Publications by authors named "Atsushi Kawakami"

Insights gained during the coronavirus disease 2019 pandemic has underscored the critical role played by both innate and adaptive immune responses in determining the severity of diseases. This newfound understanding holds significant potential to bring about a paradigm shift in the diagnosis, treatment, and management of autoimmune conditions. Advanced technologies that are emerging in the field are expected to play a pivotal role in this transformation.

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It is our pleasure to present the Special Issue "Diagnosis and Treatment of Sjögren's Syndrome" to the readers of the [...

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This exploratory study aimed to examine the impact of abatacept treatment on bone structure in patients with rheumatoid arthritis (RA) using high-resolution peripheral quantitative computed tomography (HR-pQCT). RA patients initiating either abatacept or newly introduced csDMARDs were enrolled in this prospective, non-randomized, two-group study. Bone structure in the 2nd and 3rd metacarpal heads was assessed using HR-pQCT at 0, 6, and 12 months after enrollment.

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Familial Mediterranean Fever (FMF) is the most common hereditary autoinflammatory disease, characterized by recurrent fever, arthritis, rash, and serositis, and is caused by mutations in the MEFV gene coding for the pyrin protein. The primary treatment goal is to prevent acute attacks and minimize subclinical inflammation to avoid secondary amyloidosis with colchicine as the first-line treatment. However, 10-20% of patients are colchicine-resistant or intolerant.

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Haploinsufficiency of the transcription factor interferon-regulatory factor 4 (IRF4) prevents the onset of spontaneous diabetes in NOD mice. However, the immunological mechanisms of the IRF4-mediated disease regulation remain unclear. This study aims to investigate the role of IRF4 in the pathogenesis of autoimmune diabetes by conducting adoptive transfer experiments using donor IRF4 gene-deficient CD4+ T cells from BDC2.

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Article Synopsis
  • Researchers investigated the connection between periodontal disease and glycemic control among Japanese adults, recognizing that inflammation and bacteria related to gum disease could potentially impact diabetes management.
  • The study involved 671 participants whose health was assessed through medical checkups, questionnaires, and dental examinations to understand various factors like body weight, exercise, and oral health.
  • Results indicated that factors such as age, sex, body mass index (BMI), and levels of certain bacteria in saliva were significantly linked to HbA1c levels, which are a key indicator of long-term blood sugar control.
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We herein report three cases of microscopic polyangiitis (MPA). Two patients were administered avacopan in combination with glucocorticoid (GC), whereas one patient was treated with avacopan monotherapy; none of the patients were co-administered either rituximab or cyclophosphamide. The doses of GC were successfully reduced after the introduction of avacopan in the two patients, and the serum C-reactive protein levels decreased in the patient treated with avacopan monotherapy.

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  • The study aimed to collect real-world data on VEXAS syndrome, focusing on disease activity, treatments, remission rates, and adverse events over a prospective period.
  • Researchers enrolled suspected patients in Japan, utilizing a new disease activity measure (VEXASCAF) and recorded various health metrics, including UBA1 gene variant analysis.
  • Out of 55 patients, 30 were found to have pathogenic UBA1 variants, with limited remission reported, frequent adverse events including deaths and infections, and a need for high-dose glucocorticoids to manage symptoms.
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  • Enhanced ADAM9 expression in the kidneys of lupus nephritis patients can activate TGFβ1, leading to fibrosis and organ damage.
  • Research showed that ADAM9 is upregulated in kidney tubular epithelial cells (TECs) under hypoxic conditions, contributing to TGFβ1 activation.
  • Experiments with Adam9-deficient mice revealed less fibrosis, suggesting that targeting ADAM9 could be a potential strategy to reduce kidney damage in lupus nephritis.
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Article Synopsis
  • * Factors linked to elevated IgG4 included male sex, older age, lower lipid and polyunsaturated fatty acid intake, and higher carbohydrate intake in both genders, with additional specific associations for men related to kidney function and blood sugar levels.
  • * The findings suggest that elevated serum IgG4 levels are connected to age, gender, and diet, which may reflect similar patterns seen in IgG4-related disease (IgG4-RD).
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Objective: To investigate which joint microarchitectural parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) serve as imaging markers for rheumatoid arthritis (RA).

