Publications by authors named "Akihide Ohta"

Article Synopsis
  • The study aimed to categorize patients with adult-onset Still's disease (AOSD) and analyze differences in their prognosis based on various factors.
  • A total of 153 patients were grouped into four clusters using characteristics like age, sex, clinical features, and lab results, revealing distinct profiles and outcomes for each group.
  • Patients in Cluster 4, who were older and had more complications, showed the lowest survival rates and drug-free remission compared to the other clusters, indicating varying severities of AOSD.
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Article Synopsis
  • - The study aimed to determine how well severity classification predicts outcomes in patients with adult-onset Still's disease (AOSD) during initial treatment.
  • - Researchers categorized AOSD patients into mild, moderate, and severe groups and compared clinical features, finding that severe cases had more complications and lower rates of drug-free remission.
  • - Although survival rates were similar across groups, four of the five fatalities occurred in the severe category, suggesting that severity classification can be helpful for predicting AOSD outcomes.
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Objectives: To clarify the characteristics of patients with elderly-onset Adult-onset Still's disease (AOSD).

Methods: Patients were classified into elderly-onset (>60 years: 47 patients) and younger-onset (≤60 years: 95 patients) groups according to their age at diagnosis of AOSD. Clinical features, treatments, and prognosis were compared between the elderly-onset and younger-onset groups.

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Objectives: Using an expert- and data-driven methodology, we have constructed the first clinical practice guidelines (CPGs) for adult Still's disease (ASD) after complete systematic review (SR) of the literature based upon the Medical Information Network Distribution Service (Minds) procedure.

Methods: The CPG committee for ASD organized by the Research Team for Autoimmune Diseases, the Research Program for Intractable Disease of the Japanese Ministry of Health, Labour, and Welfare has developed CPG for ASD 2017, according to the procedure proposed by Minds. The CPG development process includes (1) clarification of the purpose of CPG, (2) organization of the steering committee, (3) organization of the CPG committee and secretariat, (4) defining the scope (setting of clinical questions (CQs)), (5) SR, (6) development of recommendations, (7) drafting the CPG, (8) external evaluation and public comments, and (9) release.

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Background: Heme oxygenase (HO)-1 is a heme-degrading enzyme highly expressed in monocyte/macrophage, serum levels of which may be promising biomarker for adult-onset Still's disease (AOSD). We here report data on the use of serum ferritin and HO-1 levels in AOSD.

Methods: Under the Hypercytokinemia Study Group collaboration, we collected sera from a total of 145 AOSD patients.

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Objective: This study illuminates the degree of psychological stress response experienced by spouses of cancer patients when given bad news at three different times (notification of the name of the disease, notification of recurrence, and notification of terminality) as well as the factors that influence the response and the health status of the spouse as measured by health-related quality of life (QOL).

Methods: A total of 203 individuals (57 men and 146 women) who had received the three types of news were surveyed using a self-report questionnaire on psychological stress response, marital satisfaction, and health-related QOL scales.

Results: The degree of the psychological stress response was the highest for notification of terminality, followed by notification of the name of the disease, and notification of recurrence.

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Article Synopsis
  • The study investigates how treatments for rheumatoid arthritis (RA) with abatacept (ABT) and tocilizumab (TCZ) influence specific immune cell populations, particularly Th17 cells and regulatory T (Treg) cells.
  • Results show that ABT reduces the Foxp3/Ror-γt ratio, indicating a decrease in Treg cells, while TCZ increases this ratio, suggesting an increase in Treg cells; both treatments also altered the Ror-γt/GATA3 ratio differently.
  • Overall, the findings highlight that ABT and TCZ have distinct effects on the T cell balance in RA patients, but there was no clear link between treatment response and changes in these T cell ratios.
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Recent studies suggested that anti-TNF-α biological therapies are effective in treating Takayasu's arteritis (TA) refractory to conventional immunosuppressive therapy. However, the efficacy of golimumab (GLM) for TA therapy is unknown. We report four women with TA who were successfully treated with GLM.

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We report four cases of successful treatment with certolizumab pegol (CZP) of rheumatoid arthritis (RA) patients with persistent inflamed residual mono- or oligosynovitis resistant to prior TNF-α inhibitors. Although the patients were in a moderate disease activity, a low activity, or a remission of RA, they sustained inflammatory mono-/oligoarthritis even after treatment with prior TNF inhibitors. They were then all treated with CZP and observed in a serial ultrasonography.

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Article Synopsis
  • * A study of 1,667 cases in Japan found that hyperbaric oxygen therapy (HBO2T) significantly improved patient outcomes compared to normobaric oxygen therapy (NBO2T).
  • * The effectiveness of HBO2T was consistent across different hospitals, while the success rate of NBO2T varied based on the hospital's treatment criteria, reinforcing HBO2T's role as a beneficial treatment for CO poisoning.
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Systemic lupus erythematosus (SLE) is a prototypic systemic autoimmune disease with multiple organ disorders. Although the prognosis of SLE has been recently improved, corticosteroid and immunosuppressive agents are still main treatment used in medical practice. Refractory disease and complications by the conventional drugs still remain.

