Publications by authors named "Akizuki S"

Autoantibodies are detected in idiopathic interstitial pneumonias (IIPs) without a clear connective tissue disease diagnosis, and their clinical significance is unclear. This study aimed to identify a novel autoantibody in IIPs. We screened 295 IIP patients using a S-methionine labeled protein immunoprecipitation assay.

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Objectives: There are often discrepancies in the evaluation of disease activity between patients and physicians in systemic lupus erythematosus (SLE). In this study, we examined the factors that affect those evaluations.

Methods: Physician visual analogue scale (Ph-VAS), patient VAS (Pt-VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2k), glucocorticoid (GC) usage and dose, age, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, and three patient-reported outcomes (SLE symptom checklist [SSC], short-form 36 questionnaire [SF-36], and LupusPRO) were obtained from a study performed in 2019 using 225 SLE outpatients of the Kyoto Lupus Cohort at Kyoto University Hospital.

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Article Synopsis
  • - This study compared juvenile idiopathic inflammatory myopathy (IIM) and adult-IIM by analyzing autoantibodies, clinical characteristics, and drug-free conditions in 320 patients over 20 years.
  • - Juvenile-IIM showed a higher rate of achieving drug-free conditions (34%) compared to adult-IIM (18%), with specific autoantibodies like anti-TIF1-γ linked to fewer muscle symptoms and lower malignancy rates in juveniles.
  • - Both groups had overlapping features with certain autoantibodies (like anti-MDA-5 and anti-ARS) associated with severe symptoms and a low likelihood of drug-free conditions, while treatment patterns differed notably between the two age groups.
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Vesiculobullous dermatomyositis (VD) is a rare manifestation of dermatomyositis (DM) and has been suggested to be associated with malignancy. Although the myositis-specific autoantibodies are associated with distinct clinical presentations of DM, those associated with VD remain unclear. Here, we present the case of a 54-year-old man with VD who tested positive for anti-nuclear matrix protein 2 (NXP-2) antibody, one of the DM-specific autoantibodies.

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Objective: Infections are a critical concern for patients with microscopic polyangiitis (MPA). This study aimed to identify the risk factors associated with serious infections (SIs) and infection-related mortality in patients with MPA, as well as the effect of glucocorticoid (GC) dose tapering on these outcomes.

Methods: This multicentre, retrospective, and observational study utilised data from a cohort of patients with MPA in Japan [Registry of Vasculitis Patients to Establish REAL World Evidence (REVEAL) cohort].

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Article Synopsis
  • Avacopan is an oral medication that acts as a C5a receptor antagonist and is effective in treating microscopic polyangiitis by inhibiting the activation of neutrophils.
  • A patient case showed that despite high-dose steroids and azathioprine not reducing myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA), adding avacopan lowered these antibody levels.
  • The findings suggest avacopan might help in decreasing MPO-ANCA and improving ANCA-associated vasculitis, but more research with larger studies is needed to confirm these effects.
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Anti-aminoacyl-tRNA synthetase (ARS) antibodies are myositis-specific antibodies associated with anti-synthetase syndrome (ASSD). Some patients are positive for anti-ARS antibodies on enzyme-linked immunosorbent assay (ELISA) but negative on RNA-immunoprecipitation (RNA-IP) (the gold standard method). Whether these patients should be considered truly positive for anti-ARS antibodies remains unclear.

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TAFRO syndrome is an acute systemic inflammatory disease characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis/renal dysfunction, and organomegaly. There have been increasing reports that TAFRO is a disease distinct from idiopathic multicentric Castleman disease and that TAFRO patients may be positive for anti-SSA antibodies. To assess anti-SSA antibody positivity and the clinical characteristics of the two diseases, we retrospectively compared 7 TAFRO and 10 iMCD patients in our hospital.

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  • The study investigates the clinical features of patients with cryopyrin-associated periodic syndrome (CAPS) in Japan and assesses the effectiveness and safety of the IL-1 inhibitor canakinumab in treating these patients.
  • Out of 101 patients analyzed, a significant majority achieved complete remission with canakinumab, but 23.7% did not respond, experiencing serious complications including deaths and organ damage.
  • The research highlights the importance of early intervention and suggests that combining canakinumab with other therapies can be beneficial for those who don't adequately respond to canakinumab alone.
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In vitro reconstruction of highly mature engineered heart tissues (EHTs) is attempted for the selection of cardiotoxic drugs suitable for individual patients before administration. Mechanical contractile force generated in the EHTs is known to be a critical indicator for evaluating the EHT response. However, measuring contractile force requires anchoring the EHT in a tailored force-sensing cell culture chamber, causing technical difficulties in the stable evaluation of contractile force in long-term culture.

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  • IgG4-related disease (Ig4-RD) is a condition that can impact various organs, such as the salivary and lacrimal glands, pancreas, and liver.
  • A 72-year-old woman exhibited multiple symptoms including high eosinophil counts, elevated IgG4 levels, and dysfunction in liver and nerves, which led to a diagnosis of Ig4-RD confirmed through biopsies.
  • The patient showed improvement with glucocorticoid treatment, emphasizing the importance of biopsies to correctly differentiate Ig4-RD from similar disorders.
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Objective: Antimelanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis with interstitial lung disease (DM-ILD) progresses rapidly and has a poor prognosis. Previously, we reported the efficacy of a combination therapy comprising high-dose glucocorticoids (GCs), calcineurin inhibitors (CNIs), and intravenous cyclophosphamide (IV CYC) in a multicenter clinical trial (UMIN000014344). In the present study, we evaluated the long-term outcomes and effects of induction therapy on the maintenance of remission.

