Publications by authors named "Toshihiro Shirai"

Background: Subacute cough is subdivided and distinguished from chronic cough, because post-infectious cough is considered to be the main cause of subacute cough and differs from acute and chronic cough. However, the details of the spectrum and frequency of causes of subacute cough remain unclear because only two studies on subacute cough have been published.

Methods: Patients who presented with cough that lasted for 3-8 weeks and visited respiratory clinics or hospitals affiliated with the Japan Cough Society during 2 years were studied.

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Sensitization to Staphylococcus aureus (S. aureus) enterotoxins (SEs) A (SEA) and B (SEB) is associated with the pathogenesis of several chronic airway diseases, including asthma and chronic rhinosinusitis, but its role in chronic obstructive pulmonary disease (COPD) remains unclear. This cohort study aimed to investigate the impact of sensitization to SEs on total IgE levels, and capsaicin cough reflex sensitivity (C-CS) in COPD.

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Background: Despite the development of biologics for severe asthma, individuals with uncontrolled status persist, posing a significant social problem. This multicenter prospective study aimed to identify factors associated with the uncontrolled status of patients with severe asthma in the biologic era assessed using the Asthma Control Questionnaire (ACQ).

Methods: Subjects with severe asthma diagnosed by respiratory specialists were enrolled from 11 hospitals.

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Background: The therapeutic effectiveness of dupilumab for severe asthma in real-world settings is yet to be prospectively investigated across multiple institutions, and uncertainties persist regarding predictive factors for its effectiveness. We aimed to assess the effectiveness of dupilumab and identify predictors of its effectiveness in real-world settings using two type-2 biomarkers: FeNO concentration and blood eosinophil count.

Methods: This prospective multicenter study included 103 patients with severe asthma.

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Article Synopsis
  • The article compares the criteria established by the American Thoracic Society and European Respiratory Society for evaluating bronchodilator response in 2005 versus the updated criteria from 2021.
  • The authors discuss how these criteria have evolved over time and their implications for clinical practice and patient outcomes.
  • The findings highlight the importance of applying the most current guidelines for accurate assessment and treatment of respiratory conditions.
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We present two cases of () respiratory infection. The first case involves a 62-year-old female with abnormal chest shadows, a history of bronchial asthma, and colorectal cancer. Endobronchial ultrasound with a guide sheath (EBUS-GS) revealed granulomatous changes, and was cultured.

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A 70-year-old woman had been treated with methotrexate for rheumatoid arthritis by a rheumatologist who opened a clinic near our hospital. In January of a certain year, she had respiratory symptoms of cough, sputum, and fever. Laboratory test results showed a white blood cell count of 8600/μL (neutrophil count of 5330/μL, lymphocyte count of 2490 μ/L), C-reactive protein (CRP) of 3.

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Article Synopsis
  • Chronic cough is a prevalent symptom in respiratory diseases that significantly impacts patients' lives and social interactions, highlighting the need for comprehensive studies in Japan.
  • The study involved 379 patients with a cough lasting over 8 weeks, ultimately analyzing 334 cases, revealing major causes like cough variant asthma and sinobronchial syndrome.
  • Findings indicate that patients with gastroesophageal reflux-associated cough had a lower treatment success rate and that undiagnosed cases took longer to treat, marking this as Japan's first nationwide investigation into chronic cough causes and treatments.
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Article Synopsis
  • Inflammation reduces the activity of cytochrome P450 3A (CYP3A), and the NLRP3 gene is linked to regulating inflammation, especially in diseases like asthma.
  • A study examined 10 specific NLRP3 genetic variations (SNPs) in 152 asthma patients to see how these affect plasma levels of 4β-hydroxycholesterol (4βOHC), a marker for CYP3A activity.
  • Results indicated that certain SNPs were associated with lower 4βOHC levels and higher interleukin-6 (IL-6) concentrations, suggesting that NLRP3 polymorphisms could serve as potential indicators of CYP3A activity in asthma patients.
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This case report details a 78-year-old male with periorbital Methicillin-resistant Staphylococcus aureus (MRSA) cellulitis whose condition rapidly deteriorated despite treatment. An autopsy confirmed acute fibrinous and organizing pneumonia (AFOP), revealing fibrin ball formation and organizing pneumonia. While both idiopathic and secondary AFOP cases often exhibit bilateral consolidation on CT, our patient presented with ground-glass opacities, which are frequently associated with secondary AFOP.

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Background: We aimed to investigate risk factors predicting oxygen demand in COVID-19 patients.

Methods: Patients admitted to Shizuoka General Hospital with COVID-19 from August 2020 to August 2021 were included. First, we divided patients into groups with and without oxygen demand.

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Background: Although clinical trials including asthma and COPD patients have revealed much about exacerbation frequencies, most studies are limited in that they recruited patients only with a clear diagnosis of one disease or the other, based on conventional diagnostic criteria, which may exclude many real-world patients with mixed symptoms.

Methods: NOVELTY is a global prospective observational study of patients with asthma and/or COPD from real-world practice. In this subanalysis, we compared patient characteristics of obstructive pulmonary diseases between the Japanese population (n = 820) and the overall population excluding Japanese patients (n = 10,406).

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A 63-year-old woman with refractory atopic dermatitis started treatment with dupilumab. She developed a cough 4 days later, sputum, and a slight fever 2 weeks later. Laboratory test results showed a blood eosinophil count of 7360/μL.

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Background: It is necessary to evaluate the severity of asthma exacerbations for subjective symptoms and objective indicators. When patients cannot perform spirometry, oscillometry is a surrogate test.

Objective: We assessed the usefulness of oscillometry for the evaluation of treatment responsiveness in patients with asthma exacerbations.

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Introduction: Patients with chronic obstructive pulmonary disease (COPD) are often hospitalised due to severe acute exacerbation (AE) or community-acquired pneumonia (CAP). Previous studies revealed the association of cough reflex sensitivity with the pathophysiology of COPD and pneumonia. We hypothesised that cough reflex sensitivity may be associated with severe AE or CAP requiring hospitalisation in patients with COPD.

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Background: Cough and sputum are the significant symptoms of nontuberculous mycobacteriosis (NTM) and impair quality of life (QOL). However, the relationship between these symptoms and clinical features is not fully understood. This study aimed to investigate cough-related QOL in NTM patients.

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Purpose: There are reports concerning mucus plugs detected on high-resolution computed tomography images and airflow obstruction in asthma and chronic obstructive pulmonary disease (COPD). However, little is known about the associations between mucus plugs and small airway dysfunction (SAD). We evaluated the relationship between mucus plugs and pulmonary function in patients with asthma, COPD, and asthma-COPD overlap (ACO), and investigated the relevance to SAD and type 2 inflammation in a retrospective study.

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Background: Cough is one of the most common distressing symptoms in lung cancer. However, there is no specific measure of cough in lung cancer in Japanese. The present study aimed to determine the validity of the Japanese version of the Manchester Cough in Lung Cancer Scale (MCLCS).

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