研究者業績
基本情報
研究キーワード
5経歴
5-
2017年5月
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2013年4月 - 2017年4月
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2008年4月 - 2013年3月
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2007年4月 - 2008年3月
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1995年4月 - 1998年3月
学歴
2-
1998年4月 - 2002年3月
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1989年4月 - 1995年3月
論文
144-
Clinical nephrology 102(5) 285-294 2024年11月AIM: Patient education is crucial for preventing chronic kidney disease (CKD) progression, but adequate educational time is not always available in standard nephrology outpatient clinics. However, usefulness of educational materials provided by healthcare providers in educational settings has been reported. This study aimed to compare the efficacy of pamphlet and video materials in increasing CKD knowledge at a nephrology clinic using waiting time. MATERIALS AND METHODS: 44 CKD stage 3 - 5 patients were randomly assigned to either pamphlet or video education group, receiving a single session during an outpatient visit. We evaluated the objective CKD knowledge score, perceived kidney disease knowledge score, self-care scores, and amount of estimated salt intake before and after the educational intervention. RESULTS: In both groups, the educational intervention significantly increased objective and perceived CKD knowledge scores (p < 0.001). No significant differences in increase in total knowledge scores between both groups were observed; however, different educational effects were observed in several individual knowledge items such as urinary protein and CKD stages. In both groups, self-care scores and amount of estimated salt intake did not change significantly before and after the intervention, but amount of estimated salt intake significantly decreased in patients with a history of dietary guidance (p = 0.044). CONCLUSION: A single educational session with simple materials during outpatient waiting time at the nephrology clinic visit significantly improved patients' CKD knowledge, and suitable educational methods may differ according to knowledge items. Furthermore, patients who receive dietary guidance with specific instructions might exhibit salt reduction behavior through the use of educational materials.
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American journal of kidney diseases : the official journal of the National Kidney Foundation 2024年3月22日We present the case of a 61-year-old man who developed nephrotic syndrome as a result of syphilis-associated secondary membranous nephropathy (MN). The patient showed nephrotic syndrome remission following antibiotic treatment for syphilis alone. Pathologically, the target antigen of immune complexes accumulated on glomerular basement membranes (GBM) in secondary MN caused by syphilis has been reported to be neuron-derived neurotrophic factor (NDNF). His renal histopathology was consistent with secondary MN caused by syphilis, with a full-house pattern on immunofluorescence microscopy, in addition to NDNF deposits that co-localized with IgG deposits granularly on the GBM. However, to date, there is no serological evidence for the involvement of NDNF in the GBM. In the present study, we found that anti-NDNF autoantibodies in the acute-phase serum disappeared in the convalescent-phase serum of a patient who recovered from syphilis and nephrotic syndrome after antibiotic therapy alone. This result supports the hypothesis that treatment of syphilis with antibiotics suppresses NDNF's antigenicity. In summary, we found new serological evidence emphasizing that NDNF is an etiological antigen in secondary MN caused by syphilis.
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Allergology international : official journal of the Japanese Society of Allergology 73(1) 174-176 2024年1月
MISC
72-
日本透析医学会雑誌 55(10) 581-587 2022年10月C型肝炎ウイルス(HCV)感染透析患者は非感染患者より予後不良であるとされており,HCV感染の予防・診断・治療は重要な課題である.そこで2020年に血液透析患者のHCVの保有,検査,治療などの現状に関するアンケートを,千葉県内の透析医療機関に行った.HCV抗体陽性者は3.7%,HCV-RNA検査陽性者は1.7%であり,2018年の全国調査(5.2%,2.5%)より低率であった.肝臓専門医紹介率は41%で同全国調査(22.8%)より高い傾向にあった.抗ウイルス治療はHCV抗体陽性者の24%に行われており,そのうち71%の患者が直接作用型抗ウイルス薬による治療であった.肝臓癌の治療は過去5年間にHCV抗体陽性者の7.5%で行われていた.千葉県内では全国調査結果に比べHCV感染について高い関心を持ち検査,治療が行われているがまだ改善の余地があると考えられ,より一層の疾患啓蒙,治療,検査の周知が必要と考えられた.(著者抄録)
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NEPHROLOGY DIALYSIS TRANSPLANTATION 33 55-55 2018年5月
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MICROVASCULAR RESEARCH 110 65-65 2017年3月
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Nephrology Frontier 13(1) 96-103 2014年3月保存期慢性腎臓病患者におけるAST-120(クレメジン)服薬サポートプログラムの効果について検討した。慢性腎臓病(CKD)の診断で現在AST-120(クレメジン)を服用している、あるいはCKDの診断で初めてAST-120を服用する22例を対象とした。開始時と終了時の腎機能には変化がなかったが、観察期間での服薬率良好群と不良群では腎機能の低下に明らかな差を認めた。通院期間やこれまでのAST-120服用期間が長い症例群で服薬良好群が多い傾向であった。さらに、患者サポートプログラムによってCKD理解が向上した群では、服薬良好群が占める割合が多かった。診療によって繰り返しCKDの情報を受けた患者やAST-120の薬効などの情報を受けた患者が服薬アドヒアランスの高い患者群であるだけでなく、集中的に疾患並びに服薬の重要性、服薬に関わる情報を提供することで同様の効果が得られる可能性が示された。
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PEDIATRIC NEPHROLOGY 28(8) 1438-1439 2013年8月 査読有り
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AUTOPHAGY 8(4) 445-544 2012年4月In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field.
