Papers - UMEKITA Kunihiko
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特集 HTLV-1母子感染をもっと知ろう HTLV-1関連疾患 ATL、HAM以外の関連疾患の概要 Invited
梅北 邦彦, 岡山 昭彦
周産期医学 50 ( 10 ) 1703 - 1706 2020.10
Authorship：Lead author Publishing type：Research paper (scientific journal) Publisher：(株)東京医学社
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Detection of anti-SFTSV nuclear protein antibody in the acute phase sera of patients using double-antigen ELISA and immunochromatography. Reviewed
Umeki K, Yasuda A, Umekita K, Megumi R, Nomura H, Kawaguchi T, Matsuda M, Takajo I, Shimojima M, Okayama A
Journal of virological methods 285 113942 2020.8
Language：English Publishing type：Research paper (scientific journal)
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Effective Treatment with Tocilizumab in a Rheumatoid Arthritis Patient Complicated with Human T-cell Leukemia Virus Type 1-associated Myelopathy: A Case Report. Reviewed
Iwao C, Umekita K, Miyauchi S, Kimura M, Rikitake Y, Iwao K, Rikitake M, Aizawa A, Kawaguchi T, Kariya Y, Matsuda M, Takajo I, Shiomi K, Okayama A.
Intern Med 59 ( 15 ) 1891 - 1897 2020.8
Publishing type：Research paper (scientific journal)
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Human T-cell leukemia virus type 1 may invalidate T-SPOT.TB assay results in rheumatoid arthritis patients: A retrospective case-control observational study. Reviewed International journal
Kunihiko Umekita, Yayoi Hashiba, Kosho Iwao, Chihiro Iwao, Masatoshi Kimura, Yumi Kariya, Kazuyoshi Kubo, Shunichi Miyauchi, Risa Kudou, Yuki Rikitake, Katoko Takajo, Takeshi Kawaguchi, Motohiro Matsuda, Ichiro Takajo, Eisuke Inoue, Toshihiko Hidaka, Akihiko Okayama
PloS one 15 ( 5 ) e0233159 2020.5
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal)
BACKGROUND: CD4-positive T cells are the main target of human T-cell leukemia virus type 1 (HTLV-1). Interferon-γ release assays rely on the fact that T-lymphocytes release this cytokine when exposed to tuberculosis-specific antigens and are useful in testing for latent tuberculosis infection before initiating biologic therapy, such as anti-tumor necrosis factor agents. However, the reliability of interferon-γ release assays in detecting tuberculosis infection among HTLV-1-positive patients with rheumatoid arthritis (RA) remains unclear. The present study aimed to evaluate the use of the T-SPOT.TB assay in HTLV-1-positive RA patients. METHODS: Overall, 29 HTLV-1-positive RA patients and 87 age- and sex-matched HTLV-1-negative RA patients (controls) were included from the HTLV-1 RA Miyazaki Cohort Study. Results of the T-SPOT.TB assay for latent tuberculosis infection screening were collected from medical records of patients. RESULTS: Approximately 55% of the HTLV-1-positive RA patients showed invalid T-SPOT.TB assay results (odds ratio: 108, 95% confidence interval: 13.1-890, p < 0.0001) owing to a spot count of >10 in the negative controls. HTLV-1 proviral load values were significantly higher in patients with invalid results compared with those without invalid results (p = 0.003). CONCLUSION: HTLV-1 infection affects T-SPOT.TB assay results in RA patients. Assay results in HTLV-1 endemic regions should be interpreted with caution when screening for latent tuberculosis infection before initiation of biologic therapy.
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A case of lupus vasculopathy presenting favorable renal outcome. Reviewed
Ishizaki Y, Aizawa A, Ochiai S, Minakawa A, Miyauchi S, Umekita K, Sato Y, Ogawa Y, Kushida Y, Okayama A, Uesugi N, Fujimoto S.
