can support HSC populations in vivo, suggesting that a functional BM niche is reconstituted. These results may have a significant impact on the development of therapeutic strategies for various hematopoietic diseases.

    DOI: 10.1002/cbin.10254

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  • Effect on clinical work practice of establishing a neonatal intensive care unit at a medical school-affiliated teaching hospital.

    Yoshio Shima, Makoto Migita, Hirobumi Asakura, Tsubasa Takahashi, Kentaro Yashiro, Yoshikatsu Matsumura, Akira Kurokawa

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   81 ( 5 )   328 - 32   2014年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The aim of this study was to examine the effects of a newly established neonatal intensive care unit (NICU) on clinical work practice and educational activity at Nippon Medical School Musashikosugi Hospital. METHODS: This retrospective study analyzed the clinical records of all neonates admitted to the NICU from December 2010 through November 2013. Anthropometric data, clinical status, problems, and outcomes of patients and the related obstetrical history were extracted and analyzed. RESULTS: Of the 568 neonatal admissions, about half were related to preterm birth (49%) and low birth weight (55%). Forty-eight percent of patients were born via caesarean delivery. Maternal hypertension, diabetes, and thyroid disease were found in 8%, 5%, and 2% of cases, respectively. Mechanical ventilatory support was provided for 20% of patients. Neonates from multiple pregnancy and with significant congenital anomalies accounted for 17% and 10% of all patients, respectively. Five patients died during hospitalization. In addition training was provided in the NICU for an average of 10 residents and 20 medical students per year. CONCLUSION: Since the NICU was established, closer cooperation beyond the framework of a single department has come to be needed. In addition, NICUs in teaching hospitals are expected to provide opportunities for medical students and residents to observe and participate in multidisciplinary medical care.

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  • Cholelithiasis in a patient with type 2 Gaucher disease.

    Makoto Migita, Sakae Kumasaka, Tae Matsumoto, Hanako Tajima, Takahiro Ueda, Atsuyuki Yamataka

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   81 ( 1 )   40 - 2   2014年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Gaucher disease is an autosomal recessively inherited lysosomal storage disease in which a deficiency of glucocerebrosidase is associated with the accumulation of glucocerebroside in reticuloendothelial cells. Clinically, 3 types of Gaucher disease have been defined on the basis of the presence or absence of neurological symptoms. The frequency of gallbladder involvement is reportedly greater in patients with type 1 Gaucher disease than in healthy persons. We report a case of recurrent cholelithiasis and liver failure in a patient with type 2 Gaucher disease who showed severe progressive neurological involvement.

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  • Perinatal risk factors for adverse long-term pulmonary outcome in premature infants: comparison of different definitions of bronchopulmonary dysplasia/chronic lung disease. 国際誌

    Yoshio Shima, Sakae Kumasaka, Makoto Migita

    Pediatrics international : official journal of the Japan Pediatric Society   55 ( 5 )   578 - 81   2013年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The aim of the study was to determine factors that affect adverse long-term pulmonary outcome in premature infants. METHODS: This retrospective analysis was done using 306 clinical records of preterm singleton neonates at <32 weeks of gestation. Two definitions of adverse pulmonary outcome were used: chronic lung disease (CLD), defined as a need for supplemental oxygen for at least 28 days after birth; and bronchopulmonary dysplasia (BPD), defined as oxygen dependency for at least 28 days after birth plus at 36 weeks postmenstrual age and/or a need for positive-pressure ventilatory support. Selected perinatal variables were compared between these definitions, and factors related to disease development were identified on multivariate analysis. RESULTS: The incidence of CLD and of BPD were 42% and 17%, respectively. Regardless of the definitions, the incidence of patent ductus arteriosus and of neonatal infection were significantly higher in the patients who met the disease criteria, but that of chorioamnionitis and of small for gestational age (SGA) were significantly higher in the patients only when the BPD definition was applied. Multivariate analysis identified SGA as an independent risk factor for the development of BPD after controlling for gestational age. CONCLUSIONS: Among selected perinatal variables, prenatal risk factors, particularly SGA, contributed to prolonged dependency on oxygen and/or positive-pressure ventilatory support, in combination with neonatal risk factors.

    DOI: 10.1111/ped.12151

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  • Neonatal case of late-onset sepsis involving group B Streptococcus type Ib.

    Sakae Kumasaka, Yoshio Shima, Makiko Mine, Mizue Nakajima, Makoto Migita

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   80 ( 5 )   384 - 6   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Group B Streptococcus (GBS) is an important pathogen that causes neonatal sepsis and meningitis, which have high mortality and morbidity. Most cases of infection are early onset, with late onset infections being less common. Moreover, many cases of infection are caused by type III GBS, while type Ib GBS infections are rare. We report a case of late-onset infection by type Ib GBS. A female neonate weighing 574 g was delivered at 27 weeks' gestation. An endotracheal tube was inserted shortly after birth because of respiratory distress syndrome, and ampicillin was administered by the age of 3 days. At the age of 54 days after cardiopulmonary adaptation had been achieved, the patient presented with tachycardia following refractory apnea and bradycardia, and her skin became pale. She was suspected of having sepsis, and intensive treatment, including intubation and administration of catecholamines, was started. Despite these measures, the patient died after 5 hours after the onset of sepsis. Type Ib GBS infection may be more frequent in Japanese infants because of the low concentration of IgG antibodies against type Ib in pregnant Japanese women.

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  • Neonatal case of herpes simplex virus encephalitis after delivery from a woman whose genital herpes simplex virus infection had been treated with acyclovir.

    Sakae Kumasaka, Atsushi Takagi, Kentaro Kuwabara, Makoto Migita

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   80 ( 6 )   456 - 9   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A case of herpes simplex virus (HSV) encephalitis in a neonate after delivery from a woman whose genital HSV infection had been treated with acyclovir is reported. The main approach to prevent genital HSV infection in the neonate is interruption of transmission at the time of delivery. Guidelines for prophylactic therapy with acyclovir have been established, but the risk of neonatal infection remains. A fever began to develop in a male neonate delivered vaginally from a 35-year-old woman. Treatment with intravenous acyclovir was started on the basis of a diagnosis of HSV encephalitis, because polymerase chain reaction was positive for HSV in the cerebrospinal fluid. The mother had had a first genital HSV infection during the second trimester, but treatment with injected acyclovir had caused the blisters and erosion to resolve by the time of delivery. Important steps for preventing neonatal HSV infection are the appropriate treatment of mothers with a history of genital HSV infection, the assessment of delivery methods, and the appropriate treatment of neonates.

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  • HYDROXYSTEROID (17-BETA) DEHYDROGENASE 1 (HSD17B1) IS DYSREGULATED BY MIR-210 AND MIR-518C IN THE HUMAN PLACENTA COMPLICATED WITH PREECLAMPSIA: PLASMA LEVELS OF HSD17B1 AS A NOVEL MARKER FOR PREDICTING LATE-ONSET PREECLAMPSIA 査読

    Toshihiro Takizawa, Akihide Ohkuchi, Md. Moksed Ali, Shan-Shun Luo, Takami Takizawa, Makoto Migita, Gen Ishikawa, Shigeki Matsubara, Toshiyuki Takeshita

    PLACENTA   33 ( 9 )   A81 - A81   2012年9月

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    記述言語:英語   出版者・発行元:W B SAUNDERS CO LTD  

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  • Successful gene therapy in utero for lethal murine hypophosphatasia. 国際誌

    Hanako Sugano, Tae Matsumoto, Koichi Miyake, Atsushi Watanabe, Osamu Iijima, Makoto Migita, Sonoko Narisawa, José Luis Millán, Yoshitaka Fukunaga, Takashi Shimada

    Human gene therapy   23 ( 4 )   399 - 406   2012年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Hypophosphatasia (HPP), caused by mutations in the gene ALPL encoding tissue-nonspecific alkaline phosphatase (TNALP), is an inherited systemic skeletal disease characterized by mineralization defects of bones and teeth. The clinical severity of HPP varies widely, from a lethal perinatal form to mild odontohypophosphatasia showing only dental manifestations. HPP model mice (Akp2(-/-)) phenotypically mimic the severe infantile form of human HPP; they appear normal at birth but die by 2 weeks of age because of growth failure, hypomineralization, and epileptic seizures. In the present study, we investigated the feasibility of fetal gene therapy using the lethal HPP model mice. On day 15 of gestation, the fetuses of HPP model mice underwent transuterine intraperitoneal injection of adeno-associated virus serotype 9 (AAV9) expressing bone-targeted TNALP. Treated and delivered mice showed normal weight gain and seizure-free survival for at least 8 weeks. Vector sequence was detected in systemic organs including bone at 14 days of age. ALP activities in plasma and bone were consistently high. Enhanced mineralization was demonstrated on X-ray images of the chest and forepaw. Our data clearly demonstrate that systemic injection of AAV9 in utero is an effective strategy for the treatment of lethal HPP mice. Fetal gene therapy may be an important choice after prenatal diagnosis of life-threatening HPP.

    DOI: 10.1089/hum.2011.148

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  • Intussusception in an extremely premature infant following bacterial sepsis. 国際誌

    Yoshio Shima, Sakae Kumasaka, Kentaro Yashiro, Mizue Nakajima, Makoto Migita

    European journal of pediatrics   171 ( 4 )   725 - 7   2012年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Intussusception occurring in premature infants is exceedingly rare and shows substantially different characteristics from that in the typical age group or non-premature neonates. We present a case of intussusception in an extremely premature infant following bacterial sepsis, in which necrotizing enterocolitis was initially suspected. The correct diagnosis was made at 35 days old using abdominal ultrasonography, but the general condition of the infant had deteriorated to the point where surgery could not be performed. The patient died of multiple organ failure, and autopsy revealed ileo-ileal intussusception without a recognizable anatomical leading point. Possible mechanisms for this rare clinical entity are discussed.

    DOI: 10.1007/s00431-011-1635-y

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  • Hydroxysteroid (17-β) dehydrogenase 1 is dysregulated by miR-210 and miR-518c that are aberrantly expressed in preeclamptic placentas: a novel marker for predicting preeclampsia. 国際誌

    Osamu Ishibashi, Akihide Ohkuchi, Md Moksed Ali, Ryuhei Kurashina, Shan-Shun Luo, Tomoko Ishikawa, Takami Takizawa, Chikako Hirashima, Kayo Takahashi, Makoto Migita, Gen Ishikawa, Koichi Yoneyama, Hirobumi Asakura, Akio Izumi, Shigeki Matsubara, Toshiyuki Takeshita, Toshihiro Takizawa

    Hypertension (Dallas, Tex. : 1979)   59 ( 2 )   265 - 73   2012年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In this study, to search for novel preeclampsia (PE) biomarkers, we focused on microRNA expression and function in the human placenta complicated with PE. By comprehensive analyses of microRNA expression, we identified 22 microRNAs significantly upregulated in preeclamptic placentas, 5 of which were predicted in silico to commonly target the mRNA encoding hydroxysteroid (17-β) dehydrogenase 1 (HSD17B1), a steroidogenetic enzyme expressed predominantly in the placenta. In vivo HSD17B1 expression, at both the mRNA and protein levels, was significantly decreased in preeclamptic placentas. Of these microRNAs, miR-210 and miR-518c were experimentally validated to target HSD17B1 by luciferase assay, real-time PCR, and ELISA. Furthermore, we found that plasma HSD17B1 protein levels in preeclamptic pregnant women reflected the decrease of its placental expression. Moreover, a prospective cohort study of plasma HSD17B1 revealed a significant reduction of plasma HSD17B1 levels in pregnant women at 20 to 23 and 27 to 30 weeks of gestation before PE onset compared with those with normal pregnancies. The sensitivities/specificities for predicting PE at 20 to 23 and 27 to 30 weeks of gestation were 0.75/0.67 (cutoff value=21.9 ng/mL) and 0.88/0.51 (cutoff value=30.5 ng/mL), and the odds ratios were 6.09 (95% CI: 2.35-15.77) and 7.83 (95% CI: 1.70-36.14), respectively. We conclude that HSD17B1 is dysregulated by miR-210 and miR-518c that are aberrantly expressed in preeclamptic placenta and that reducing plasma level of HSD17B1 precedes the onset of PE and is a potential prognostic factor for PE.