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JOURNAL OF CLINICAL INVESTIGATION 122(2) 781-781 2012年2月
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順天堂医学 = Juntendo medical journal 57(5) 488-493 2011年10月31日
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Therapeutic Research 31(10) 1471-1480 2010年10月高カリウム血症を伴う慢性腎臓病患者55例を対象に、ポリスチレンスルホン酸カルシウム(PS-Ca)ゼリーを6ヵ月以上投与し、その効果を検討した。その結果、PS-Caゼリーは10ヵ月間にわたり有意で安定した血清カリウム値の低下が得られることが確認された。その低下作用は用量依存性で、血清カリウム低下量はPS-Caゼリー1個/日で0.65mEq/L、2個/日で0.84mEq/L、3個/日で1.00mEq/Lであった。また、PS-CaゼリーはRAAS抑制薬使用の有無にかかわらず、血清カリウム値を有意に低下した。一方、血清カリウム値の変化量で比較すると、RAAS抑制薬使用症例の方が低下の程度は大きかったが、PS-Caゼリーは血清カリウム以外の血清電解質に対する影響はなく、副作用も試験期間中に認められなかった。以上、これらのことからも、高カリウム血症を伴う慢性腎臓病患者に対するPS-Caゼリーの長期投与の効果が確認された。
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NITRIC OXIDE-BIOLOGY AND CHEMISTRY 22 S74-S75 2010年6月
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日本透析医学会雑誌 42(11) 899-904 2009年11月症例は34歳男性で、劣性栄養障害型表皮水疱症で通院中に腎機能障害となった。顔面浮腫、四肢全身に多発する表皮剥離・水疱、両手足の棍棒状変形を認めた。血液生化学検査では高度な貧血、低蛋白、電解質異常を認め、慢性的な炎症性変化によると思われる鉄の利用障害を認めた。特殊検査では血清アミロイドA蛋白、iPTH、hANP高値を認めた。動脈血液ガス分析では低酸素血症を認め、胸部X線で両側に胸水を認めた。腎機能悪化、鬱血性心不全、高度な貧血を認めたことから緊急的に右内頸動脈よりダブルルーメンカテーテルを挿入し、続発性アミロイドーシスによると考え血液透析を施行した。末期腎不全(EKSD)を合併した劣性栄養障害型表皮水疱症で長期留置型カテーテルを用い、血液透析を導入し、維持透析に移行することができた。先天性表皮水疱症は軽微な機械的な刺激により表皮下水疱や糜爛を生じるため腹膜透析や内シャントを造設すること、シャントの穿刺・止血が困難で透析療法やバスキュラーアクセスの選択には検討が必要と思われた。
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順天堂医学 54(2) 230-230 2008年6月
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NEPHROLOGY 13 A28-A28 2008年5月
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NEPHROLOGY 12 S15-S20 2007年12月Glomerular visceral epithelial cells, also known as podocytes, are highly specialized epithelial cells that cover the outer layer of the glomerular basement membrane. Podocytes consist of cell bodies, major processes and foot processes (FP) of neighbouring cells, with the filtration slits bridged by the slit membrane between them. The function of podocytes is largely based on their specialized cell architecture and functions such as stabilization of glomerular capillaries and participation in the barrier function of the glomerular filter. Therefore, they form the final barrier to protein loss, which explains why podocyte injury is typically associated with marked proteinuria. Under pathological conditions, podocytes exhibit various changes. Among these changes, FP effacement represents the most characteristic change in cell shape of podocytes. FP effacement is dependent on disruption of the actin cytoskeletal network in the podocytes, The mechanisms of organization and re-organization of actin in the FP of podocytes are discussed in this review.