CEN Case Rep 9 ( 1 ) 74 - 80 2020.2
Publishing type：Research paper (scientific journal)
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Effectiveness and safety of non-tumor necrosis factor inhibitor therapy for anti-human T-cell leukemia virus type 1 antibody-positive rheumatoid arthritis. Reviewed International journal
Yushiro Endo, Shoichi Fukui, Kunihiko Umekita, Takahisa Suzuki, Junya Miyamoto, Shimpei Morimoto, Toshimasa Shimizu, Tomohiro Koga, Shin-Ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Mami Tamai, Tomoki Origuchi, Akitomo Okada, Keita Fujikawa, Akinari Mizokami, Naoki Matsuoka, Toshiyuki Aramaki, Yukitaka Ueki, Katsumi Eguchi, Yumi Kariya, Yayoi Hashiba, Toshihiko Hidaka, Akihiko Okayama, Atsushi Kawakami, Hideki Nakamura
Modern rheumatology 31 ( 5 ) 972 - 978 2020
Language：English Publishing type：Research paper (scientific journal)
OBJECTIVES: Our previous study showed that the effectiveness of tumor necrosis factor (TNF) inhibitors was attenuated in anti-human T-cell leukemia virus type 1 (HTLV-1) antibody-positive patients with rheumatoid arthritis (RA). We aimed to evaluate the effectiveness and safety of non-TNF inhibitors in anti-HTLV-1 antibody-positive patients with RA. METHODS: We reviewed patients with RA who received abatacept or tocilizumab as the first biologic agent. We used the data of patients treated with TNF inhibitors from our previous study to compare the effectiveness between the anti-HTLV-1 antibody-positive patients treated with TNF inhibitors and non-TNF inhibitors using the inverse probability of treatment weights (IPTW) method. RESULTS: A total of 359 patients were divided into anti-HTLV-1 antibody-negative and -positive patients of 332 and 27, respectively. No statistically significant difference was observed in the change in the clinical disease activity index between the anti-HTLV-1 antibody-positive and -negative patients. The results using the IPTW method showed a significant association between the non-TNF inhibitors treatment and a better response. None of the patients developed adult T-cell leukemia/lymphoma or HTLV-1-associated myelopathy/tropical spastic paraparesis during the 24 weeks. CONCLUSION: Our results indicate that non-TNF inhibitors treatment is safety, and the effectiveness is not attenuated also in anti-HTLV-1 antibody-positive patients.
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Umekita K., Hashiba Y., Kariya Y., Kubo K., Miyauchi S., Aizawa A., Umeki K., Nomura H., Kawaguchi T., Matsuda M., Takajo I., Hidaka T., Okayama A.
Modern Rheumatology 29 ( 5 ) 795 - 801 2019.9
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Modern Rheumatology
© 2018, © 2018 Japan College of Rheumatology. Objective: This study aimed to investigate the time-sequential changes of risk factors for adult T-cell leukemia (ATL) development in human T-cell leukemia virus type 1 (HTLV-1)-positive rheumatoid arthritis (RA) patients. Methods: HTLV-1 infection was screened using particle agglutination assay and confirmed via western blotting in 365 RA patients. Twenty-three HTLV-1-positive RA patients were included in the study cohort. Blood samples were obtained from these patients at each observation time point. The values of HTLV-1 proviral load (PVL) and serum soluble IL-2 receptor (sIL2-R), which are risk factors for ATL development, were measured using real-time PCR and enzyme immunoassay, respectively. Results: The study cohort comprised 79 person-years. The median HTLV-1 PVL and sIL2-R values of the HTLV-1-positive RA patients were 0.44 copies per 100 white blood cells (WBCs) and 406 U/mL, respectively. Three HTLV-1-positive RA patients showed a high PVL value. No remarkable changes were observed in the PVL and sIL2-R values during the observation period. However, one elderly HTLV-1-positive RA patient who had a high PVL value developed ATL during treatment with methotrexate and infliximab. Conclusion: A thorough clinical assessment of the risk factors for ATL development may be necessary in daily clinical practice for RA patients in HTLV-1-endemic areas in Japan.
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Takajo Ichiro, Umekita Kunihiko, Ikei Yoshihiko, Oshima Koichi, Okayama Akihiko
Internal Medicine 57 ( 14 ) 2071 - 2075 2018.7
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：一般社団法人 日本内科学会
The patient was a 74-year-old Japanese woman with rheumatoid arthritis (RA) who developed generalized lymphadenopathy with elevated levels of lactase dehydrogenase (LD), and soluble IL-2 receptor (sIL-2R). She was found to be positive for anti-human T-cell leukemia virus type 1 (HTLV-1) antibodies. Her symptoms and laboratory abnormalities spontaneously regressed after the cessation of methotrexate (MTX), suggesting that she had an MTX-associated lymphoproliferative disorder; however, her lymphadenopathy appeared again approximately 14 months later with LD and sIL-2R elevation. A histopathological analysis and Southern blotting of a lymph node biopsy specimen for HTLV-1 provirus supported the diagnosis of adult T-cell leukemia/lymphoma (ATL) (lymphoma type). These data confirmed that an HTLV-1 positive RA patient may develop ATL.
