Publications by authors named "Mitsuhiro Kawano"
Allergen-specific antibodies (Abs), IgE, and IgG4 increase during the early phase of oral immunotherapy (OIT) of allergen food in patients; subsequently, IgE levels decrease and specific IgG4 levels increase after successful OIT treatment. The detailed profile of these Abs during OIT remains largely unclear. We developed a diagnostic tool to assess the OIT efficacy and extent of responsiveness based on a profiling method by identifying epitopes recognized by the Ab classes of IgE or IgG4.
View Article and Find Full Text PDFArticle 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).
Objective: Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory condition affecting multiple organs, including the pancreas, salivary glands, lungs, kidneys, skin, and lymph nodes. Clinically, it is characterized by elevated serum IgG and IgG4 levels and tissue infiltration by IgG4-positive plasma cells, lymphocytes, fibrosis, and phlebitis obliterans. IgG4-RD is linked to increased Th2-dominant cytokines, contributing to eosinophilia, elevated serum IgG4, and fibrosis.
View Article and Find Full Text PDFA 77-year-old man presented with right inguinal lymphadenopathy and swollen parotid and submandibular glands bilaterally. Histopathology revealed germinal center B-cell type diffuse large B-cell lymphoma (DLBCL) in the inguinal lymph node. Lymphocyte and plasma cell infiltration in the submandibular gland with elevated serum IgG4 levels (13 g/L) prompted a diagnosis of IgG4-related disease (IgG4-RD).
View Article and Find Full Text PDFThe CCL2-CCR2 axis is involved in lupus nephritis, however the precise roles in the mechanisms by which different pathological lesions develop after glomerular immune complex deposition remain elusive. Previously, we demonstrated that genetic CCR2 inhibition induced a histological switch from glomerular endocapillary hypercellularity to wire-loop lesions in murine lupus nephritis. This study aimed to clarify the CCL2-CCR2 axis-mediated cellular mechanism in the formation of these different pathological lesions.
View Article and Find Full Text PDFBackground: In 2018, diagnostic criteria were introduced for IgG4-related periaortitis/periarteritis and retroperitoneal fibrosis (PA/RPF). This study assessed the existing criteria and formulated an improved version.
Methods And Results: Between August 2022 and January 2023, we retrospectively analyzed 110 Japanese patients diagnosed with IgG4-related disease (IgG4-RD) involving cardiovascular and/or retroperitoneal manifestations, along with 73 non-IgG4-RD patients ("mimickers") identified by experts.
We report a case of IgG4-related disease (IgG4-RD) with marked eosinophilia. A 79-year-old woman was admitted due to diarrhoea and weight loss. Cervical lymphadenopathy, bilateral submandibular glands swelling, anaemia (Hb8.
View Article and Find Full Text PDFDiagnostic challenges of the idiopathic plasmacytic lymphadenopathy (IPL) subtype of idiopathic multicentric Castleman disease (iMCD): Factors to differentiate from IgG4-related disease.
J Clin Pathol
February 2024
Aims And Methods: Idiopathic multicentric Castleman disease (iMCD) is currently considered to be classified into three clinical subtypes, including idiopathic plasmacytic lymphadenopathy (IPL), thrombocytopaenia, anasarca, fever, reticulin fibrosis/renal dysfunction, organomegaly (TAFRO) and not otherwise specified (NOS). Among the three, iMCD-IPL closely mimics IgG4-related disease (IgG4-RD). In diagnosing IgG4-RD, it is sometimes challenging to distinguish iMCD-IPL patients that also meet the histological diagnostic criteria for IgG4-RD.
View Article and Find Full Text PDFIgG4-related disease (IgG4-RD) is a systemic and chronic inflammatory disorder that can affect every part of the body. The formation of tertiary lymphoid tissues (TLT) in the affected organs may be a key phenomenon in understanding the pathogenesis of this disease because T follicular helper (Tfh) 2 cells play an important role in IgG4 class switching within TLT in the affected organs or tissues. TLT formation leads to the formation of masses or swelling of the affected organs.
View Article and Find Full Text PDFArticle Synopsis
- The study examined the long-term outcomes, complications, and mortality in patients with immunoglobulin G4-related kidney disease (IgG4-RKD) using data from 95 patients over an average follow-up of 71 months.
- It found that early treatment led to improved kidney function, with a significant portion of patients developing chronic kidney disease, while factors like eGFR and extensive fibrosis at the start significantly affected outcomes.
- The results indicate that timely intervention may enhance survival and reduce complications related to glucocorticoid treatment in IgG4-RKD patients.
Article Synopsis
- The study aimed to assess the effectiveness of a new CLAM-LC-MS/MS system for monitoring levels of immunosuppressive drugs (tacrolimus and cyclosporin A) in whole blood, addressing the drawbacks of existing methods like liquid chromatography and immunoassays.