    DOI: 10.1161/HYPERTENSIONAHA.111.180232

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  • Idiopathic severe constriction of the fetal ductus arteriosus: a possible underestimated pathophysiology. 国際誌

    Yoshio Shima, Hiroko Ishikawa, Yoshikatsu Matsumura, Kentaro Yashiro, Mizue Nakajima, Makoto Migita

    European journal of pediatrics   170 ( 2 )   237 - 40   2011年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Idiopathic intrauterine constriction/closure of the ductus arteriosus, which is distinct from that secondary to maternal exposure to non-steroidal anti-inflammatory drugs, such as indomethacin, or structural cardiac defect, is an uncommon event that often results in severe fetal-neonatal morbidity and mortality. We reported a case of idiopathic fetal ductal constriction, in which the diagnosis was confirmed by documentation of an abnormal four-chamber view of the fetal heart at 38 weeks of gestation on obstetric ultrasound examination. A female infant weighing 2,816 g was born by Cesarean section, and her postnatal course was mild; transient tachypnea requiring only several days of supplemental oxygen with spontaneous regression of the abnormal echocardiographic findings by 3 months of age. The incidence of idiopathic constriction/closure of the fetal ductus arteriosus may be underestimated, particularly with a negative history of maternal drug exposure and mild postnatal clinical presentation.

    DOI: 10.1007/s00431-010-1295-3

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  • A 6-year-old girl with hemoglobin H disease.

    Takahiro Ueda, Makoto Migita, Miho Yamanishi, Miho Maeda, Keiko Harano, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   78 ( 2 )   101 - 4   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Hemoglobin H (HbH) disease is the severe nonfatal form of α-thalassemia syndrome. It is usually caused by molecular defects of 3 of 4 α-globin genes (--/-α) which cause α-globin expression to be decreased. HbH disease is rare in Japan. Here, we report on a 6-year-old girl with HbH disease who had profound hypochromatic and microcytic anemia. Analysis of the α-globin genes of the patient's family showed that the father, who was Japanese, had an abnormal gene with a 3.7-kb deletion (-α(3.7)/αα), and the mother, who was Filipino, had a deletion removing both α-globin genes of the Filipino type (--(FIL)/αα). Neither parent had anemia. The patient was found to have HbH disease with a heterozygous genetic abnormality (--(FIL)/-α(3.7)). Recently, the number of marriages of Japanese to natives of areas where thalassemia is epidemic has increased. Therefore, the incidence of HbH disease can be expected to increase in Japan. Long-term follow-up will be needed to evaluate the long-term complications and to improve the quality of life of patients with HbH disease.

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  • Infantile case of early manifestation of SLE-like symptoms in complete C1q deficiency.

    Jun Hayakawa, Makoto Migita, Takahiro Ueda, Yasuhiko Itoh, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   78 ( 5 )   322 - 8   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    C1q deficiency is a rare complement deficiency in the early part of the complement cascade. Patients with C1q deficiency have severe recurring life-threatening infections and systemic lupus erythematosus (SLE)-like symptoms. We report on a boy with recurrent life-threatening infections and SLE-like recurrent skin conditions before 2 years of age. Immunological studies revealed an undetectable level of C1q. No abnormality was observed in the urine, but renal biopsy showed segmental granulonephritis. However, the changes observed were atypical for SLE nephritis. This case of C1q deficiency was unusual because the SLE-like symptoms appeared earlier than that normally seen in complement deficiency. Therefore, this case provides insights into the development of autoimmune disease, particularly in the early phase of component deficiency, and in managing renal disease that may develop in the future.

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  • An 8-year-old girl with a recurrence of obstructive sleep apnea syndrome caused by hypertrophy of tubal tonsils 4 years after adenotonsillectomy.

    Makoto Migita, Yoshihiro Gocho, Takahiro Ueda, Hideto Saigusa, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   77 ( 5 )   265 - 8   2010年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Obstructive sleep apnea syndrome affects 1% to 2% of children. It is caused mainly by upper airway obstruction and manifests as snoring and sleep disturbance. Adenotonsillectomy can improve quality of life because airway obstruction occurs when both tonsils and adenoids are enlarged. We describe an 8-year-old girl with a recurrence of obstructive sleep apnea syndrome caused by hypertrophy of the tubal tonsils 4 years after adenotonsillectomy. The findings from this case highlight the importance of 1) identifying hypertrophy of the residual adenoid and compensatory hypertrophy of the tubal tonsils in patients with obstructive sleep apnea syndrome after adenotonsillectomy and 2) determining the optimal timing of adenotonsillectomy with respect to both the severity of obstructive sleep apnea and compensatory hypertrophy of other lymphoid tissue of Waldeyer's ring, as growth of such tissues is most active during the first several years of life.

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  • Pichia anomala pneumonia in a patient with acute lymphoblastic leukemia on maintenance therapy. 国際誌

    Hanako Sugano, Takahiro Ueda, Makoto Migita, Shigenao Mimura, Miho Maeda, Takashi Sugita, Yoshitaka Fukunaga

    Leukemia & lymphoma   51 ( 8 )   1574 - 6   2010年8月

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  • Hematopoiesis in regenerated bone marrow within hydroxyapatite scaffold. 国際誌

    Atsushi Fujita, Makoto Migita, Takahiro Ueda, Rei Ogawa, Yoshitaka Fukunaga, Takashi Shimada

    Pediatric research   68 ( 1 )   35 - 40   2010年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We examined whether regenerated bone marrow (BM) with BM-derived stromal cells (BMSCs) on hydroxyapatite (HA) scaffolds can reconstitute the functional niche. Ly5.2 BMSCs on HA scaffolds were implanted s.c. onto the backs of Ly5.2 recipient mice. Lineage negative Ly5.1 BM cells expressing luciferase (luc) were i.v. administered into the recipient mice. Eight weeks after primary transplantation, secondary implantation was performed; the scaffolds removed from the first recipient mice were s.c. implanted into secondary recipient mice. Luc+ cells were detected in the scaffolds for 6 mo after secondary implantation. Injection of G-CSF resulted in wide distribution of bioluminescence from the original scaffolds to the whole body. Even after removing the scaffolds from the secondary recipient mice, luc+ cells were emitted by G-CSF stimulation, indicating that regenerated BM is capable of supporting hematopoietic stem cells (HSCs) and delivering HSCs to native BM in vivo. These data suggest that the functional niche is reconstituted at least partly and that regenerated BM on the scaffold may be used as a portable source of HSCs.

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  • Hematopoietic capacity of preterm cord blood hematopoietic stem/progenitor cells. 国際誌

    Mizue Nakajima, Takahiro Ueda, Makoto Migita, Yuki Oue, Yoshio Shima, Takashi Shimada, Yoshitaka Fukunaga

    Biochemical and biophysical research communications   389 ( 2 )   290 - 4   2009年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Full-term cord blood (TCB) hematopoietic stem/progenitor cells (HSC/HPCs) are used for stem cell transplantation and are well characterized. However, the properties of preterm cord blood (PCB) HSC/HPCs remain unclear. In the present study, we compared HSC/HPCs from TCB and PCB with respect to their expression of surface markers, homing capacity and ability to repopulate HSCs in the NOD/Shi-scid mice bone marrow. The proportion of CD34+CD38- cells was significantly higher in PCB. On the other hand, the engraftment rate of TCB CD34+ cells into NOD/Shi-scid mice was significantly higher than PCB CD34+ cells. The expression of VLA4 was stronger among TCB CD34+ cells than PCB CD34+ cells. Moreover, there was a positive correlation between the proportion of CD34+CXCR4+ cells and gestational age. These data suggest that the homing ability of HSCs increases during gestation, so that TCB may be a better source of HSCs for transplantation than PCB.

    DOI: 10.1016/j.bbrc.2009.08.139

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  • Dextran sulfate and stromal cell derived factor-1 promote CXCR4 expression and improve bone marrow homing efficiency of infused hematopoietic stem cells.

    Jun Hayakawa, Makoto Migita, Takahiro Ueda, Ryuji Fukazawa, Kumi Adachi, Yuki Ooue, Mari Hayakawa, Takashi Shimada, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   76 ( 4 )   198 - 208   2009年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Although the homing of hematopoietic stem cells (HSC) to the bone marrow (BM) is a crucial step in hematopoietic development and BM repopulation, the mechanisms underlying these processes have not been fully clarified. Recent studies suggest that interaction between the chemokine receptor CXCR4 and its ligand, stromal cell-derived factor 1 (SDF-1), plays a critical role in these processes. In addition, dextran sulfate increases plasma SDF-1 levels in mice and nonhuman primates. Thus, we examined the effects of preconditioning with SDF-1 and dextran sulfate on the homing efficiency of HSCs following BM transplantation in mice. We found that the preconditioning of donor mice with either SDF-1 or dextran sulfate enhanced the homing efficiency of infused HSCs in vivo. The greatest effects were obtained with dextran sulfate. Moreover, reverse transcriptase polymerase chain reaction analysis demonstrated that SDF-1 and dextran sulfate increased transcription of a variety of homing-related genes, including those for CXCR4, lymphocyte function associated antigen-1, matrix metalloproteinase-9, very late antigen-4/5, and macrophage inflammatory protein-1. We suggest that whereas SDF-1 directly acts to upregulate CXCR4 expression in HSCs, dextran sulfate acts via multiple pathways involved in the induction of various homing-related molecules, in addition to SDF-1. Thus, preconditioning donors with dextran sulfate offers a novel clinical approach for improving the homing and engraftment of HSCs in the BM.

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  • Prenatal diagnosis of isolated congenitally corrected transposition of the great arteries. 国際誌

    Yoshio Shima, Mizue Nakajima, Sakae Kumasaka, Makoto Migita

    Archives of gynecology and obstetrics   279 ( 4 )   557 - 9   2009年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac defect characterized by the atria connecting with anatomically discordant ventricles and the ventricles connecting with discordant and transposed great arteries, which allows hemodynamic compensation. Most patients with ccTGA have associated intracardiac anomalies, which could be a diagnostic clue, whereas isolated forms are infrequently diagnosed during the neonatal period and in utero. We describe a fetus that was diagnosed with ccTGA and without additional cardiac anomalies at 25 weeks of gestation. The parallel course of the great arteries discovered during a routine obstetric scan indicated this rare cardiac anomaly. Further detailed examination of the ventricular morphology helped to confirm the diagnosis. Despite hemodynamic compensation, the long-term prognosis of ccTGA is uncertain because of the possible development of arrhythmias or heart failure later in life. Our findings showed that fetal echocardiography can detect prenatal ccTGA.

    DOI: 10.1007/s00404-008-0739-8

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  • An infant with congenital nemaline myopathy and hypertrophic cardiomyopathy.