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Suzuki T., Fukui S., Umekita K., Miyamoto J., Umeda M., Nishino A., Okada A., Koga T., Kawashiri S., Iwamoto N., Ichinose K., Tamai M., Fujikawa K., Aramaki T., Mizokami A., Matsuoka N., Ueki Y., Eguchi K., Sato S., Hidaka T., Origuchi T., Okayama A., Kawakami A., Nakamura H.
Arthritis and Rheumatology 70 ( 7 ) 1014 - 1021 2018.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Arthritis and Rheumatology
© 2018, American College of Rheumatology Objective: To evaluate the effectiveness of tumor necrosis factor (TNF) inhibitors for the treatment of human T lymphotropic virus type I (HTLV-I)–positive patients with rheumatoid arthritis (RA) in an area endemic for HTLV-I infection. Methods: We conducted an observational study of 585 RA patients in whom TNF inhibitors were newly introduced as a first biologic disease-modifying antirheumatic drug in an area in southwestern Japan that is endemic for HTLV-I infection. Results: Fifty patients (8.5%) were anti–HTLV-I antibody–positive. The ages of the patients in this group were significantly higher at entry compared with the ages of patients who were anti–HTLV-I antibody–negative (n = 535). The median Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28-ESR) was 5.21. Among the total group of patients, 82% were anti–citrullinated protein antibody (ACPA)–positive. The persistence rate of TNF inhibitors at 24 weeks was 89%. The median DAS28-ESR was significantly decreased at 24 weeks in each group. The European League Against Rheumatism (EULAR) response rate was significantly better in the anti–HTLV-I antibody–negative patients (P = 0.0277). Multiple regression analysis demonstrated that anti–HTLV-I antibody status was significantly associated with the EULAR response rate and change in the DAS28-ESR and was prominent especially in the ACPA-negative subjects. No patients developed adult T cell leukemia/lymphoma (ATL) or HTLV-I–associated myelopathy (HAM) during the 24-week treatment period. Conclusion: The efficacy of TNF inhibitors may be attenuated in anti–HTLV-I antibody–positive patients with RA. ATL and HAM did not develop when TNF inhibitors were used for 24 weeks, but the long-term risk is not known.
DOI： 10.1002/art.40461
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Remission of chronic type ATL in a patient with rheumatoid arthritis after withdrawing methotrexate and infliximab combination therapy: a case report. Reviewed
Hashiba Y, Hidaka T, Umekita K, Nishi E, Kai Y, Kubo K, Okayama A.
Modern Rheumatology Case Reports. 2 ( 1 ) 9 - 13 2018.1
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)
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Umeki K., Umekita K., Hashikura Y., Yamamoto I., Kubo K., Nagatomo Y., Okayama A.