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TRENDS IN CELL BIOLOGY 17(9) 428-437 2007年9月Podocytes of the renal glomerulus are unique cells with a complex cellular organization consisting of a cell body, major processes and foot processes. Podocyte foot processes form a characteristic interdigitating pattern with foot processes of neighboring podocytes, leaving in between the filtration slits that are bridged by the glomerular slit diaphragm. The highly dynamic foot processes contain an actin-based contractile apparatus comparable to that of smooth muscle cells or pericytes. Mutations affecting several podocyte proteins lead to rearrangement of the actin cytoskeleton, disruption of the filtration barrier and subsequent renal disease. The fact that the dynamic regulation of the podocyte cytoskeleton is vital to kidney function has led to podocytes emerging as an excellent model system for studying actin cytoskeleton dynamics in a physiological context.
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AMERICAN JOURNAL OF PATHOLOGY 171(2) 415-427 2007年8月The actin-based foot processes of kidney podocytes and the interposed slit diaphragm form the final barrier to proteinuria. Mutations affecting several podocyte proteins cause disruption of the filtration barrier and rearrangement of the highly dynamic podocyte actin cytoskeleton. Proteins regulating the plasticity of the podocyte actin cytoskeleton are therefore of critical importance for sustained kidney barrier function. Synaptopodin is an actin-associated protein essential for the integrity of the podocyte actin cytoskeleton because synaptopodin-deficient mice display impaired recovery from protamine sulfate-induced foot process effacement and lipopolysaccharide-induced nephrotic syndrome. Moreover, bigenic heterozygosity for synaptopodin and CD2AP is sufficient to induce spontaneous proteinuria and focal segmental glomerulosclerosis-like glomerular damage in mice. Mechanistically, synaptopodin induces stress fibers by blocking the proteasomal degradation of RhoA. Here we show that synaptopodin directly binds to IRSP53 and suppresses Cdc42:IRSp53:Mena-initiated filopodia formation by blocking the binding of Cdc42 and Mena to IRSp53. The Mena inhibitor FP4- Mito suppresses aberrant filopodia formation in synaptopodin knockdown podocytes, and when delivered into mice protects against lipopolysaccharide-induced proteinuria. The identification of synaptopodin as an inhibitor of Cdc42:IRSp53:Mena signaling defines a novel antiproteinuric signaling pathway and offers new targets for the development of antiproteinuric therapeutic modalities.
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PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA 104(24) 10134-10139 2007年6月Kidney podocytes and their slit diaphragms (SDs) form the final barrier to urinary protein loss. There is mounting evidence that SD proteins also participate in intracellular signaling pathways. The SD protein nephrin serves as a component of a signaling complex that directly links podocyte junctional integrity to actin cytoskeletal dynamics. Another SD protein, CD2-associated protein (CD2AP), is an adaptor molecule involved in podocyte homeostasis that can repress proapoptotic TGF-ss signaling in podocytes. Here we show that dendrin, a protein originally identified in telencephalic dendrites, is a constituent of the SD complex, where it directly binds to nephrin and CD2AP. In experimental glomerulonephritis, dendrin relocates from the SD to the nucleus of injured podocytes. High-dose, proapoptotic TGF-ss 1 directly promotes the nuclear import of dendrin, and nuclear dendrin enhances both staurosporine- and TGF-ss 1-mediated apoptosis. In summary, our results identify dendrin as an SD protein with proapoptotic signaling properties that accumulates in the podocyte nucleus in response to glomerular injury and provides a molecular target to tackle proteinuric kidney diseases. Nuclear relocation of dendrin may provide a mechanism whereby changes in SD integrity could translate into alterations of podocyte survival under pathological conditions.
講演・口頭発表等
10担当経験のある科目(授業)
1-
腎臓内科学 (千葉大学)
共同研究・競争的資金等の研究課題
18-
日本学術振興会 科学研究費助成事業 基盤研究(B) 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2020年4月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2018年4月 - 2021年3月
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科学研究費補助金(挑戦的萌芽研究) 2017年 - 2018年
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科学研究費補助金(挑戦的萌芽研究) 2014年 - 2016年