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Advanced systemic sclerosis-associated interstitial lung disease (SSc-ILD) can be treated with lung transplantation. There is limited data on lung transplantation outcomes in patients with SSc-ILD, in non-Western populations.We assessed survival data of patients with SSc-ILD, on the lung transplant (LT) waiting list, and evaluated post-transplant outcomes in patients from an Asian LT center.

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Objectives: Decreased sialylation of IgG-Fc glycans has been reported in autoimmune diseases, but its role in systemic lupus erythematosus (SLE) is not fully understood. In this study, we examined the pathogenicity of IgG desialylation and its association with Th17 in SLE using an animal model.

Methods: B6SKG mice, which develop lupus-like systemic autoimmunity due to the ZAP70 mutation, were used to investigate the pathogenicity of IgG desialylation.

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Objectives: Although the SLE Disease Activity Score (SLE-DAS) and its definitions to classify disease activity have been recently developed to overcome the drawbacks of the SLE Disease Activity Index 2000 (SLEDAI-2K), the performance of the SLE-DAS for patient-reported outcomes (PROs) has not been fully examined. We aimed to compare SLE-DAS with SLEDAI-2K and validate the classifications of disease activity based on SLE-DAS in terms of PROs.

Methods: We assessed generic quality of life (QoL) using the Medical Outcome Survey 36-Item Short-Form Health Survey (SF-36), disease-specific QoL using the lupus patient-reported outcome tool (LupusPRO), burden of symptoms using the SLE Symptom Checklist (SSC), patient global assessment (PtGA) and physician global assessment (PhGA).

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The high content of nitrogen in wastewater brings some operational, technical, and economical issues in conventional technologies. The aim of this study was to evaluate the nitrogen removal by hybrid hydrogels containing consortium microalgae-nitrifying bacteria in the presence of activated carbon (AC) used as an adsorbent of inhibitory substances. Hybrid hydrogels were synthesized from polyvinyl alcohol (PVA), sodium alginate (SA), biomass (microalgae-nitrifying bacteria), and AC.

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Immunoglobulin (Ig) G4 is an IgG subclass that can exhibit inhibitory functions under certain conditions because of its capacity to carry out Fab-arm exchange, inability to form immune complexes, and lack of antibody-dependent and complement-dependent cytotoxicity. Although several diseases have been associated with IgG4, its role in the disease pathogeneses remains unclear. Since mice do not express an IgG subclass that is identical to the human IgG4 (hIgG4), we generated hIGHG4 knock-in (KI) mice and analyzed their phenotypes.

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Article Synopsis
  • Finding the right mix of how to safely reduce the immune system's activity in severe TAFRO syndrome can be tough!
  • A 60-year-old man with a serious case of TAFRO syndrome got better after receiving special medications, even though he had a virus!
  • The study looked at 14 cases and found that while everyone improved, recovery from low blood platelets (thrombocytopenia) was slow, but all patients on dialysis were able to stop it successfully!
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Objectives: Osteoporosis and compression fractures of the lumbar spine are some of the major adverse effects of glucocorticoid therapy in patients with systemic lupus erythematosus (SLE). This study examined the association between bone mineral density, bone turnover markers, presence of vertebral fractures, and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index in SLE patients.

Methods: This was a cross-sectional study of 246 outpatients with SLE at the Kyoto University Hospital.

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  • The study explores how rheumatoid factor (RF) recognizes the complex of IgG heavy chain (IgGH) and a specific HLA class II molecule linked to rheumatoid arthritis (RA).
  • It involved synthesizing various IgGH segments and testing their expression and recognition by RF using a human kidney cell line.
  • Results showed that the CH1 domain of IgGH binds to the HLA-DR4 molecule and that RF specifically targets the CH3 domain of the IgGH/HLA-DR4 complex.
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Autoimmune diseases are often accompanied by acute exacerbation. However, the mechanism underlying systemic lupus erythematosus (SLE) flares remains unclear. We investigated whether short-term enteric Toll-like receptor 7 (TLR7) stimulation can exacerbate SLE using B6SKG mice, which spontaneously develop SLE due to a mutation in the zeta‒chain‒associated protein kinase 70 (Zap70) gene.

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Thymic selection and peripheral activation of conventional T (Tconv) and regulatory T (Treg) cells depend on TCR signaling, whose anomalies are causative of autoimmunity. Here, we expressed in normal mice mutated ZAP-70 molecules with different affinities for the CD3 chains, or wild type ZAP-70 at graded expression levels under tetracycline-inducible control. Both manipulations reduced TCR signaling intensity to various extents and thereby rendered those normally deleted self-reactive thymocytes to become positively selected and form a highly autoimmune TCR repertoire.

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Purpose: Upregulation of type I interferon (IFN) signaling has been increasingly detected in inflammatory diseases. Recently, upregulation of the IFN signature has been suggested as a potential biomarker of IFN-driven inflammatory diseases. Yet, it remains unclear to what extent type I IFN is involved in the pathogenesis of undifferentiated inflammatory diseases.

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Objectives: Numerous case reports have referred to new onset or flare of SLE after SARS-CoV-2 messenger RNA (mRNA) vaccines. Several observational studies showed that the short-term flare rate of SLE after SARS-CoV-2 vaccination is low. However, well-controlled clinical surveys are unavailable and the medium-term impact of the SARS-CoV-2 mRNA vaccines against the flare of SLE is uncertain.

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