Papers - UMEKITA Kunihiko
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Possible case of novel spotted fever group rickettsiosis in traveler returning to Japan from India Reviewed
Takajo I., Sekizuka T., Fujita H., Kawano A., Kawaguchi T., Matsuda M., Kubo K., Miyauchi S., Umekita K., Nagatomo Y., Kuroda M., Takasaki T., Okayama A., Ando S.
Emerging Infectious Diseases 22 ( 6 ) 1079 - 1082 2016.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Emerging Infectious Diseases
© 2016, Centers for Disease Control and Prevention (CDC). All rights reserved. A 60-year-old woman experienced fever, headache, rash, and altered vision after returning to Japan from India. Testing detected elevated antibody titers to spotted fever group rickettsia; PCR on blood yielded positive results for the rickettsial outer membrane protein A gene. We isolated a unique rickettsial agent and performed a full-genome analysis.
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Umekita K., Umeki K., Miyauchi S., Ueno S., Kubo K., Kusumoto N., Takajo I., Nagatomo Y., Okayama A.
Modern Rheumatology 25 ( 5 ) 784 - 797 2015.9
Language：English Publishing type：Research paper (scientific journal) Publisher：Modern Rheumatology
© 2013 Japan College of Rheumatology. Anti-tumor necrosis factor (anti-TNF) biologics are effective in the treatment of rheumatoid arthritis (RA); however, it is still not clear whether this treatment promotes the development of malignancies such as lymphoma. Human T-lymphotropic virus type 1 (HTLV-1), which is a causative agent of adult T-cell lymphoma (ATL), is prevalent in Japan. Many HTLV-1-positive patients with RA are assumed to exist; however, there have thus far been no reports on the effect of anti-TNF biologics on HTLV-1-positive patients. We analyzed the response to treatment with anti-TNF biologics and change of HTLV-1 markers in two cases of RA. The two cases showed no response based on the European League Against of Rheumatism response criteria 60-96 weeks after administration of anti-TNF biologics (infliximab and etanercept). No signs of ATL were observed and HTLV-1 markers, such as proviral load and clonality of HTLV-1-infected cells, showed no significant change in either of two cases. Therefore, treatment with anti-TNF biologics did not induce activation of HTLV-1, although the effect on RA was not as effective as in HTLV-1-negative patients in this limited study. Further long-term study with a greater number of patients is necessary to clarify the safety and efficacy of anti-TNF biologics in HTLV-1-positive patients with RA.
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P38-4 炎症性肺疾患におけるマイクロパーティクル発現に関する検討(内科症例8,Posterセッション38,第38回日本呼吸器内視鏡学会学術集会) Reviewed
長友 安弘, 宮内 俊一, 楠元 規生, 梅北 邦彦, 岡山 昭彦
気管支学 37 ( 0 ) 2015
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：特定非営利活動法人 日本呼吸器内視鏡学会
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Miyauchi S., Umekita K., Hidaka T., Umeki K., Aratake Y., Takahashi N., Sawaguchi A., Nakatake A., Morinaga I., Morishita K., Okayama A.
Rheumatology (United Kingdom) 53 ( 11 ) 1966 - 1972 2014.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Rheumatology (United Kingdom)
© The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Objective. The aim of this study was to clarify the mechanism of leucocytapheresis (LCAP) in patients with RA. Methods. Protein profiles of blood samples from two patients with RA obtained via LCAP column inlet and outlet lines were analysed by two-dimensional fluorescence difference gel electrophoresis and mass spectrometry. The lactoferrin (LTF) levels of peripheral and circulating blood samples from seven patients obtained via the LCAP column blood circuit were then determined by ELISA. Peripheral blood samples from 14 patients with RA were exposed to unwoven polyester fibre filters and the LTF level was determined. In addition, morphological changes in neutrophils after exposure to the filter were examined by optical microscopy, electronic microscopy and LTF immunostaining. Results. LTF levels were increased in both samples from the LCAP column outlet and peripheral blood at the end of LCAP treatment. Furthermore, peripheral blood samples exposed to the filter revealed a decreased number of neutrophils and an increased level of LTF. Morphological analysis of the exposed neutrophils showed vacuolization of the cytoplasm and degranulation of LTF-positive granules. These data suggest that LTF stored in the granules of neutrophils is released from the neutrophils caught in the LCAP column. Conclusion. Because LTF has been reported to have multiple anti-inflammatory properties, increased levels of LTF may contribute to the clinical effect of LCAP in patients with RA.