Methods: The second and third metacarpophalangeal (MCP) joints of 50 patients with RA and 50 healthy controls (HCs) (aged 50-79 years, all females) were scanned using a HR-pQCT. Joint space, trabecular bone microarchitecture, and erosion were measured and compared between RA patients and HCs.

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Subclavian artery aneurysm is usually rare. We report a case of a right subclavian artery aneurysm with infective endocarditis. A 36-year-old woman was admitted at our hospital due to a cerebral embolism.

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Introduction: Bone fragility is a critical issue in the treatment of elderly people with type 2 diabetes (T2D). In the Canagliflozin Cardiovascular Assessment Study, the subjects with T2D who were treated with canagliflozin showed a significant increase in fracture events compared to a placebo group as early as 12 weeks post-initiation. In addition, it has been unclear whether sodium-glucose co-transporter 2 (SGLT2) inhibitors promote bone fragility.

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Exercise-associated hyponatremia (EAH) is a life-threatening dilutional hyponatremia that typically occurs during or immediately after exercise in endurance athletes. A 49-year-old actress experienced dizziness 15 min after a 2-h stage performance while drinking several bottles of water. Thirty minutes later, the patient fell unconscious and was hospitalized.

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Idiopathic multicentric Castleman disease (iMCD) and TAFRO syndrome present a variety of symptoms thought to be caused by excessive inflammatory cytokines and chemokines, but the underlying mechanisms are unknown. iMCD is broadly classified into two types: iMCD-NOS and iMCD-TAFRO, which have distinct laboratory findings, pathological features, and responses to treatments. It is thought that iMCD-NOS, particularly the IPL type, responds favorably to IL-6 inhibitors due to its IL-6-centric profile.

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Objectives: We aimed to evaluate the effects of age on clinical characteristics and outcomes in biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-naïve patients with rheumatoid arthritis (RA).

Methods: We analysed the cases of 234 Japanese b/tsDMARD-naïve RA patients who underwent b/tsDMARD treatment in a multicentre ultrasound prospective observational cohort. We compared the clinical characteristics at baseline and outcomes at 12 months between those aged ≥60 years and those <60 years.

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The magnitude of the effect of human T-lymphotropic virus 1 (HTLV-1) infection on uveitis remains unclear. We conducted a cross-sectional study in a highly endemic area of HTLV-1 in Japan. The study included 4265 residents (men, 39.

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A 29-year-old Japanese woman was admitted to our hospital with a fever, cardiogenic shock, and cardiac arrest. Laboratory data indicated multiple organ failure in addition to hemoconcentration, hypoalbuminemia, and myocardial damage. The coronary angiography findings were normal, and fulminant myocarditis was suspected.

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Context: Telomerase reverse transcriptase promoter (TERT-p) mutations, which upregulate TERT expression, are strongly associated with tumor aggressiveness and worse prognosis in papillary thyroid carcinomas (PTCs). TERT expression is also observed in a proportion of PTCs without TERT-p mutations, but such tumors show less aggressiveness and better prognosis than TERT-p mutation-positive tumors.

Objective: TERT has multiple splicing variants whose relationships with the TERT-p status and clinicopathological characteristics remain poorly understood.

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Article Synopsis
  • Glucocorticoids can effectively treat rheumatoid arthritis (RA) when used at low doses, but their impact on subsequent treatments with biologic and targeted synthetic drugs (b/tsDMARDs) needs evaluation.
  • In a study of 307 RA patients, 160 were on glucocorticoids; those treated with these medications showed higher disease activity and less effective treatment responses after 12 months compared to those who were not.
  • The findings suggest that patients requiring glucocorticoids may be in poorer health, which could explain their diminished response to b/tsDMARDs, highlighting the need to carefully consider glucocorticoid use during RA treatment.
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