Publications by authors named "Kiyoshi Migita"
Rationale: Takayasu arteritis (TAK) is an autoimmune disease that causes chronic inflammation targeting the aortic wall. Since many patients are resistant to steroid treatment, multiple immunosuppressants or interleukin-6 (IL-6) suppression therapy have served as treatment alternatives. However, there are very few reports on the effectiveness of biologics against inflammatory cytokines upstream of IL-6.
View Article and Find Full Text PDFMyositis-specific autoantibodies play an important role on the disease phenotype of idiopathic inflammatory myopathies (IIMs). Anti-signal recognition particle (SRP) antibody-positive patients with IIMs may present with severe myopathy and highly elevated serum creatine kinase levels. These patients are often resistant to immunosuppressive therapy, but there is no established treatment strategy.
View Article and Find Full Text PDFFamilial Mediterranean fever (FMF) is the most prevalent hereditary autoinflammatory disease and is caused by the MEFV gene. In patients carrying MEFV exon 10 variants, FMF usually develops at an early age. A 76-year-old Japanese man presented with a periodic fever lasting 2-3 days, chest pain, and abdominal pain.
View Article and Find Full Text PDFThis study aimed to identify biomarkers to distinguish adult-onset Still's disease (AOSD) and to predict disease phenotypes. In total, 49 patients diagnosed with AOSD and 200 patients with common diseases (controls) were included in the analysis. The levels of 69 cytokines were analyzed using a multi-suspension cytokine array.
View Article and Find Full Text PDFArticle Synopsis
- CEACAM1 is an adhesion molecule important in the immune response, mainly found on neutrophils from patients with rheumatoid arthritis (RA), and this study aimed to explore how Janus kinase inhibitors (JAKi) affect its expression.
- Researchers used neutrophils from healthy subjects and stimulated them with cytokines like TNF-α and GM-CSF, analyzing CEACAM1 expression and protein phosphorylation using flow cytometry and western blot techniques.
- The results showed that JAKi, especially baricitinib, significantly inhibited GM-CSF-induced CEACAM1 expression in neutrophils, suggesting that JAKi can modulate immune responses by affecting key adhesion molecules in neutrophils.
Low remission rates and high incidence of adverse events in a prospective VEXAS syndrome registry.
Rheumatology (Oxford)
September 2024
Article Synopsis
- 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.
Article Synopsis
- The study investigates serum caspase-1 levels as a potential inflammatory biomarker in patients with adult-onset Still's disease (AOSD), comparing it with rheumatoid arthritis (RA) patients and healthy controls (HCs).
- Findings show that AOSD patients have significantly higher serum caspase-1 levels than RA patients and HCs, with strong correlations between caspase-1 levels and AOSD disease activity, alongside key inflammatory cytokines.
- The results suggest that caspase-1 could serve as a valuable biomarker for diagnosing and monitoring AOSD, indicating its role in the disease's inflammatory processes through inflammasome activation.
Article Synopsis
- Janus kinase (JAK) inhibitors are common treatments for rheumatoid arthritis (RA), but patients with certain risk factors may experience more side effects, like serious cardiovascular issues and infections.
- This study evaluated 184 RA patients who started JAKi treatment to analyze drug retention rates and the impact of adverse effects on patient outcomes.
- Results showed that higher RA disease activity and the use of pan-JAK inhibitors were linked to lower drug retention rates, with many patients stopping treatment due to ineffectiveness or adverse effects.
Article Synopsis
- Primary biliary cholangitis (PBC) is often linked to autoimmune diseases, and this study specifically looks at patients with PBC and CREST syndrome (PBC-CREST) to analyze their long-term outcomes compared to those with PBC alone.
- The research involved 302 patients over several decades, revealing that PBC-CREST patients had significantly better liver transplant-free survival rates and lower risks of liver-related death compared to PBC-alone patients.
- Moreover, the study's findings support the idea that having CREST syndrome serves as a protective factor against developing cirrhosis in PBC patients.
Article Synopsis
- This study examined the clinical features, outcomes, and risk factors associated with flares in patients with systemic lupus erythematosus (SLE) using data from newly diagnosed patients at Fukushima Medical University Hospital over a period of 11 years.
- Out of 387 SLE patients, 83 were newly diagnosed, with 29 experiencing flares; it was found that the flare group had similar characteristics to the no-flare group, except for the frequency of anti-SS-A antibodies and the observation period.
- The results indicated that anti-SS-A positivity may increase the risk of SLE flares, while using combination immunosuppressive therapy and hydroxychloroquine may improve flare-free survival in patients.
This study aimed to compare the incidence rates (IRs) of infections, including herpes zoster (HZ), in rheumatoid arthritis (RA) patients treated with Janus kinase inhibitors (JAKis) or interleukin-6 inhibitors (IL-6is). We retrospectively analyzed 444 RA patients treated using IL-6is ( = 283) or JAKis ( = 161). After adjusting for clinical characteristic imbalances by propensity score matching (PSM), we compared the IRs of infections including HZ between the JAKi and IL-6i groups.