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Umekita K., Hidaka T., Miyauchi S., Ueno S., Kubo K., Takajo I., Hashiba Y., Kai Y., Nagatomo Y., Okayama A.
Arthritis Care and Research 66 ( 5 ) 788 - 792 2014.5
Language：English Publishing type：Research paper (scientific journal) Publisher：Arthritis Care and Research
Objective To investigate the response to and safety of anti-tumor necrosis factor (anti-TNF) therapy in human T lymphotropic virus type I (HTLV-I)-positive patients with rheumatoid arthritis (RA). Methods Therapeutic response was evaluated in 10 HTLV-I-positive and 20 HTLV-I-negative patients with RA (sex and age matched) at 3 months after the beginning of anti-TNF therapy using the European League Against Rheumatism improvement criteria. As secondary end points, the discontinuation rate of anti-TNF therapy and its safety, especially the development of adult T cell leukemia (ATL), were evaluated over a 2-year period. Results Significantly higher baseline levels of C-reactive protein (CRP) were observed in HTLV-I-positive patients than in HTLV-I-negative patients (P = 0.0003). The response rate to anti-TNF therapy was lower in HTLV-I-positive patients than in HTLV-I-negative patients. The median CRP level, erythrocyte sedimentation rate, and Disease Activity Score in 28 joints at 3 months after anti-TNF treatment in HTLV-I-positive patients were significantly higher than in HTLV-I-negative patients (P = 0.003, P = 0.03, and P = 0.003, respectively). The discontinuation rate due to insufficient response was significantly higher in HTLV-I-positive patients than in HTLV-I-negative patients (P = 0.013). During the 2-year observation period, no patients developed ATL. Conclusion These data suggest that HTLV-I-positive patients with RA had higher inflammation and greater resistance to anti-TNF treatment than HTLV-I-negative patients. Further study is necessary to determine whether HTLV-I infection should be measured when anti-TNF agents are administered to patients with RA, especially in areas were HTLV-I is endemic. © 2014, American College of Rheumatology.
DOI： 10.1002/acr.22205
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宮崎県における関節リウマチに対する生物学的製剤の使用実態調査～第2報～. Reviewed
濱田浩朗, 梅北邦彦, 岡山昭彦, 日高利彦, 甲斐睦章, 上田章, 税所幸一郎, 村井幸一,大平卓, 松山幹太郎, 金井一男, 坂田師通, 佐々木隆, 岡本将幸, 安藤徹, 秋元正樹, 首藤敏秀, 三股恒夫, 田中弦一, 松本英裕, 吉永一春, 谷口博信, 福田健二, 川野啓一郎, 木屋博昭, 市原正彬, 谷畠満, 佐保修二, 宮本義明, 帖佐悦男.
宮崎県医師会医学会誌. 38 ( 1 ) 26 - 33 2014.3
Language：Japanese Publishing type：Research paper (scientific journal)
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関節リウマチ診療における超音波検査の注意点 Reviewed
濱田浩朗, 帖佐悦男, 梅北邦彦, 岡山昭彦
九州リウマチ 33 ( 2 ) 64 - 67 2013.9
Language：Japanese Publishing type：Research paper (scientific journal)
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宮崎県における関節リウマチに対する生物学的製剤の使用実態調査（第１報）. Reviewed
梅北邦彦, 濱田浩朗, 岡山昭彦, 日高利彦, 甲斐睦章, 上田章, 税所幸一郎, 村井幸一,大平卓, 松山幹太郎, 坂田師通, 佐々木隆, 岡本将幸, 安藤徹, 秋元正樹, 首藤敏秀, 黒沢治, 田中弦一, 松本英裕, 吉永一春, 谷口博信, 福田健二, 川野啓一郎, 木屋博昭, 市原正彬, 谷畠満, 佐保修二, 宮本義明, 帖佐悦男.
宮崎県医師会医学会誌 36 ( 2 ) 172 - 180 2012.9
Language：Japanese Publishing type：Research paper (scientific journal)
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トシリズマブ投与中の関節リウマチ患者における関節エコーの意義.