    Mizue Nakajima, Yoshio Shima, Sakae Kumasaka, Kentaro Kuwabara, Makoto Migita, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   75 ( 6 )   350 - 3   2008年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We describe an infant with nemaline myopathy accompanied by hypertrophic cardiomyopathy. The patient required long-term, intermittent positive-pressure ventilation after birth owing to muscle weakness, and cardiac failure developed during infancy. We diagnosed hypertrophic cardiomyopathy with outflow tract obstruction, and treated the heart failure with beta-adrenergic and angiotensin II receptor blockers. We discuss the prognosis of nemaline myopathy combined with hypertrophic cardiomyopathy.

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  • A 2-year-old girl with Diphyllobothrium nihonkaiense infection treated with oral praziquantel and a laxative.

    Atsushi Fujita, Makoto Migita, Takahiro Ueda, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   75 ( 4 )   225 - 7   2008年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We report a case of Diphyllobothrium nihonkaiense infection in a 2-year-old Japanese girl. When infection occurs in early childhood, it is necessary to offer supportive care in addition to standard treatment with oral praziquantel or with of a duodenal tube using a radiopaque contrast medium. We treated D. nihonkaiense infection in a 2-year-old girl successfully treated with oral praziquantel and a laxative.

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  • Hematopoiesis in regenerated, bone marrow on the hydroxyapatite scaffold

    Atsushi Fujita, Makoto Migita, Takahiro Ueda, Yoshitaka Fukunaga, Takashi Shimada

    BLOOD   110 ( 11 )   425A - 425A   2007年11月

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    記述言語:英語   出版者・発行元:AMER SOC HEMATOLOGY  

    DOI: 10.1182/blood.V110.11.1419.1419

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  • AAV1 mediated co-expression of formylglycine-generating enzyme and arylsulfatase a efficiently corrects sulfatide storage in a mouse model of metachromatic leukodystrophy. 国際誌

    Toshiyuki Kurai, Sanae Hisayasu, Ryo Kitagawa, Makoto Migita, Hidenori Suzuki, Yukihiko Hirai, Takashi Shimada

    Molecular therapy : the journal of the American Society of Gene Therapy   15 ( 1 )   38 - 43   2007年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Metachromatic leukodystrophy (MLD) is a lysosomal storage disorder caused by a deficiency of arylsulfatase A (ASA) and is characterized by deposition of sulfatide in all organs, particularly the nervous system. Recently, formylglycine-generating enzyme (FGE) was found to be essential for activation of sulfatases. This study examined the utility of FGE co-expression in AAV type 1 vector (AAV1)-mediated gene therapy of ASA knockout (MLD) mice. AAV1-ASA alone or AAV1-ASA and AAV1-FGE were co-injected into a single site of the hippocampus. Enzyme assay and immunohistochemical analysis showed that ASA was detected not only in the injected hemisphere but also in the non-injected hemisphere by 7 months after injection. Level of ASA activity and extent of ASA distribution were significantly enhanced by co-introduction of AAV1-FGE. Marked reductions in sulfatide levels were observed throughout the entire brain. The unexpectedly widespread distribution of ASA may be due to a combination of diffusion in extracellular spaces, transport through axons, and circulation in cerebrospinal fluid. The rotarod test revealed improvement of neurological functions. These results demonstrate that direct injection of AAV1 vectors expressing ASA and FGE represents a highly promising approach with significant implications for the development of clinical protocols for MLD gene therapy.

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  • Transient cardiomyopathy in a patient with congenital contractural arachnodactyly (Beals syndrome).

    Tae Matsumoto, Atsushi Watanabe, Makoto Migita, Yoshihiro Gocho, Jun Hayakawa, Shun-ichi Ogawa, Takashi Shimada, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   73 ( 5 )   285 - 8   2006年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We report on an infant with Beals syndrome (congenital contractural arachnodactyly [CCA], MIM 121050) with transient cardiomyopathy showing ballon-like dilatation of the left ventricle that was similar to noncompaction. The patients father and two of his brothers were also found to have CCA without cardiovascular complications. CCA, which is caused by a mutation of the gene for fibrillin 2 protein is similar to Marfan syndrome (MIM 154700), which is caused by a mutation of fibrillin 1 but produces a life-threatening cardiovascular complications. This is the first report of CCA with transient cardiomyopathy. We discuss the mechanism of the spontaneous improvement of cardiomyopathy in this case on the basis of expression of the responsible gene.

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  • Ex vivo cell-mediated gene therapy for metachromatic leukodystrophy using neurospheres. 国際誌

    Ken Kawabata, Makoto Migita, Hideki Mochizuki, Koichi Miyake, Tsutomu Igarashi, Yoshitaka Fukunaga, Takashi Shimada

    Brain research   1094 ( 1 )   13 - 23   2006年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Metachromatic leukodystrophy (MLD) is an autosomal recessive disease caused by mutations in the gene encoding the lysosomal enzyme arylsulfatase A (ASA). In MLD, accumulation of the substrate, sulfated glycoprotein, in the central and peripheral nervous systems results in progressive motor and mental deterioration. Neural progenitor cells are thought to be useful for cell replacement therapy and for cell-mediated gene therapy in neurodegenerative diseases. In the present study, we examined the feasibility of ex vivo gene therapy for MLD using neural progenitor cells. Neural progenitor cells (neurospheres) were prepared from the striatum of E14 embryo MLD knockout mice or GFP transgenic mice and were transduced with the VSV pseudotyped HIV vector carrying the ASA gene (HIV-ASA). For in vivo study, neurospheres from GFP mice were transduced with HIV-ASA and inoculated into the brain parenchyma of adult MLD mice. HIV vector-transduced progenitor cells retained the potential for differentiation into neurons, astrocytes and oligodendrocytes in vitro. Expression of ASA in neurospheres transduced with HIV-ASA was confirmed by spectrophotometric enzyme assay and Western blotting. In vivo, GFP-positive cells were detectable 1 month after injection. These cells included GFAP- and MAP2-positive cells. Immunohistochemistry using anti-ASA antibody demonstrated localization of ASA in both GFP-positive and -negative cells. Partial clearance of accumulated sulfatide was confirmed in vivo in MLD knockout mice. The present findings suggest that ASA enzyme is released from migrated neurospheres and is able to digest sulfatide in surrounding cells. Our results suggest the potential of genetically engineered neural progenitor cells (neurospheres) for ex vivo therapy in MLD.

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  • An asymptomatic heterozygous female with fabry disease: implications for enzyme replacement therapy.

    Shin-ichiro Inagaki, Makoto Migita, Mari Hayakawa, Atushi Fujita, Junko Yoshida, Masamichi Ishizaki, Masaharu Kotani, Hitoshi Sakuraba, Takashi Shimada, Mutsumi Murakami, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   72 ( 6 )   387 - 90   2005年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We report an asymptomatic female with Fabry disease immunohistochemically diagnosed by renal biopsy. She was initially diagnosed as having nephrotic syndrome, and renal biopsy was performed for pathological diagnosis. The renal specimen revealed non-specific findings (minor glomerular abnormalities) for nephrotic syndrome. Numerous laminated bodies in glomerular epithelial cells in electron microscopic findings and accumulations of ceramidetrihexoside immunohistochemically were observed and she was diagnosed with Fabry disease. However, no other laboratory data or clinical findings supported the diagnosis of Fabry disease. Since the efficacy of recombinant human alpha-galactosidase replacement therapy in this disease has been reported, whether enzyme replacement therapy for subclinical Fabry female patients is indicated or not is an important issue.

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  • Clinical aspects of infant leukemia--experiences of a single institution of Japan: high level of serum immunoglobulin M in infant leukemia.

    Miho Maeda, Yoshitaka Fukunaga, Takeshi Asano, Makoto Migita, Takahiro Ueda, Hisamitsu Hamada, Jun Hayakawa, Hidehiko Narazaki, Kiyohiko Kaizu

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   72 ( 6 )   355 - 63   2005年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The prognosis and clinical and biological characteristics of infant leukemia differ from those of leukemia in children 1 year or older. We reviewed the charts of patients younger than 1 year in whom leukemia was diagnosed from January 1981 through December 2003 at our institution. Fourteen infants had leukemia, 6 had acute lymphoblastic leukemia (ALL), and 8 had acute myeloid leukemia (AML). The age of patients at diagnosis ranged from 2 to 11 months. Five of 8 AML patients presented with cutaneous manifestations, such as erythema and nodules, at diagnosis. Central nervous system (CNS) involvement was seen in 1 AML patient at diagnosis. Hyperleukocytosis of more than 50 x 10(9)/L was seen in 4 of 6 ALL patients and in 4 of 8 AML patients at diagnosis. All ALL patients showed a morphological diagnosis of L1 using the French-America-British classification system. For patients with AML, the morphological diagnoses were M0 for 1 patient, M2 for 1 patient, M4 for 2 patients (1 with eosinophilia), M5b for 2 patients, and M7 for 2 patients. One patient showing M7 morphology had Down syndrome. Surface markers were examined in 5 of 6 ALL patients and all AML patients. Five ALL patients showed a B-cell precursor immunophenotype. Two of 5 patients with ALL had CD10-positive leukemic cells and 3 of 5 patients with ALL had CD10-negative leukemic cells. All AML patients were positive for CD13 or CD33 or both. Three of 5 patients with ALL showed abnormal chromosomes related to 11q. Six of 7 patients with AML showed abnormal karyotypes. MLL gene rearrangements were seen in 3 (2 ALL, 1 AML) of 5 (2 ALL, 3 AML) patients. Serum immunoglobulin M levels were increased in 9 of 14 patients. Complete remission (CR) was achieved in all infants with ALL. Three patients relapsed and then died of the original disease. One of these 3 patients died after cord blood transplantation. Three ALL patients are alive without leukemia. CR was achieved in 6 of 8 AML patients. Four of 6 patients are alive without leukemia. Infant leukemia patients in our institution had some special features. CNS involvement at diagnosis was seen in only 1 patient and serum IgM levels were higher than those in children whose leukemia was diagnosed at 1 to 10 years of age.

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  • A case of Henoch-Schönlein purpura with rare complications: necrosis of the small intestine, neurological symptoms, and pericardial tamponade.

    Makoto Migita, Jun Hayakawa, Hideki Shima, Hiroyuki Kobayashi, Atsutaka Yamataka, Mutsumi Murakami, Takeshi Miyano, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   72 ( 6 )   383 - 6   2005年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A case of Henoch-Schönlein purpura (HSP) with necrosis of the small intestine, neurological symptoms, and pericardial tamponade after frequent recurrence is described. Neurological symptoms were controlled well with steroid pulse therapy, and pericardial tamponade was treated successfully with pericardiocentesis and steroid pulse therapy. To treat necrosis of the small intestine, the necrotic tissue was excised and artificial anuses were constructed. Five months later, the small intestine was anastomosed in a curative operation. Periodic administration of coagulation factor XIII was required from the onset of symptoms until curative surgery, but the activity of this factor returned to normal levels after surgery operation. We report a case of Henoch-Schönlein purpura with extremely rare complications: necrosis of the small intestine, neurological symptoms, and pericardial tamponade.

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  • Brain white matter changes during treatment of a child for acute lymphoblastic leukemia.