- Researchers validated this system using blood samples from patients at Kanazawa University Hospital, comparing results from the CLAM-LC-MS/MS with commercial immunoassay techniques.
- The findings revealed strong correlations between the two methods, although CLAM-LC-MS/MS showed approximately 20% lower drug concentrations; the system also improved efficiency in drug measurement compared to traditional manual pretreatment processes.
Background: IgG4-related disease (IgG4-RD), an example of a type I immune disease, is an immune-mediated fibrotic disorder characterized by dysregulated resolution of severe inflammation and wound healing. However, truly dominant or pathognomonic autoantibodies related to IgG4-RD are not identified.
Objective: We sought to perform single-cell RNA sequencing and T-cell receptor and B-cell receptor sequencing to obtain a comprehensive, unbiased view of tissue-infiltrating T and B cells.
Article Synopsis
- Immune checkpoint inhibitors (ICIs), like pembrolizumab, can lead to immune-related adverse events (irAEs), including a rare condition known as remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE).
- A case study highlights a 49-year-old Japanese man who experienced sudden joint pain and swelling in his hands and legs after receiving pembrolizumab for lung cancer, which was in complete remission at that time.
- The report suggests that rheumatologists should be alert to the possibility of RS3PE as an irAE during ICI treatment and should rule out other causes like malignancy or systemic diseases.
Article Synopsis
- - Scleroderma renal crisis (SRC) is a serious complication of systemic sclerosis that can lead to kidney failure, with normotensive SRC being particularly hard to diagnose; this condition may develop after kidney transplantation in patients who have received high doses of glucocorticoids.
- - A case study highlights a 37-year-old man with overlapping systemic sclerosis and lupus who developed normotensive SRC after kidney transplantation and glucocorticoid treatment, leading to worsening kidney function and eventual hemodialysis.
- - It's important for nephrologists to recognize the potential for SRC in transplanted kidneys and to monitor patients closely, especially when they are on high-dose glucocorticoids, to ensure timely diagnosis and management.
Objectives: Reportedly, patients with LN and low-level proteinuria have favourable short-term renal outcomes. We aimed to clarify the long-term renal outcomes and overall survival of these patients, and the significance of renal biopsy in the early phase with low-level proteinuria.
Methods: We included 144 Japanese patients with biopsy-proven LN from 10 hospitals.
Coronary periarteritis is a dangerous manifestation of IgG4-related disease, because it forms coronary artery aneurysms, which may cause sudden cardiac death. We report the case of a 78-year-old woman with IgG4-related coronary periarteritis and a coronary aneurysm, which showed progressive enlargement despite maintenance therapy for Type 1 autoimmune pancreatitis. This case was unique, in that coronary periarteritis was the only active lesion that recurred.
View Article and Find Full Text PDFArticle Synopsis
- Immunoglobulin G4 (IgG4) is a crucial protein in the immune system, with elevated levels linked to various IgG4-related diseases that cause inflammation in organs, predominantly affecting males.
- The study analyzed the relationship between gut microbiota and serum IgG4 levels in a population of 191 men and 207 women aged 40 and older, utilizing advanced genetic sequencing methods.
- Results indicated that different gut microbiota patterns significantly influence IgG4 levels differently for men and women, highlighting the need for a gender-specific approach in understanding these levels and their implications for health.
Article Synopsis
- * The review examined pediatric IgG4-RD through published studies, highlighting differences in sex distribution, organ involvement, and the need for better diagnostic criteria for kids compared to adults.
- * Pediatric IgG4-RD often presents less aggressively and more unilaterally, making diagnosis challenging; only 20% of cases align with existing classification criteria, emphasizing the need for improved collaboration and research in this area.
A 65-year-old man presented with apparent bronchopneumonia. After treatment with antibiotics, he showed eosinophilia. Computed tomography (CT) imaging revealed bilateral consolidation, ground-glass opacities with nodular consolidations, and pleural effusion.
View Article and Find Full Text PDFObjectives: Although elevated serum immunoglobulin A (IgA) levels are thought to exclude a diagnosis of IgG4-related disease (IgG4-RD), IgG4-RD has been definitively diagnosed in some patients despite elevated serum IgA levels. This study aimed to clarify the prevalence of elevated IgA levels in patients with IgG4-RD and to compare the clinical features of IgG4-RD patients with and without elevated IgA levels.
Methods: The clinical features of 169 IgG4-RD patients were retrospectively compared among those with and without elevated serum IgA levels.
Introduction: To allow the identification of IgG4-related disease (IgG4-RD) from a subclinical phase as it is important to understand the risk of elevated serum IgG4 levels. We planned to evaluate serum IgG4 levels in the participants of the Nagasaki Islands Study (NaIS), a large-scale health checkup cohort study.
Methods: This study included 3,240 individuals who participated in the NaIS between 2016 and 2018 and consented to participate in the study.