View Article and Find Full Text PDFArticle Synopsis
- Anti-MDA5 antibody-positive clinically amyopathic dermatomyositis (CADM) is a form of dermatomyositis that primarily features skin symptoms and severe lung disease without significant muscle inflammation.
- Joint issues can arise in these patients, but effective treatment methods, particularly involving ultrasound, are not well established.
- This report discusses an 85-year-old man with anti-MDA5 antibody-positive CADM who experienced improved joint inflammation after receiving medium-dose corticosteroid treatment, confirmed by ultrasound.
Article Synopsis
- Adult-onset Still's disease (AOSD) may involve autoinflammation and cytokine imbalance, with the study focusing on the relationship between galectin-3 (Gal-3), a specific protein, and multiple cytokines in Japanese AOSD patients.
- The study included 44 AOSD patients, alongside controls with rheumatoid arthritis and healthy individuals, measuring serum levels of Gal-3, M2BPGi, and 69 cytokines to identify patterns and correlations.
- Results revealed significantly elevated levels of Gal-3 and M2BPGi in AOSD patients, with Gal-3 linked to disease activity and various inflammatory cytokines, and immunosuppressive treatment effectively lowering the levels of both
Systemic lupus erythematosus (SLE) is often seen with antiphospholipid antibody syndrome (APS), and these conditions may occur concurrently with severe immune thrombocytopenia (ITP) and even acute kidney injury (AKI); however, post-renal AKI due to bleeding is uncommon. Here, we describe a case of post-renal AKI and anuria in a patient with SLE and APS, which were attributable to urinary tract obstruction due to massive blood clots caused by secondary ITP. A 50-year-old Japanese woman was admitted to our hospital with anuria, abdominal tenderness, purpura in the trunk and in both legs, and severe thrombocytopenia.
View Article and Find Full Text PDFArticle Synopsis
- - The report discusses a 38-year-old Japanese woman who developed systemic lupus erythematosus (SLE) after contracting COVID-19, showing symptoms like skin issues, joint pain, and positive autoantibodies.
- - The patient met classification criteria for SLE, experienced renal involvement, and improved with immunosuppressive treatment.
- - A literature review found 10 similar cases, suggesting that SLE should be considered for patients with ongoing nonspecific symptoms post-COVID-19, especially with hematologic and renal symptoms.
Article Synopsis
- The study assessed the effectiveness of belimumab (BLM) in treating Japanese patients with moderate to high systemic lupus erythematosus (SLE) across 129 participants over a follow-up period of 17 months.
- Results demonstrated a significant reduction in the SLE Disease Activity Index (SLEDAI-2K) score and a decrease in daily prednisone dosage for the BLM group, although flare-free survival rates showed no significant difference compared to mycophenolate mofetil (MMF).
- Additionally, a comparison with intravenous cyclophosphamide (IV-CY) indicated no significant differences in flare-free survival or SLEDAI-2K score decline, suggesting BLM could be a viable
Article Synopsis
- The study investigates how the complement component C5a influences the activation of immune cells and the secretion of the proinflammatory cytokine IL-1β in response to inflammation.
- Human peripheral blood mononuclear cells (PBMCs) were stimulated with C5a, showing that this component enhances IL-1β production and caspase-1 activation, particularly in monocytes.
- The findings suggest that C5a independently drives the production of mature IL-1β mainly through the activation of caspase-1 in CD14 monocytes, highlighting its role in inflammatory processes.
Article Synopsis
- Interstitial lung disease and airway disease are serious complications of rheumatoid arthritis, leading to a poor prognosis among affected individuals.
- This study examined the genetic factors linked to these lung diseases in Japanese RA patients, specifically focusing on two single nucleotide variants (rs2736100 and rs1278769).
- Findings indicated that rs2736100 is associated with increased susceptibility to airway disease, while rs1278769 is linked to nonspecific interstitial pneumonia in older patients, marking a significant step in understanding genetic risks in RA-related lung issues.
The articular involvement in patients with familial Mediterranean fever (FMF) represents a clinical characteristic of acute monoarthritis with pain and hydrarthrosis, which always resolves spontaneously. Colchicine prevents painful arthritis attacks in most FMF cases. Spondyloarthritis is rarely associated with Japanese patients with FMF.
View Article and Find Full Text PDFBackground: The ORAL Surveillance trial showed a potentially higher incidence of malignancy and major adverse cardiovascular events (MACEs) associated with tofacitinib than those associated with tumor necrosis factor (TNF) inhibitors (TNFis). However, few studies have compared the safety of non-TNFis or other Janus kinase (JAK) inhibitors (JAKis). This study was aimed at comparing the incidence rates (IRs) of malignancies and MACEs in patients with rheumatoid arthritis (RA) treated using interleukin-6 (IL-6) inhibitors (IL-6is) or JAKis.
View Article and Find Full Text PDF