    Miho Maeda, Jun Hayakawa, Takahiro Ueda, Makoto Migita, Takeshi Asano, Yoshitaka Fukunaga, Yasuo Amano

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   72 ( 5 )   252 - 3   2005年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 13-year old boy with acute lymphoblastic leukemia had bilateral paresis of the upper extremities and aphasia 1 week after high dose methotrexate and triple intrathecal therapy (methotrexate, cytarabin, hydrocortisone). The stroke-like neurological symptoms disappeared on the third day. T2-weighted magnetic resonance imaging showed hyperintensities of white matter on the second day. Despite resolution of the neurological symptoms, magnetic resonance images were still abnormal 3 years after the attack. Methotrexate has been considered to be responsible for ischemic damage to oligodendroglial cells, resulting in demyelination. The changes are occasionally prolonged without persistent neurologic symptoms.

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  • Role of bone marrow cells in the healing process of mouse experimental glomerulonephritis. 国際誌

    Mari Hayakawa, Masamichi Ishizaki, Jun Hayakawa, Makoto Migita, Mutsumi Murakami, Takashi Shimada, Yoshitaka Fukunaga

    Pediatric research   58 ( 2 )   323 - 8   2005年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recent studies have shown bone marrow (BM) cells to differentiate into a variety of cell types and to thereby participate in the reconstitution of damaged organs. In the present study, we examined the extent to which BM-derived cells are incorporated into glomeruli during recovery from experimentally induced nephritis. To investigate the localization of BM cells in glomeruli, chimeric mice were prepared by transplanting BM cells from green fluorescent protein (GFP) transgenic mice into wild-type mice. Five weeks later, glomerulonephritis was induced by intravenous injection of Habu snake venom. Groups of mice were then killed every few days for 42 d, and harvested kidney samples were subjected to immunohistochemical and immunoelectron microscopic analyses with the aim of detecting the presence of GFP(+) cells within glomeruli. Chimeric animals injected with Habu venom developed proliferative glomerulonephritis within 1-3 d. The lesion gradually subsided and the glomerular structure returned to normal within 42 d. Consistent with the disease course, large numbers of GFP(+) cells were present within glomeruli on d 1-3, but most had disappeared by d 7. Nevertheless, some GFP(+) cells did remain within glomeruli showing mesangial proliferative changes, and were found to express thrombomodulin (TM), a specific endothelial cell marker. These GFP-TM-double-positive cells accounted for a mean of 1.31-2.24% of the total glomerular nuclei from d 7 through d 42, levels that remained stable for at least 12 mo. It thus appears that BM cells can give rise to endothelial cells that participate in the remodeling of glomeruli.

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  • The role of bone marrow-derived cells in bone fracture repair in a green fluorescent protein chimeric mouse model. 国際誌

    Kazuhiro Taguchi, Rei Ogawa, Makoto Migita, Hideki Hanawa, Hiromoto Ito, Hideo Orimo

    Biochemical and biophysical research communications   331 ( 1 )   31 - 6   2005年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We investigated the role of bone marrow cells in bone fracture repair using green fluorescent protein (GFP) chimeric model mice. First, the chimeric model mice were created: bone marrow cells from GFP-transgenic C57BL/6 mice were injected into the tail veins of recipient wild-type C57BL/6 mice that had been irradiated with a lethal dose of 10Gy from a cesium source. Next, bone fracture models were created from these mice: closed transverse fractures of the left femur were produced using a specially designed device. One, three, and five weeks later, fracture lesions were extirpated for histological and immunohistochemical analyses. In the specimens collected 3 and 5 weeks after operation, we confirmed calluses showing intramembranous ossification peripheral to the fracture site. The calluses consisted of GFP- and osteocalcin-positive cells at the same site, although the femur consisted of only osteocalcin-positive cells. We suggest that bone marrow cells migrated outside of the bone marrow and differentiated into osteoblasts to make up the calluses.

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  • 【G-CSF療法の現状と将来展望】G-CSFが原因と思われる皮膚症状を起こした小児急性リンパ性白血病の1例

    前田 美穂, 右田 真, 植田 高弘, 早川 潤, 福永 慶隆

    MEDICO   36 ( 5 )   182 - 185   2005年5月

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    記述言語:日本語   出版者・発行元:千代田開発(株)  

    12歳3ヵ月男児.患者はB前駆型急性リンパ性白血病と診断され,東京小児癌研究グループのL99-15HRプロトコール治療を開始した.第2コース治療終了後に好中球減少を認め,lenograstim投与を開始した.第2回目の投与から数時間後,左側肘関節,膝関節,臀部に有痛性紅斑の主訴を認めた.Lenograstimの過敏症を疑い,投与を中止したが症状に変化はなく,投与を再開した.この有痛性紅斑はlenograstim終了翌日になっても消失せず,以前に使用されていたcytarabinの影響も疑った.化学療法3コース目終了後,再び好中球減少し,lenograstimを投与すると,右大腿部近位部に有痛性結節を認めた.Cytarabinは使用していなかったので,顆粒球コロニー刺激因子製剤の副作用を疑い,filgrastimに変更した.Filgrastimでも大きな変化は認めず,nartograstimに変更した結果,皮膚過敏症はなく,数日後に好中球数が回復した.以後,好中球数減少時にはnartograstimを投与しているが,有害事象は認めていない

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  • Multiple fungal splenic abscesses in a patient with T-acute lymphoblastic leukemia undergoing chemotherapy. 国際誌

    Makoto Migita, Kiyohiko Kaizu, Makiko Asai, Kazuko Yamaguchi, Ei Ikegami, Miho Maeda, Shigeki Yokomuro, Takashi Taziri, Yoshitaka Fukunaga

    Pediatrics international : official journal of the Japan Pediatric Society   46 ( 6 )   733 - 5   2004年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Chondrogenic and osteogenic differentiation of adipose-derived stem cells isolated from GFP transgenic mice.

    Rei Ogawa, Hiroshi Mizuno, Hiko Hyakusoku, Atsushi Watanabe, Makoto Migita, Takashi Shimada

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   71 ( 4 )   240 - 1   2004年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recent studies suggest that human adipose tissue contain pluripotent cells similar to bone marrow-derived stromal cells (BSCs). Taking advantage of homogeneously marked cells from green fluorescent protein (GFP) transgenic mice, we have previously demonstrated that BSCs differentiate into a variety of cell lineages both in vitro and in vivo). In the present study, we extend this approach to characterize adipose-derived stromal cells (ASCs)). These cells derived from human are sometimes called processed lipoaspirate (PLA) cells. ASCs were prepared from inguinal fat pads of GFP transgenic mice after extensive washing with PBS and treatment with collagenase. After the primary culture in control medium (DMEM + 10% FBS), the cells were incubated in either chondrogenic medium (DMEM + 1% FBS + insulin + ascorbate 2-phosphate + TGF-beta 1) or osteogenic medium (DMEM + 10%FBS + dexamethasone + ascorbate-2-phosphate + beta-glycerophosphate) for two to four weeks. Chondrogenic differentiation was assessed by Alcian blue staining, while osteogenic differentiation was by von Kossa and Alkaline phosphatase staining. ASCs incubated in chondrogenic medium induced Alcian blue positive cells. Incubation with osteogenic medium became positive for von Kossa and Alkaline phosphatase staining. No osteochondrogenic differentiation was observed in cells incubated with control medium. This cell population can be easily identified through fluorescence microscope, it should be an ideal source of ASCs for further experiments of stem cell biology and tissue engineering.

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  • Adipogenic differentiation by adipose-derived stem cells harvested from GFP transgenic mice-including relationship of sex differences. 国際誌

    Rei Ogawa, Hiroshi Mizuno, Atsushi Watanabe, Makoto Migita, Hiko Hyakusoku, Takashi Shimada

    Biochemical and biophysical research communications   319 ( 2 )   511 - 7   2004年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We have previously demonstrated that adipose-derived stromal cells (ASCs) as well as bone marrow-derived stromal cells (BSCs) differentiate into a variety of cell lineages both in vitro and in vivo. Both types are considered to include mesenchymal stem cells. Taking advantage of homogeneously marked cells from green fluorescent protein (GFP) transgenic mice, we have also previously reported the plasticity of BSCs and ASCs. In this study, we focused on adipogenic differentiation in vitro by ASCs harvested from GFP transgenic mice. Moreover, preadipocytes and mature adipocytes were harvested at the same time, and the cells were cultured to compare them with ASCs. Inguinal fat pads from GFP transgenic mice were used for the isolation of ASCs, preadipocytes, and mature adipocytes. After expansion to three passages of ASCs, the cells were incubated in an adipogenic medium for two weeks. Adipogenic differentiation of ASCs was assessed by Oil Red O staining and the expression of the adipocyte specific peroxisome proliferative activated receptor gamma2 (PPAR-gamma2) gene. These ASCs stained positively, and expression of PPAR-gamma2 was detected. Moreover, we also tried to characterize the influence of sex differences on the adipogenic differentiation of ASCs harvested from both male and female mice. This was assessed by the expression levels of the PPAR-gamma2 gene using real-time PCR. The results showed that the expression levels of ASCs harvested from female mice were a maximum of 2.89 times greater than those harvested from male mice. This suggests that the adipogenic differentiation of ASCs is closely related to sex differences.

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  • Establishment of modified retroviral vector targeting X-linked severe combined immunodeficiency.

    Cai Ling Zhi, Makoto Migita, Jun Hayakawa, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   71 ( 1 )   51 - 6   2004年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Gene therapy targeting hematopoietic stem cells has been proposed as a potential therapy for numerous genetic disorders affecting hematopoiesis. Moloney murine leukemia retroviral vectors are now widely used for clinical gene transfer into hematopoietic progenitors and progeny. However, maintaining expression of therapeutic genes inserted via moloney murine leukemia virus (MoMLV)-based vectors has proven to be more difficult than previously expected. In this study, an MND-IL-2R vector containing IL-2Rc gamma cDNA to treat X-linked severe combined immunodeficiency (X-SCID) was constructed from an MND vector that was modified by substituting the myeloproliferative sarcoma virus (MPSV) enhancer for that of MoMLV, deleting the negative control region located in the long terminal repeat (LTR) as an enhancer, and replacing the primer binding site (PBS) of MoMLV with the PBS of the endogenous murine retrovirus dl587rev. This vector was transduced into human CD34 + progenitor cells with comparable efficiency to that of the MoMLV-based vector. The use of this newly created vector may be advantageous for gene therapy of X-SCID.

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  • Osteogenic and chondrogenic differentiation by adipose-derived stem cells harvested from GFP transgenic mice. 国際誌

    Rei Ogawa, Hiroshi Mizuno, Atsushi Watanabe, Makoto Migita, Takashi Shimada, Hiko Hyakusoku

    Biochemical and biophysical research communications   313 ( 4 )   871 - 7   2004年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recent studies suggest that human adipose tissue contains pluripotent stem cells similar to bone marrow-derived stem cells. Taking advantage of homogeneously marked cells from green fluorescent protein (GFP) transgenic mice, we have previously demonstrated that bone marrow-derived stromal cells (BSCs) differentiate into a variety of cell lineages both in vitro and in vivo. In the present study, we extend this approach to characterize adipose tissue-derived stromal cells, sometimes called processed lipoaspirate (PLA) cells. Adipose-derived stromal cells (ASCs) were isolated from inguinal fat pads of GFP transgenic mice after extensive washing with phosphate-buffered saline and treatment with collagenase. After primary culture in a control medium (Dulbecco's modified Eagle's medium+10% fetal bovine serum) and expansion to two passages, the cells were incubated in either an osteogenic medium (Dulbecco's modified Eagle's medium+10% fetal bovine serum+dexamethasone+ascorbate-2-phosphate+beta-glycerophosphate) or a chondrogenic medium (Dulbecco's modified Eagle's medium+1% fetal bovine serum+insulin+ascorbate-2-phosphate+transforming growth factor-beta1) for 2-4 weeks to induce osteogenesis and chondrogenesis, respectively. Osteogenic differentiation was assessed by von Kossa and alkaline phosphatase staining, while chondrogenic differentiation was assessed by Alcian blue staining. Expression of osteocyte specific osteopontin, osteocalcin, and alkaline phosphatase, and chondrocyte specific aggrecan and type II/X collagen was confirmed by RT-PCR. ASCs incubated in the osteogenic medium were stained positively for von Kossa and alkaline phosphatase staining. Expression of osteocyte specific genes, except osteocalcin, was also detected. Incubation with chondrogenic medium induced Alcian blue positive cells and expression of aggrecan and type II/X collagen genes. No osteochondrogenic differentiation was observed in cells incubated in the control medium. ASCs from GFP transgenic mice have both osteogenic and chondrogenic potential in vitro. Since this cell population can be easily identified through fluorescence microscopy, it may be an ideal source of ASCs for further experiments on stem cell biology and tissue engineering.