Clinical Laboratory 63 ( 2 ) 227 - 233 2017.2
Language：English Publishing type：Research paper (scientific journal) Publisher：Clinical Laboratory
Background: Human T-Iymphotropic virus type 1 (HTLV-1) has been recognized as a cause of adult T-cell leuke- mia/lymphoma, HTLV-1-associated myelopathy/tropical spastic paraparesis, and HTLV-1-associated uveitis. HTLV-1 infection is normally detected by screening for HTLV-1 antibodies, and positive samples are confirmed by Western blot (WB). However, WB fails to confirm some samples that were positive for HTLV-1 antibodies on screening. Line immunoassay (LIA) is commonly used in Europe and Brazil, but not in Japan. Therefore, we evaluated the performance of LIA as a method of confirming HTLV-1 antibodies using samples in Japan. Methods: LIA was compared with polymerase chain reaction (PCR) and WB using 50 negative and 70 positive samples tested by chemiluminescent enzyme immunoassay (CLEIA) in Miyazaki, Japan, an HTLV-1 endemic area. LIA (INNO-LIA HTLVI/II Score) and WB (Problot HTLV-I) were performed according to the manufacturer's instructions. Real-time PCR for HTLV-1 pX region was performed using DNA derived from white blood cells. The samples that tested negative by real-time PCR were further tested by nested PCR. Results: All 50 CLEIA negative samples were determined to be negative by LIA and PCR. Of the 70 positive samples, 66 tested positive by both of LIA and PCR. Three samples tested negative by LIA and PCR, and the remaining sample (PCR negative) showed non-specific staining in LIA and WB. WB showed more indeterminate results than LIA. Gp21 antibody in LIA demonstrated a high ability to discriminate between positive and negative PCR results. Furthermore, the degree of gp21 antibody reaction by LIA showed correlation with HTLV-1 proviral loads (PVLs). Conclusions: Our results indicate that LIA performs well in confirming HTLV-1 seropositivity by showing a low incidence of indeterminate results and good agreement with PCR using samples in Japan, although the number of samples tested was small. In addition, semi-quantitative antibody titer to gp21 correlated well with HTLV-1 PVLs. Further study including larger samples is necessary to determine the positioning of LIA for HTLV-1 detection in Japan.
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Successful treatment of disseminated cryptococcosis with liposomal amphotericin B and isavuconazole in an adult living with HIV: A case report and literature review. Reviewed
Kawaguchi T, Kitamura A, Kimura M, Rikitake Y, Iwao C, Iwao K, Sumiyoshi M, Kariya Y, Matsuda M, Umekita K, Takajo I, Moriguchi-Goto S, Yamashita A, Matsumoto K, Miyazaki T.
J Infect Chemother. 31 ( 1 ) 102534 2025.1
Publishing type：Case report
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Kawaguchi T., Matsuda M., Umekita K., Miyazaki T.
Respirology Case Reports 12 ( 7 ) e01428 2024.7
Language：English Publishing type：Case report Publisher：Respirology Case Reports
Nintedanib has been demonstrated to inhibit the rate of forced vital capacity decline in patients with progressive fibrosing interstitial lung diseases (PF-ILD) at a dose of 200 or 300 mg/day in the INBUILD trial. Although concomitant use of nintedanib with P-glycoprotein inhibitors reportedly increases the plasma concentrations of the former, tacrolimus, a P-glycoprotein inhibitor, is often used to treat connective tissue diseases-related interstitial lung diseases. The optimal dose of nintedanib in combination with tacrolimus for the treatment of PF-ILD with connective tissue disease is unknown. We herein present two patients with PF-ILD with anti-aminoacyl-tRNA synthetase antibody-positive dermatomyositis who were successfully treated with low-dose nintedanib (<200 mg/day) in combination with tacrolimus.
DOI： 10.1002/rcr2.1428
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Human granulocytic anaplasmosis with rash and rhabdomyolysis: A case report Reviewed
Kawaguchi T., Rikitake Y., Rikitake M., Kimura M., Iwao C., Iwao K., Aizawa A., Sumiyoshi M., Kariya Y., Matsuda M., Miyauchi S., Umekita K., Takajo I., Ohashi N., Miyazaki T.
Journal of Infection and Chemotherapy 2024
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Infection and Chemotherapy
Human granulocytic anaplasmosis (HGA) is a tick-borne infection caused by Anaplasma phagocytophilum. Only seven cases of HGA have been reported in Japan to date. We report the case of a 61-year-old female farmer who developed HGA with rash and rhabdomyolysis. The patient had fever and erythema covering the entire body, including the palms. An induration with an eschar was observed on the right leg, indicating that the patient had been bitten by a tick. Elevated serum creatinine and creatinine kinase levels and hematuria indicated rhabdomyolysis. We suspected Japanese spotted fever, a tick-borne illness caused by Rickettsia Japonica, and administered minocycline and ciprofloxacin for a week. Transient neutropenia and thrombocytopenia were observed, but the symptoms improved. Polymerase chain reaction (PCR) and antibody tests for R. japonica and Orientia tsutsugamushi, which causes scrub typhus, were both negative. The PCR test for severe fever with thrombocytopenia syndrome virus was also negative. Antibodies against A. phagocytophilum–related proteins were detected by western blotting, indicating seroconversion of IgG with paired serum samples, and the patient was diagnosed with HGA. HGA should be suspected in acute febrile patients with a history of outdoor activity and cytopenia, with or without a rash. A testing system and the accumulation of cases in Japan are necessary for the early diagnosis and appropriate treatment of HGA.