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Objective: The efficacy of biologics in treating adult Still's disease (ASD) is suggested, but the information is still lacking and the validation is insufficient. To determine the efficacy of several biologic agents in refractory ASD in Japan, a multicenter survey was performed.

Method: Clinical data on 16 ASD patients who had been treated with at least 1 of the biological agents (total 24 occasions) were collected retrospectively.

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This study aimed to investigate phenotype of RP105(-) B cell subsets in patients with systemic lupus erythematosus (SLE). Flow cytometry was used for phenotyping RP105-negaive B cell subsets. Based on CD19, RP105, and CD138 expression, RP105(-) B cells consist of at least 5 subsets of late B cells, including CD19(+)RP105(int), CD19(+) RP105(-), CD19(low) RP105(-) CD138(-), CD19(low) RP105(-)CD138(int), and CD19(low) RP105(-) CD138(++) B cells.

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Article Synopsis
  • A 67-year-old woman with chronic kidney disease developed microscopic polyangiitis (mPA) and giant cell arteritis (GCA) after receiving an influenza vaccine, presenting with fever and headache.
  • Diagnosis was confirmed through symptoms, renal function decline, biopsies, and specific antibodies, and she was treated with prednisolone which initially improved her condition.
  • Two months later, she suffered from severe infections and, despite intensive treatment, died, highlighting that the vaccine may trigger mPA and GCA due to a common underlying mechanism.
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Objective: Interferon regulatory factor 5 (IRF-5) is a transcription factor that mediates intracellular signals activated by engagement of Toll-like receptors (TLRs). IRF5 polymorphisms are associated with an increased or decreased risk of systemic lupus erythematosus (SLE) in various human populations, but the precise role of IRF5 in SLE development is not fully understood. This study was undertaken to examine the role of IRF5 in the development of murine lupus.

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There have been several reports indicating the association between recent stress experiences and the onset or the exacerbation of rheumatic diseases, although few such reports exist in patients with scleroderma (SSc). The present study was performed to elucidate whether there were any functional disturbances in the neuro-endocrine-immune system as a homeostatic system upon stress in SSc patients. Various serum levels of stress-related hormones and cytokines were examined before and after a mental calculation stress test, and a basal questionnaire study of sense of coherence (SOC, which is related to the ability to cope with stress), recent stress experiences, and quality of life (QOL) was performed in 17 SSc patients and in 38 healthy volunteers.

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Aim: Though inflammatory bowel disease (IBD) is known as a stress-related disorder, basic evidence for this claim is lacking. The current study was performed to investigate the function of the neuroendocrine-immune system as a main pathway in stress response and stress-coping ability and the associations among stress response, stress-coping ability, and disease activity in IBD patients.

Method: A questionnaire was administered to obtain information concerning stress state and stress-coping ability (self-efficacy and sense of coherence [SOC]) in 78 IBD patients and 21 healthy volunteers.

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Objective: B cells lacking RP105 produce autoantibodies in patients with SLE. Expression of B-cell activating factor (BAFF) binding receptors (BBRs) and survival of RP105(-) B cells from SLE patients were examined.

Methods: Detection of difference of gene expression between RP105(-) and RP105(+) B cells was done by DNA microarrays.

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Article Synopsis
  • The study evaluated how systemic lupus erythematosus (SLE) and high-dose corticosteroids impact endothelial injuries by measuring specific proteins (sEPCR and sTM) in patient serum samples.
  • Results showed that patients with SLE and other rheumatic diseases had higher levels of sEPCR and sTM compared to healthy individuals, with SLE patients showing significantly higher levels of sEPCR during active disease.
  • sEPCR was identified as a more sensitive biomarker than sTM for detecting endothelial injuries associated with active SLE and corticosteroid treatment.
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Introduction: RP105 is a Toll-like receptor homolog expressed on B cells, dendritic cells (DCs), and macrophages. We investigated the role of RP105 in the development of collagen-induced arthritis (CIA).

Methods: CIA was induced in RP105-deficient DBA/1 mice and the incidence and arthritis index were analyzed.

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Article Synopsis
  • A study was conducted in Japan to examine the recent clinical features and treatment of adult-onset Still's disease (AOSD) due to a lack of recent clinical research in over 10 years.
  • Data from 34 AOSD patients admitted between 1994 and 2007 were analyzed, focusing on the effectiveness of cyclosporin A (CyA) as a treatment option.
  • The results indicated that CyA, used alongside corticosteroids, was highly effective in inducing remission for patients with severe AOSD, suggesting it as a viable alternative for those resistant to corticosteroids.
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Four cases of nocardiosis in patients with adult-onset Still disease and vasculitis syndrome are presented. Three patients developed lung abscesses and 1 case developed a brain abscess. All were treated with high-dose corticosteroids, and 3 were given cyclosporine when they developed nocardiosis.

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Objective: Interstitial lung disease (ILD) associated with polymyositis (PM) and dermatomyositis (DM) sometimes progresses rapidly and is resistant to therapy. Clinical features that forecast the prognosis of the disease remain to be elucidated. Our aim was to assess if selected clinical features and high-resolution computed tomography (HRCT) findings can assist in predicting the clinical course of ILD in PM/DM.

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