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  • Recipient non-hematopoietic bone marrow cells in the intestinal graft after fetal small intestinal transplantation. 国際誌

    Yoshifumi Kato, Atsuyuki Yamataka, Katsumi Miyahara, Noriyoshi Sueyoshi, Jun Hayakawa, Mari Hayashida, Makoto Migita, Takashi Shimada, Hiroyuki Kobayashi, Geoffrey J Lane, Takeshi Miyano

    Pediatric surgery international   20 ( 1 )   1 - 4   2004年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We examined whether non-hematopoietic BM cells can migrate into the intestinal graft after fetal small intestinal transplantation (FSITx). Fetal small intestine from donor C57BL/6 mice was transplanted into the rectus abdominis of recipient C57BL/6 mice with only green fluorescent protein (GFP) BM cells (syngeneic FSITx). Intestinal grafts were harvested on days 5, 10, and 30 after FSITx and stained immunohistochemically using anti-CD45 antibody (a marker for hematopoietic BM cells). Although there were no GFP-positive cells identified in the epithelium of the graft intestinal villi, there were a few cells positive for both GFP and CD45 in the lamina propria on day 5 after FSITx, and many present on days 10 and 30. In some grafts there were only cells that were GFP positive/CD45 negative (i.e., non-hematopoietic BM cells) found in the lamina propria on days 10 and 30. These data indicate that non-hematopoietic BM cells as well as hematopoietic BM cells can migrate from the recipient's bone marrow, suggesting that recipient mesenchymal stem cells may be strongly implicated in graft regeneration and development after FSITx.

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  • [Cell-mediated gene therapy using bone marrow derived cells towards regenerative medicine].

    Makoto Migita, Jun Hayakawa, Mari Hayashida, Ryuji Fukazawa, Yoshitaka Fukunaga, Takashi Shimada

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   70 ( 5 )   432 - 5   2003年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Cardiomyocyte regeneration from circulating bone marrow cells in mice. 国際誌

    Yukio Kuramochi, Ryuji Fukazawa, Makoto Migita, Jun Hayakawa, Mari Hayashida, Yohko Uchikoba, Daichi Fukumi, Takashi Shimada, Shunichi Ogawa

    Pediatric research   54 ( 3 )   319 - 25   2003年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We investigated the role of circulating bone marrow cells (BMC) in cardiomyocyte regeneration. BMC, isolated from transgenic mice expressing enhanced green fluorescent protein (GFP), were transplanted into lethally irradiated C57BL6 mice. Five weeks after bone marrow transplantation (BMT), flow cytometric analysis for GFP-positive cells confirmed reconstitution of transplanted bone marrow. Bone marrow transplant mice subsequently underwent left coronary artery ligation (myocardial infarction) or sham-operation, and were killed at 1 mo or 3 mo after operation. Infarct size was similar in bone marrow transplant mice at 1 mo (47.1 +/- 5.9%) and at 3 mo (45.3 +/- 7.8%), and echocardiography at 2 and 8 wk revealed decreasing left ventricular function. In infarcted heart, GFP-positive cells that expressed desmin and troponin T-C were identified by confocal microscopy. GFP and troponin T-C double-positive cells were predominantly in the peri-infarcted region (1 mo, 365 +/- 45 cells/50 sections; 3 mo: 458 +/- 100 cells/50 sections; p < 0.05 versus noninfarct, infarct, and sham-operated regions). Furthermore, BMC mobilization and differentiation into cardiomyocytes was found to be complete within 1 mo after myocardial infarction. These results demonstrate that circulating BMC undergo mobilization and differentiation in cardiac cells after myocardial infarction. Future studies are required to determine the molecular signaling mechanisms responsible for this phenomenon.

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  • Glucocerebrosidase level in the cerebrospinal fluid during enzyme replacement therapy--unsuccessful treatment of the neurological abnormality in type 2 Gaucher disease. 国際誌

    Makoto Migita, Hisamitsu Hamada, Juri Fujimura, Atsushi Watanabe, Takashi Shimada, Yoshitaka Fukunaga

    European journal of pediatrics   162 ( 7-8 )   524 - 525   2003年7月

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  • Home treatment with enzyme replacement therapy in a 5-year-old girl with type 2 Gaucher disease. 国際誌

    Makoto Migita, Takashi Shimada, Jun Hayakawa, Cai Ling Zhi, Toshisada Morita, Kiyohiko Ohshiro, Yoshitaka Fukunaga

    Pediatrics international : official journal of the Japan Pediatric Society   45 ( 3 )   363 - 5   2003年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Generation of a chimeric mouse reconstituted with green fluorescent protein-positive bone marrow cells: a useful model for studying the behavior of bone marrow cells in regeneration in vivo.

    Jun Hayakawa, Makoto Migita, Takahiro Ueda, Takashi Shimada, Yoshitaka Fukunaga

    International journal of hematology   77 ( 5 )   456 - 62   2003年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Studies have indicated that bone marrow contains both hematopoietic stem cells and mesenchymal stem cells that can differentiate into a variety of mesenchymal tissues, such as bone, cartilage, muscle, and adipose tissue. Therefore, bone marrow cells are thought to be very useful for cell and gene therapy for various diseases. However, the multipotentiality of these cells remains unclear. To address this issue, we established a chimeric model mouse stably reconstituted with green fluorescent protein (GFP)-marked bone marrow cells. We injected bone marrow cells from GFP-transgenic C57BL/6 mice into the tail veins of recipient wild-type C57BL/6 mice that had been irradiated with a lethal dose of 10 Gy from a cesium source. Microscopic examination and fluorescence-assisted cell sorter (FACS) analysis showed that bone marrow cells, including mesenchymal cells, were almost completely reconstituted with GFP+ cells 5 weeks after transplantation. FACS analysis with lineage-specific antibodies confirmed that the GFP+ cells could differentiate into all types of blood cells. To confirm the usefulness of this mouse model, we studied the role of circulating bone marrow-derived cells in healing of damaged intestine. We performed amputation and anastomosis of the jejunum 10 cm from the pyloric region of the stomach. On the third day after operation, a large number of GFP+ cells were infiltrated in the area of anastomosis, and these cells were positive for CD45 and F4/80 antigens. In 7 days, several cells became negative for CD45 and F4/80 and positive for alpha smooth muscle actin antigen, which is specific for smooth muscle. This finding suggested that bone marrow-derived cells had differentiated into smooth muscle. Because reconstituted bone marrow cells as opposed to injected bone marrow cells, behave naturally, this model is ideal for studying the multipotentiality of bone marrow cells in vivo.

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  • Successful immunosuppressive therapy for a child with Myelodysplastic syndrome. 国際誌

    Mizue Orimoto, Miho Maeda, Ling-Zhi Cai, Jun Hayakawa, Takahiro Ueda, Makoto Migita, Takeshi Asano

    Medical and pediatric oncology   40 ( 5 )   334 - 5   2003年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Establishment of modified chimeric mice using GFP bone marrow as a model for neurological disorders. 国際誌

    Tsuyoshi Furuya, Ryota Tanaka, Takao Urabe, Jun Hayakawa, Makoto Migita, Takashi Shimada, Yoshikuni Mizuno, Hideki Mochizuki

    Neuroreport   14 ( 4 )   629 - 31   2003年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Chimeric mice stably reconstituted with bone marrow cells represent a good model for analysis of the mechanism of bone marrow cell infiltration in the brain. However, in preparing chimeric mice, irradiation of the recipient mice is necessary to kill their own bone marrow before transplantation, which induces gliosis and inflammatory response by activation of astrocytes and microglia in the brain. Here, we determined the most suitable dose of irradiation associated with the least brain damage before transplantation for reconstitution of chimeric mice, using FACS analysis. Our mouse model of 10 Gy body/5 Gy head irradiation should be useful for investigating the mechanism(s) of microglial activation in various neurological disorders such as stroke, Alzheimer's disease and Parkinson's disease.

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  • Genetic diagnosis of Werdnig-Hoffmann disease: a problem for application to prenatal diagnosis.

    Makoto Migita, Makoto Migita, Yohko Uchikoba, Hideo Orimo, Takashi Shimada, Takashi Shimada, Tae Matsumoto, Jun Hayakawa, Osamu Fujino, Makiko Saitoh, Yoshitaka Fukunaga

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   70 ( 1 )   45 - 8   2003年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We report a floppy infant with Werdnig-Hoffmann disease (spinal muscular atrophy: SMA type 1) and Klinefelter syndrome. After genetic counseling with parents, a genetic diagnosis using DNA from the infant's peripheral blood mononuclear cells was performed. The parents' deletion of exons 7 and 8 of the survival motor neuron (smn) gene and exons 4 and 5 of the neuronal apoptosis inhibitory protein (naip) gene were noted in the infant, so he was confirmed to have SMA type 1. The parents wanted to receive a prenatal diagnosis on the next pregnancy. However this genetic test is achieved by confirming that a specific band can not be detected by PCR. Therefore, this method should be applied with great care to prenatal diagnosis using chorionic villi, which may be contaminated with maternal tissue.

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  • Long-term systemic therapy of Fabry disease in a knockout mouse by adeno-associated virus-mediated muscle-directed gene transfer. 国際誌

    Hiroshi Takahashi, Yukihiko Hirai, Makoto Migita, Yoshihiko Seino, Yuh Fukuda, Hitoshi Sakuraba, Ryoichi Kase, Toshihide Kobayashi, Yasuhiro Hashimoto, Takashi Shimada

    Proceedings of the National Academy of Sciences of the United States of America   99 ( 21 )   13777 - 82   2002年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Fabry disease is a systemic disease caused by genetic deficiency of a lysosomal enzyme, alpha-galactosidase A (alpha-gal A), and is thought to be an important target for enzyme replacement therapy. We studied the feasibility of gene-mediated enzyme replacement for Fabry disease. The adeno-associated virus (AAV) vector containing the alpha-gal A gene was injected into the right quadriceps muscles of Fabry knockout mice. A time course study showed that alpha-gal A activity in plasma was increased to approximately 25% of normal mice and that this elevated activity persisted for up to at least 30 weeks without development of anti-alpha-gal A antibodies. The alpha-gal A activity in various organs of treated Fabry mice remained 5-20% of those observed in normal mice. Accumulated globotriaosylceramide in these organs was completely cleared by 25 weeks after vector injection. Reduction of globotriaosylceramide levels was also confirmed by immunohistochemical and electronmicroscopic analyses. Echocardiographic examination of treated mice demonstrated structural improvement of cardiac hypertrophy 25 weeks after the treatment. AAV vector-mediated muscle-directed gene transfer provides an efficient and practical therapeutic approach for Fabry disease.