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Luteibacter jiangsuensis blood stream infection: a first case report. Reviewed
Horiguchi T, Sumiyoshi M, Nagatomo E, Sakamoto K, Ogawa S, Ichinari N, Yamada A, Rikitake Y, Iwao C, Kawaguchi T, Umekita K, Takajo I, Yamamoto S, Miyazaki T.
BMC Infect Dis. 23 ( 1 ) 863 2023.12
Publishing type：Case report
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Coronavirus disease 2019 in a patient with pulmonary fibrosis and emphysema: An autopsy report. Reviewed
Kudo R, Kawaguchi T, Kimura M, Rikitake Y, Iwao C, Rikitake M, Iwao K, Aizawa A, Kariya Y, Matsuda M, Miyauchi S, Takajo I, Sato Y, Asada Y, Miyazaki T, Umekita K.
Heliyon. 9 ( 11 ) e22221 2023.11
Publishing type：Case report
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血液腫瘍関連の遺伝子検査 Reviewed
橋倉悠輝、猪﨑みさき、梅北邦彦
生物試料分析 46 ( 3 ) 115 - 121 2023.6
Publishing type：Research paper (other academic)
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Analysis of the genus <i>Malassezia</i> isolated in our hospital Reviewed
YANAGI Masaki, YAMADA Akiteru, HASHIKURA Yuki, IZAKI Misaki, KAWAKAMI Megumi, MEGUMI Ryoya, UMEKITA Kunihiko
Japanese Journal of Medical Technology 72 ( 2 ) 191 - 196 2023.4
Authorship：Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Association of Medical Technologists
<i>Malassezia</i> is a yeast-like fungus that is endemic to human and animal skin. It can be pathogenic bacteria for various diseases such as tinea versicolor, <i>Malassezia</i> folliculitis, seborrheic dermatitis, atopic dermatitis, and others. <i>Malassezia</i> is a lipid-requiring fungus and difficult to isolate by conventional culture methods. The morphological and biochemical findings of <i>Malassezia</i> spp. are similar, making it very difficult to identify the species on the basis of phenotype alone. Therefore, molecular biological methods to identify fungi at the species level are used, but few laboratories are available. Recently, selective culture media have been developed, allowing for easy cultivation. However, there are only a few studies on the analysis of the isolation of <i>Malassezia</i> in detail. In this study, we analyzed the frequency of isolation, identification of fungi at the species level by molecular biological methods, and detection of fungi in various types of the sample using a selective culture medium. The results showed a ninefold increase in the separation frequency when using the selective medium compared with cultivation in the olive oil-stratified medium. <i>Malassezia</i> spp. were detected in five types of sample: otorrhea (20/43), skin (10/43), nasal swabs (9/43), sputum (3/43), and eye discharge (1/43) using 43 clinical isolates and preserved strains. All the <i>Malassezia</i> spp. detected were identified at the species level using molecular biological techniques. These results indicate that the selective medium increases the frequency of fungal isolation and, when combined with molecular biological techniques, identifies the species. In the future, it will be necessary to further improve the culture method and establish a simple and rapid identification method using a mass spectrometer.
DOI： 10.14932/jamt.22-79
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骨髄標本のスマッジ細胞集簇像が診断の契機となった血管内大細胞型B細胞リンパ腫 Reviewed
河野克海、橋倉悠輝、髙木覚、松浦成美、長安真由美、久冨木庸子、梅北邦彦.
医学検査 71 ( 3 ) 574 - 580 2022.7
Publishing type：Case report
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特集 ウイルス性皮膚疾患アップデート 臨床例 全身性強皮症と関節リウマチで治療中の患者に生じた尖圭コンジローマ,bowenoid papulosisの合併例 Reviewed
西元 順子, 成田 幸代, 梅北 邦彦, 天野 正宏
皮膚病診療 44 ( 4 ) 334 - 337 2022.4
Language：Japanese Publishing type：Case report Publisher：協和企画