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  • Zanamivir is an effective treatment for influenza in children undergoing therapy for acute lymphoblastic leukemia. 国際誌

    Miho Maeda, Yoshitaka Fukunaga, Takeshi Asano, Makoto Migita, Takahiro Ueda, Jun Hayakawa

    Scandinavian journal of infectious diseases   34 ( 8 )   632 - 3   2002年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We diagnosed influenza infection in 2 children receiving maintenance treatment for acute lymphoblastic leukemia. Both patients received zanamivir within 1 d of the onset of fever and their symptoms of influenza were rapidly alleviated. We conclude that inhaled zanamivir seems to be an effective treatment for influenza infection in immunocompromised patients.

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  • Differentiation of transplanted bone marrow cells in the adult mouse brain 査読

    Kikue Nakano, Makoto Migita, Hideki Mochizuki, Takashi Shimada

    Transplantation   71 ( 12 )   1735 - 1740   2001年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Lippincott Williams and Wilkins  

    Background. Bone marrow transplantation is reportedly effective in preventing the progression of neurological deterioration in lysosomal storage disorders, although the mechanism underlying the therapeutic effects remains to be elucidated. Recent research on stem cell biology suggests that bone marrow cells contain nonhematopoietic stem cells, including brain precursor cells. To evaluate the contribution of bone marrow cells as carriers for cell and gene therapy of neurological disorders, we studied the fate of transplanted bone marrow cells in the adult mouse brain. Methods. Bone marrow cells were genetically marked with a retroviral vector containing the green fluorescence protein gene and then transplanted into irradiated mice by either systemic infusion or direct injection. To identify cell types, brain sections were stained with specific antibodies against neuronal cell markers - neuron specific enolase for neurons, glial fibrillary acidic protein (GFAP) for astrocytes, carbonic anhydrase II (CAII) for oligodendrocytes, and ionized calcium binding adaptor molecule 1 (Iba1) for microglia - and then examined under a confocal microscope. Results. Twenty-four weeks after systemic infusion, transplanted cells expressed Iba1 but none of the other brain cell markers. Conversely, 12 weeks after direct injection, transplanted cells were stained with antibodies against GFAP, CAII, and Iba1. Conclusions. Bone marrow contains cells capable of differentiating into oligodendrocytes, astrocytes, and microglia when exposed to the brain microenvironment. Autologous bone marrow cells may be useful as carriers for ex vivo gene therapy for lysosomal disorders with neurological symptoms.

    DOI: 10.1097/00007890-200106270-00006

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  • Two cases of influenza with impaired ocular movement 査読

    Makoto Migita, Tae Matsumoto, Osamu Fujino, Yasuko Takaishi, Nobuhiro Yuki, Yoshitaka Fukunaga

    European Journal of Paediatric Neurology   5 ( 2 )   83 - 85   2001年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W.B. Saunders Ltd  

    Complications of influenza include respiratory disorders (pneumonia, bronchitis and croup) and occasionally myocarditis, myositis, encephalitis, encephalopathy and Reye's syndrome, which may be life-threatening and cause various sequelae. We report two patients who developed unusual complications of influenza infection: one had ptosis and impaired ocular movement, and the other suffered from Guillain-Barré syndrome with paralysis of the extraocular muscles.

    DOI: 10.1053/ejpn.2001.0470

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  • Improvement of bone disease with increased dose of glucocerebrosidase in a Gaucher disease patient who had a bone lesion presenting during low-dose enzyme replacement therapy

    Takahiro Ueda, Yoshitaka Fukunaga, Makoto Migita, Atsushi Watanabe, Kiyoshi Kaneko, Toshisada Morita, Masao Yamamoto

    Pediatrics International   38 ( 3 )   260 - 264   1996年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In recent years, enzyme replacement therapy has been shown to be useful for the treatment of Gaucher disease. A 10 year old Japanese boy with Gaucher disease underwent splenectomy at the age of 5 years and received enzyme replacement therapy from the age of 6 years. He had avascular necrosis of the bilateral femoral heads, which was not seen at the beginning of the therapy, without deterioration of hematological variables during maintenance therapy. The enzyme dosage was increased from 20 to 120 IU/kg per month resulting in an improvement of the clinical symptoms and bone lesion. In enzyme replacement therapy, dose increase is considered to be essential for improvement in bone disease
    however, it is important to watch for the development of bone lesion. © 1996 Japan Pediatric Society.

    DOI: 10.1111/j.1442-200X.1996.tb03482.x

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MISC

  • 幼児期に糖尿病ケトアシドーシスに皮下気腫・縦郭気腫を合併し、Hamman症候群と診断した一例

    濱本 光, 田嶋 華子, 竹下 輝, 佐野 透美, 右田 真

    神奈川医学会雑誌   48 ( 2 )   79   2021年7月

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究発表ペーパー・要旨(全国大会,その他学術会議)  

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  • 感染症診療における臨床検査技師の役割~COVID-19の経験から~ 当院における新型コロナウイルス感染症対応と検査体制 クラスター対応を交えて

    井上 雅則, 臼井 一城, 右田 真, 高木 聡, 今田 ゆかり, 上野 ひろむ, 望月 徹, 八木 孝, 松田 潔

    日本臨床救急医学会雑誌   24 ( 2 )   198   2021年5月

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    記述言語:日本語   掲載種別:研究発表ペーパー・要旨(全国大会,その他学術会議)  

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  • 学校検尿で発見され、確定診断までに時間を要した緩徐進行1型糖尿病の2症例

    田嶋 華子, 高橋 美奈子, 右田 真

    小児保健研究   80 ( 講演集 )   182   2021年5月

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究発表ペーパー・要旨(全国大会,その他学術会議)  

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  • 新生児に対する低体温療法の経験

    濱本 光, 島 義雄, 猪狩 直之, 矢代 健太郎, 峯 牧子, 右田 真

    日本医科大学医学会雑誌   16 ( 4 )   257 - 257   2020年10月

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    記述言語:日本語   出版者・発行元:日本医科大学医学会  

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  • インフリキシマブ被投与母体児7例の薬剤血中濃度と生ワクチン接種時期の検討

    永井 博之, 峯 牧子, 松本 多絵, 赤尾 見春, 山西 愼吾, 早川 潤, 右田 真

    日本小児科学会雑誌   124 ( 2 )   287 - 287   2020年2月

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    記述言語:日本語   出版者・発行元:(公社)日本小児科学会  

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  • 胎盤由来のエクソソーム 胎盤特異的microRNAはエクソソームを介して母体循環に分泌される

    瀧澤 俊広, アリ・モハメド, 羅 善順, 石橋 宰, 菊地 邦生, 石川 朋子, 瀧澤 敬美, 倉品 隆平, 右田 真, 大口 昭英, 松原 茂樹, 竹下 俊行

    日本生化学会大会プログラム・講演要旨集   84回   2S4a - 4   2011年9月

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    記述言語:日本語   出版者・発行元:(公社)日本生化学会  

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  • Heinz小体の出現を伴う一過性溶血発作を呈した極低出生体重児10例の経験

    熊坂栄, 島義雄, 中島瑞恵, 右田真

    日本医科大学医学会雑誌   7 ( 1 )   16-19 (J-STAGE) - 19   2011年

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    記述言語:日本語   出版者・発行元:日本医科大学医学会  

    We report on 10 premature infants with acute hemolytic anemia and Heinz bodies treated from 1999 to 2007 and discuss their clinical characteristics. All patients were very low birth weight infants (mean gestational age, 27 weeks; range, 24~30 weeks; mean birth weight, 889g; range, 598~1,412g), and hemolytic anemia developed after cardiopulmonary adaptation had been achieved. Heinz body appeared an average of 20 days after birth (range, 11~25 days), and hemolysis persisted for an average of 9 days (range, 4~16 days) and spontaneously resolved. Hemolytic anemia and jaundice developed suddenly, during which time Heinz bodies were observed on hematologic examination. The affected infants showed refractory apnea just before the onset of hemolytic anemia.&lt;br&gt; The exact cause of these hemolytic episodes remains unclear. However, the immature antioxidant function of the red blood cell membrane against oxygen radicals was a suspected cause, because most of the infants required ventiratory managements with high concentration of supplemental oxygen.&lt;br&gt;

    DOI: 10.1272/manms.7.16

    CiNii Books

    J-GLOBAL

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  • HIV陽性患者に対する造血幹細胞を標的とした遺伝子治療時の遺伝子挿入部位の検討

    早川 潤, 植田 高弘, 右田 真, 福永 慶隆

    日本小児科学会雑誌   113 ( 2 )   380 - 380   2009年2月

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    記述言語:日本語   出版者・発行元:(公社)日本小児科学会  

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  • 脂肪由来ストローマ細胞を用いた人工骨髄の作製

    藤田 敦士, 右田 真, 植田 高弘, 早川 潤, 福永 慶隆, 島田 隆

    日本小児科学会雑誌   113 ( 2 )   308 - 308   2009年2月

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    記述言語:日本語   出版者・発行元:(公社)日本小児科学会  

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  • 在胎週数による臍帯血造血幹/前駆細胞の相違の検討

    中島瑞恵, 植田高弘, 島義雄, 右田真, 島田隆, 福永慶隆

    日本小児科学会雑誌   112 ( 2 )   275 - 275   2008年2月

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    記述言語:日本語   出版者・発行元:(公社)日本小児科学会  

    J-GLOBAL

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  • Hematopoiesis in bone marrow regenerated from adipose-derived stromal cells

    Makoto Migita, Atsushi Fujita, Rei Ogawa, Takabiro Ueda, Yoshitaka Fukunaga, Takashi Shimada

    BLOOD   110 ( 11 )   96B - 96B   2007年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:AMER SOC HEMATOLOGY  

    0

    DOI: 10.1182/blood.V110.11.4108.4108

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  • 早産由来臍帯血造血幹細胞の機能解析

    中島瑞恵, 植田高弘, 島義雄, 熊坂栄, 水書教雄, 大上友紀, 右田真

    日本周産期・新生児医学会雑誌   43 ( 2 )   613 - 613   2007年6月

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    記述言語:日本語   出版者・発行元:(一社)日本周産期・新生児医学会  

    J-GLOBAL

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  • 在胎周数による臍帯血造血幹/前駆細胞の相違の検討

    中島瑞恵, 植田高弘, 島義雄, 右田真, 島田隆, 福永義隆

    日本小児血液学会・日本小児がん学会学術集会・日本小児がん看護研究会・血友病看護研究会・財団法人がんの子供を守る会公開シンポジウムプログラム・総会号   49th-23rd-5th-4th-12th ( プログラム・総会号 )   343 - 343   2007年

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    記述言語:日本語   出版者・発行元:(NPO)日本小児がん学会  

    J-GLOBAL

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  • A Single Unilateral Injection of AAV1-ASA and AAV1-FGE Vectors into the Hippocampus Results in Bilateral Expression and Widespread Distribution of ASA and Prevention of Sulfatide Storage in the Whole Brain of MLD Model Mice

    Toshiyuki Kurai, Sanae Hisayasu, Yukihiko Hirai, Makoto Migita, Hidenori Suzuki, Takashi Shimada

    MOLECULAR THERAPY   13   S156 - S156   2006年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:NATURE PUBLISHING GROUP  

    Web of Science

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  • 一過性の神経障害とMRI上大脳白質の変化を呈した造血器悪性腫瘍症例

    海津 聖彦, 前田 美穂, 黒田 奈緒, 小林 史子, 楢崎 秀彦, 右田 真, 福永 慶隆

    日本小児血液学会雑誌   19 ( 5 )   522 - 522   2005年10月

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    記述言語:日本語   出版者・発行元:日本小児血液学会  

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  • 薬剤耐性白血病細胞に対するDNAマイクロアレイによる解析

    浅野 健, 蔡 霊芝, 早川 潤, 右田 真, 前田 美穂, 福永 慶隆

    日本小児血液学会雑誌   16 ( 4 )   221 - 221   2002年8月

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    記述言語:日本語   出版者・発行元:日本小児血液学会  

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  • 骨髄細胞の多能性の解析に向けて GFP陽性骨髄細胞のモデルマウスの作成

    早川 潤, 右田 真, 植田 高弘, 福永 慶隆, 島田 隆

    Journal of Nippon Medical School   68 ( 6 )   570 - 570   2001年12月

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    記述言語:日本語   出版者・発行元:日本医科大学医学会  

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  • 先天代謝異常症の新しい治療法の開発 骨髄細胞の多能性の解明に向けて GFP陽性骨髄細胞のモデルマウスの作成

    早川 潤, 右田 真, 植田 高弘, 島田 隆, 福永 慶隆

    日本先天代謝異常学会雑誌   17 ( 2 )   101 - 101   2001年10月

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    記述言語:日本語   出版者・発行元:日本先天代謝異常学会  

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  • 骨髄細胞の多能性の解明にむけたGFP陽性骨髄細胞モデルマウスの作成 再生医学への応用

    早川 潤, 右田 真, 植田 高弘, 島田 隆, 福永 慶隆

    日本小児血液学会雑誌   15 ( 4 )   340 - 340   2001年8月

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    記述言語:日本語   出版者・発行元:日本小児血液学会  

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  • ドキソルビシン耐性白血病細胞株に対するマイクロアレイ法による検討(Microarray analysis on doxorubicin-resistant leukemia cell lines)

    浅野 健, 早川 潤, 植田 高広, 右田 真, 前田 美穂

    International Journal of Hematology   73 ( Suppl.1 )   121 - 121   2001年3月

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    記述言語:日本語   出版者・発行元:(一社)日本血液学会  

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  • 骨髄細胞の多能性の解析に向けて GFP陽性骨髄細胞のモデルマウスの作成

    早川 潤, 右田 真, 植田 高弘, 島田 隆, 福永 慶隆

    日本小児科学会雑誌   105 ( 3 )   297 - 297   2001年3月

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    記述言語:日本語   出版者・発行元:(公社)日本小児科学会  

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共同研究・競争的資金等の研究課題

  • 脂肪由来間葉系幹細胞を用いた骨髄再生の研究・人工骨髄の作成をめざして

    研究課題/領域番号:26461595  2014年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    植田 高弘, 右田 真

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    配分額:4940000円 ( 直接経費:3800000円 、 間接経費:1140000円 )

    マウス脂肪由来間葉系細胞を用い作成した人工骨髄が、免疫不全マウスであるNODマウスの皮下で、造血細胞の長期維持が可能であること確認し骨髄ニッチを提供する能力を有することを示した。また、脂肪由来間葉系幹細胞の抗炎症効果の確認のため冠動脈血管炎モデルマウスを用いて検証したところ、炎症性サイトカインの抑制や血管炎の面積の減少など抗炎症効果や免疫調節機能があることが確認できており、今後の骨髄再構築の機序の解明に役立つデターが得られている。

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  • 重篤な遺伝病に対する周産期遺伝子治療

    研究課題/領域番号:22390212  2010年 - 2012年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    島田 隆, 三宅 弘一, 右田 真, 渡邉 淳

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    配分額:18980000円 ( 直接経費:14600000円 、 間接経費:4380000円 )

    遺伝性神経脱髄疾患である異染性白質ジストロフィー(MLD)と、遺伝性骨系統疾患である低フォスファターゼ症(HPP)のモデルマウスを使い、アデノ随伴ウイルスベクター(AAV)による胎児/新生児遺伝子治療の可能性を検討した。新生児MLDマウスにAAVベクターを静脈内投与すると、ベクターは血液脳関門(BBB)を越えて中枢神経系に侵入し、広範囲な脳組織への遺伝子導入が認められた。その結果、モデルマウスの神経症状が改善した。HPPモデルマウスの胎児の腹腔内にAAVベクターを投与する実験では、出生児の骨形成不全の改善と生存期間の延長が認められた。これらの結果は周産期の遺伝子治療が重篤な遺伝病の治療法として有用であることを示している。

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  • ヒト人工骨髄の作成と造血幹細胞・白血病幹細胞のニッチの解析研究

    研究課題/領域番号:22591169  2010年 - 2012年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    植田 高弘, 右田 真

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    配分額:4420000円 ( 直接経費:3400000円 、 間接経費:1020000円 )

    ヒト間葉系細胞を用い作成した人工骨髄が、免疫不全マウスであるNODマウスの皮下で、ヒト造血細胞の長期維持が可能であること確認し骨髄ニッチを提供する能力を有することを示した。また、マウスの脂肪細胞より人工骨髄を作成してその機能解析を行い脂肪由来ストローマ細胞から作成した人工骨髄が自己複製能と多分化能を維持できる環境(骨髄ニッチ)を提供する能力を有することを示した。

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  • 遺伝性神経変性疾患に対する非侵襲遺伝子治療法の開発(BBBを越えられるか?)

    研究課題/領域番号:17390305  2005年 - 2007年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    島田 隆, 右田 真, 三宅 弘一, 渡邉 淳, 望月 秀樹, 塙 秀樹, 久安 早苗

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    配分額:16410000円 ( 直接経費:15300000円 、 間接経費:1110000円 )

    ASA(ArylsulfataseA)酵素欠損症であるMLD(Metachromatic leukodystrophy)をモデルとした、遺伝性神経変性疾患の非侵襲的治療法について検討した。
    1.リソゾーム酵素受容体発現ベクターの構築:ヒト胎盤RNAライブラリーからリソソーム酵素受容体である全長7.6kbのマンノース-6-リン酸レセプター(M6PR)遺伝子をPCRクローニングした。M6PRからinsulin-like growth factor II receptor(IGFIIR)機能を欠損させた4.8kbのminigeneがリソゾーム酵素受容体活性をもつことを示した。Minigeneを組み込んだレンチウイルスベクターを作製し、浮遊系細胞を含む様々な細胞でM6PRを強制発現させることを可能にした。このレンチウイルスベクターをヒト臍帯静脈内皮細胞(HUVEC細胞)やラットのBBB細胞に感染させたところM6PRminigeneの発現とASAの細胞内への取り込みが確認された。M6PRminigine発現レンチウイルスベクターはリソゾーム酵素の細胞内移動の研究に役立つだけでなく、リソゾーム病の酵素補充療法や作用増強や、BBBを越えての神経組織の治療に役立つことが期待される。
    2.ウイルスベクターの髄腔内投与による中枢神経系組織への遺伝子導入:現在、研究されているウイルスベクターを脳実質内に注射する侵襲的遺伝子治療は、ヒトへの治療法としては技術的にも倫理的にも問題がある。非侵襲的遺伝子導入法として髄腔内投与法の可能性を検討した。GFPを発現するAAV1ベクターをマウスの後頭蓋窩から注入した。8週間後の解析で、広範囲の脳組織でのベクターの導入が確認された。更に、脊髄後根神経節細胞及び後索神経線維でのGFPの発現を認めた。ASAノックアウトマウスへの髄腔内投与実験では有意なスルファチドの減少が確認された。AAV1ベクターの髄腔内注入はMLD等の遺伝性神経変性疾患の非侵襲的遺伝子治療として有用であるとともに、慢性疼痛などの末梢神経疾患の治療法としても期待される。

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  • 造血幹細胞の生着のメカニズムの解明

    研究課題/領域番号:16659282  2004年 - 2006年

    日本学術振興会  科学研究費助成事業  萌芽研究

    右田 真, 植田 高弘, 早川 潤

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    配分額:2800000円 ( 直接経費:2800000円 )

    近年、骨髄生着に骨髄ストローマ由来のケモカインSDF-1とそのレセプターとしてのCXCR4が同定され、造血幹細胞においてCXCR4の発現が重要な役割を果たしていることがわかった。さらに、SDF-1の発現にDextran sulfateの関与も示唆されている。そこで、少ない造血幹細胞でもこれらのケモカインや受容体を付加することにより骨髄生着率が上がり臍帯血移植の適応拡大につなげられると思い至った。我々は造血幹細胞移植において、SDF-1の分泌因子Dextran sulfate(Dex)、SDF-1着目した。この研究を通じて、骨髄移植のドナーに対するDexとSDF-1の前投与が骨髄生着を向上させること、DexがSDF-1と比較すると効率よく働くことを示した。さらにRT-PCR法を用いてDexのこの作用はCXCR4,LFA1,MMP9,VLA4/5などの骨髄生着に関する遺伝子を発現をup-regurateしていることを証明した。この研究成果は造血幹細胞の含有数の少ない臍帯血を用いた移植治療の適応拡大に直結するものです。

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  • 遺伝子導入及び幹細胞移植技術を応用した遺伝性神経変性疾患の治療法の開発

    研究課題/領域番号:14370253  2002年 - 2004年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    島田 隆, 右田 真, 三宅 弘一, 望月 秀樹, 西 克典, 平井 幸彦, 鈴木 聡

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    配分額:14000000円 ( 直接経費:14000000円 )

    ASA(ArylsulfataseA)酵素欠損症であるMLD(Metachromatic leukodystrophy)をモデルとした、遺伝性神経変性疾患の細胞遺伝子治療の可能性を検討した。
    1.遺伝子治療
    (1)ASAの活性化:スルファターゼの活性化酵素として最近クローニングされたFGE(SUMF1)の発現ベクターを作製し、ASA発現への影響を検討した。in vitroの実験では、FGEの共発現により、数十倍のASA活性の上昇が認められた。FGEによる活性化作用は、マウス肝臓や脳組織でも認められた。
    (2)AAVベクターによる遺伝子治療:これまでの2型AAVに加え、1、5、7、8型サブタイプのAAVベクターの作製に成功した。1型AAVのマウス脳内への直接注入により広い範囲に、高率に遺伝子が導入された。ASA遺伝子を組み込んだAAV1ベクターによる治療実験では、脳全体にわたるASA活性の上昇、蓄積スルファチドの減少が確認された。運動機能の改善も認められた。
    2.幹細胞治療
    (1)グリーンマウスを使った多能性幹細胞実験系の確立:GFPトランスジェニックマウスから調整した骨髄由来幹細胞(BSC)や脂肪組織由来幹細胞(ASG)を移植してその多分化能を調べる実験系を確立した。BSCが様々な組織の修復に関係していることを明らかにした。また、ASCがBSC同様の分化能を示すことを確認し、その組織細胞工学への応用への道を開いた。
    (2)神経幹細胞を使った細胞遺伝子治療:マウス胎児より調整した神経幹細胞(Neursphere)をキャリアーとする遺伝子治療の可能性を検討した。HIVベクターによりASAを高発現している幹細胞を脳内に注入した1月後の解析ではドナー細胞のみならず、周囲のレシピエント細胞でもASAの発現が認められ、ASAの分泌と取り込みが示唆された。

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  • 体外増幅したヒト造血幹細胞に対するCXCR-4遺伝子導入-臍帯血移植の適応拡大を目指して-

    研究課題/領域番号:14570780  2002年 - 2003年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    福永 慶隆, 植田 高弘, 右田 真

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    配分額:3000000円 ( 直接経費:3000000円 )

    造血幹細胞移植は、血液疾患、悪性腫瘍のみならず代謝異常症や免疫不全症など多くの疾患に対する日常的な治療となりつつあり、そのソースとして臍帯血の有用性はすでに認められている。しかし含有される造血幹細胞の量的な制限がある。もし造血幹細胞の骨髄への生着率を向上することができれば、造血幹細胞移植成立に必要な幹細胞数を減少させる事が可能となる。近年の、骨髄ストローマ由来のケモカインでpreB細胞の増殖因子であるSDF-1とそのレセプターCXCR4の造血幹細胞における発現が骨髄生着に重要な役割を果たしていること、さらにDextran sulfate(Dex)がSDF-1の分泌に関与することがわかてきた。そこで我々は、GFPマウスをドナー、Ly5.2マウスをレシピエントとして骨髄移植実験を行なった。Dex及びSDF1をマウスに経静脈的に投与すると濃度依存性に末梢白血球数の上昇を認めた。また前処置としてSDF1、Dexを各々投与したドナーGFPマウスから採取した4×105個の骨髄単核球を移植した群と、前処置していないドナーマウスの骨髄を移植したコントロール群を比較したところ、移植1カ月後に骨髄生着率はコントロール群に比しSDF1、DEXを投与した群は有意に上昇した。また移植10日後の末梢白血球数とキメラリズムを解析したSDF1、Dex投与群ではキメリズムの上昇と末梢白血球の早期回復が認められた。さらに、DNAチップを用いてマウスにSDF1,DEXを投与したのちに骨髄採取し、SDF1,DEX投与時の骨髄生着に関与するケモカイン、サイトカインの発現を調べ骨髄生着率向上に関与する因子の検討を進めていく。

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  • TH遺伝子を導入したヒト羊膜細胞を用いたパーキンソン病に対する細胞移植治療

    研究課題/領域番号:11877110  1999年 - 2000年

    日本学術振興会  科学研究費助成事業  萌芽的研究

    北村 伸, 望月 秀樹, 右田 真

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    配分額:2100000円 ( 直接経費:2100000円 )

    難治性神経変性疾患であるパーキンソン病に対する治療法は未だに確立していない。ヒト羊膜は発生学的には外、中、内胚葉に分化する以前の胎生8日目に胚盤葉上層より生じ、免疫学的にも幼弱であり同種移植により急性拒絶反応を惹起しない組織である。我々はヒト羊膜細胞にレトロウイルスベクターを用いてドーパミン産生における補酵素であるチロシンハイドロキシラーゼ(TH)遺伝子を導入してドーパミン産生能を高めた上で細胞移植する方法を確立した。我々は治療用遺伝子THとマーカー遺伝子GFPを組み込んだレトロウイルスベクターを作製した。これらのウイルスベクターを用いてヒト羊膜細胞に遺伝子導入が可能であることを確認した。さらに遺伝子導入した羊膜細胞をラットの脳に定位的移植術を行ない中枢神経系での遺伝子の発現を確認した。

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  • 常染色体劣性遺伝若年性パーキンソン病(ARJP)に対する遺伝子治療の基礎研究

    研究課題/領域番号:11470150  1999年 - 2000年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    望月 秀樹, 右田 真, 服部 信孝, 卜部 貴夫, 水野 美邦, 島田 隆

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    配分額:2800000円 ( 直接経費:2800000円 )

    我々の教室では常染色体劣性遺伝形成を呈する若年性パーキンソニズム(AR-JP)の連鎖解析及び遺伝子クローニングに成功しparkin遺伝子と命名し報告した。AR-JPは若年発症がために薬物治療のみでは,多くの問題を抱えている.したがって新たな治療の確立はAR-JP患者にとって極めて重要と考える.特に常染色体劣性遺伝形式のため遺伝子変異は全てloss of functionを呈する.loss of function型は,そのコードする蛋白が細胞維持に必須であることを示しているため,欠損した遺伝子のreplacementは疾患治療となることが推測される。日本で同定されたparkin遺伝子を用いて,日本に多い若年性パーキンソン病の恒久的治癒を目標とした遺伝子治療の確立は独創的かつ臨床症状の改善に直結するものと思われる。そこで我々は、安全でかつ効果的に神経細胞に,遺伝子導入が可能なアデノ随伴ウイルスベクターに着目し、治療用遺伝子としてparkin遺伝子を組み込んだ組換えウイルスベクターを作成した.具体的には,CAGプロモーターにparkin遺伝子をdriveさせ,さらにB19プロモーターにEGFPを働かせることにより同時に2種の遺伝子を発現できるシステムを開発した.すでの培養系で働くことを確認し,正常ラット,マウスでその発現を確認している.ラット,マウスでは,すでに3ヶ月間の発現を確認しており長期発現も可能なベクターであることを示した。
    現在ノックアウトマウスを作製中である。

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  • ヒト羊膜細胞をキャリアーとする酵素欠損症に対する遺伝子導入細胞移植治療の検討

    研究課題/領域番号:11877135  1999年 - 2000年

    日本学術振興会  科学研究費助成事業  萌芽的研究

    右田 真

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    配分額:2000000円 ( 直接経費:2000000円 )

    今日、ゴーシェ病や異染性白質ジストロフィーなどの先天性酵素欠損症に対する治療は、骨髄移植、酵素補充療法などが試みられているものの、いまだ確立されていない。ヒト羊膜は発生学的には外、中、内胚葉に分化する以前の胎生8日目に胚盤葉上層より生じ、免疫学的にも幼弱であり同種移植により急性拒絶反応を惹起しない組織である。本研究ではこのヒト羊膜細胞に治療用遺伝子を導入し(遺伝子治療)、欠損酵素の産生能を高めた細胞を同種移植する(細胞移植治療)という新しい治療方法の基礎研究を行った。我々は治療用遺伝子としてGaucher病の責任遺伝子であるglucocerebrosidase cDNA(GC)や異染性白質ジストロフィーの責任遺伝子ArylsulfataseA cDNA(ASA)、マーカー遺伝子としてGreen fluorescent protein(GFP)を有する2種類のレトロウイルスベクターを作製した。これらのウイルスベクターを用いてヒト羊膜細胞に遺伝子導入が可能であることを確認した。さらに遺伝子導入した羊膜細胞をラットの脳に定位的移植術を行ない中枢神経系での遺伝子の発現を確認した。

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  • 造血幹細胞移植による異染性ロイコジストロフィーの遺伝子治療法の開発

    研究課題/領域番号:10877127  1998年 - 1999年

    日本学術振興会  科学研究費助成事業  萌芽的研究

    大木 由加志, 右田 真

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    配分額:1600000円 ( 直接経費:1600000円 )

    異染性白質ジストロフィー(MLD)は、リソゾーム酵素の一種であるアリルサルファターゼA(ASA)の欠損による常染色体劣勢遺伝の先天性代謝異常症である。MLDに対しては現在のところ症状が出現する前の骨髄移植がある程度有効とされている。そこで我々はレトロウィルスに治療用遺伝子ASAcDNAとともに選択マーカーとしてヒトCD24のcDNAを選択マーカーとして組み込んだ選択レトロウィルスベクターを作製して、遺伝子導入された細胞のみを選択採取することが可能であることを確認して論文発表した。さらに、本疾患は有髄神経の脱髄が主病変であり有効な遺伝子治療を達成するためには髄鞘の形成、保持を担うoligodendrogliaへの遺伝子導入が必要である。神経系細胞への安定した遺伝子導入が可能と考えられるアデノ随伴ウィルス(AAV)ベクターを用いて治療用遺伝子としてASAcDNAをマーカー遺伝子としてEGFPcDNAを有するAAVベクタープラスミドを作製した。このベクターがMLD患者由来の皮膚線維芽細胞へも導入が可能であることを確認した。さらに、モデルマウスであるMLDノックアウトマウスの脳内に注入し ASAの発現を確認した。以上のことよりこのAAVベクターはMLDをはじめ神経症状を呈する先天性代謝異常症に対する遺伝子治療のために期待されるベクターシステムと思われた。

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  • Gaucher病に対する造血幹細胞を標的とした遺伝子治療

    研究課題/領域番号:09557207  1997年 - 1999年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    島田 隆, 右田 真, 山本 正生

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    配分額:11600000円 ( 直接経費:11600000円 )

    Gaucher病は常染色体劣性の遺伝性疾患で、リソソーム酵素の一つであるグルコセレブシダーゼ(GC)の欠損により、その基質であるグルコセレブロシドがマクロファージなどの網内系細胞に蓄積する脂質代謝異常症である。本研究課題はGaucher病をはじめとする遺伝性脂質代謝異常症の遺伝子治療のためのベクターの開発と造血幹細胞への遺伝子導入の最適化を行ったものである。レトロウイルスベクターによるヒトCD34+細胞に対する導入実験では、サイトカインの組み合わせ、ベクターとの反応時間、骨髄ストローマやフィブロネクチンの併用などの条件を検討することで導入効率の上昇が確認できた。しかし、分裂細胞にしか感染できないレトロウイルスベクターによるヒト造血幹細胞への遺伝子導入効率は依然として極めて低く、遺伝子導入細胞にgrowth advantageのないGaucher病の治療で効果を期待することは難しいことが明らかになってきた。そこで、新たに非分裂細胞に感染できるHIVベクターを作製し、レトロウイルスベクターでは遺伝子導入が難しい造血幹細胞や神経系細胞への遺伝子導入法を開発した。又、アデノ随伴ウイルス(AAV)のベクターにより神経組織や筋肉で長期間リソソーム酵素を発現できることを明らかにした。更に、骨髄中には造血幹細胞だけでなく神経系細胞に分化できる多能性幹細胞が存在することを明らかにした。これらの新しい遺伝子導入技術と、多能性幹細胞の利用により神経症状を伴うII型のGaucher病の遺伝子細胞治療の可能性を示した。

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  • FACSによる選択性を有するウイルスベクターを用いた造血幹細胞への遺伝子導入

    研究課題/領域番号:09770834  1997年 - 1998年

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    右田 真

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    配分額:1800000円 ( 直接経費:1800000円 )

    我々は昨年まで選択マーカーを有するレトロウイルスベクターの開発を行ってきた。これは、標的細胞にウイルス上清を用いて導入した後に本当に遺伝子が導入がされた細胞のみを選択するシステムを作成しようとするものである。本年はアデノ随伴ウイルスベクター(AAV)においてこの選択システムを確立した。AAVベクターでは神経系細胞への安定した遺伝子導入が可能と考えられる。そこで我々は治療用遺伝子としてASAcDNAを、マーカー遺伝子としてEGFPcDNAを有するAAVベクタープラスミドを作製した。このAAVベクターはベクタープラスミドとパッケージングプラスミド(AAV/Ad)とを同時にHeLa細胞にトランスフェクションし、さらにアデノウイルスを感染させ作成した後に、硫酸セルロースを用いたアフィニティクロマトグラフィーにより精製、濃縮し感染実験を行った。HeLa細胞におけるGFPの発現をFACSで検討したところ、約6%の細胞がGFP陽性であり、陽性細胞が選択可能であることを示し、ASA酵素活性は非導入細胞に比較し1.6倍の増加を認めた。さらにこのベクターがMLD患者由来の皮膚線維芽細胞へも導入が可能であることを確認した。

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