鈴木千代子, 尾方美幸, 河野満子, 日高百合子, 梅木一美, 梅北邦彦, 岡山昭彦.
日本臨床化学会九州支部会誌 22 71 - 75 2012.7
Language：Japanese Publishing type：Research paper (scientific journal)
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Arteriosclerosis of whole aorta in Takayasu arteritis Reviewed
Umekita K., Hashiba Y., Kariya-Kaneko Y., Matsuda M., Okayama A.
Journal of Rheumatology 39 ( 6 ) 1291 2012.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Rheumatology
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Ueno S., Umeki K., Takajo I., Nagatomo Y., Kusumoto N., Umekita K., Morishita K., Okayama A.
International Journal of Cancer 130 ( 10 ) 2318 - 2326 2012.5
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Cancer
High human T-lymphotropic virus Type 1 (HTLV-1) proviral DNA load (PVL) has been reported to be one risk factor for the development of adult T-cell leukemia/lymphoma (ATL). ATL is also believed to develop in HTLV-1 carriers who acquire infection perinatally. ATL cells have been reported to frequently harbor defective provirus. In our study, PVLs for three different regions of HTLV-1 provirus (5'LTR-gag, gag and pX) were measured in 309 asymptomatic carriers with different infection routes. PVLs for the pX region in 21 asymptomatic carriers with maternal infection was significantly higher than in 24 carriers with spousal infection. Among 161 carriers with relatively high pX PVLs (equal to or greater than 1 copy per 100 peripheral blood mononuclear cells), 26 carriers (16%) had low gag PVL/pX PVL (less than 0.5) and four (2%) had low 5'LTR-gag PVL/pX PVL (less than 0.5). Low gag PVL/pX PVL ratio, which reflects deficiency and/or polymorphism of HTLV-1 proviral DNA sequences for the gag region, was also associated with maternal infection. These data suggest that HTLV-1 carriers with maternal infection tend to have high PVLs, which may be related to provirus with deficiency and/or the polymorphism of proviral DNA sequences. In addition, there is a possibility that this ratio may be used as a tool to differentiate the infection routes of asymptomatic HTLV-1 carriers, which supports the need for a large scale study. © 2011 UICC.
DOI： 10.1002/ijc.26289
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話題 IL-6 阻害薬と感染症のマスキング Reviewed
梅北邦彦. 日高利彦. 岡山昭彦.
臨床と検査 55 ( 11 ) 1367 - 1370 2011.9
Language：Japanese Publishing type：Research paper (scientific journal)
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Umekita K., Miyauchi S., Ueno S., Takajo I., Kusumoto K., Hasuike S., Umekita Y., Tanaka H., Nagata K., Nagatomo Y., Kataoka H., Shimoda K., Okayama A.
Internal Medicine 50 ( 11 ) 1245 - 1249 2011.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Internal Medicine
We report a case of rheumatoid arthritis (RA) with autoimmune hepatitis (AIH) and Sjogren syndrome (SjS) that was treated with the tumor necrosis factor (TNF) inhibitor, etanercept (ETN). Both RA activity and transaminase levels improved as a result of treatment. Follow-up liver biopsy showed improvement of hepatitis. Although the efficacy of anti-TNF for RA patients with AIH remains controversial, this case suggests that treatment with ETN may result in a favorable clinical course in a certain subset of patients with RA and AIH. © 2011 The Japanese Society of Internal Medicine.
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Defective human T-lymphotropic virus type 1 provirus in asymptomatic carriers Reviewed
Takenouchi H., Umeki K., Sasaki D., Yamamoto I., Nomura H., Takajo I., Ueno S., Umekita K., Kamihira S., Morishita K., Okayama A.
International Journal of Cancer 128 ( 6 ) 1335 - 1343 2011.3
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Cancer
Few studies have specifically examined defective provirus in asymptomatic human T-lymphotropic virus Type 1 (HTLV-1) carriers and its relation to proviral DNA loads (PVLs). To assess the significance of defective provirus in asymptomatic carriers, we examined PVLs in peripheral blood mononuclear cells of 208 asymptomatic HTLV-1 carriers. The mean PVLs determined using primers for the pol region were less than that for the pX region in these carriers. Analysis of seven carriers with high PVLs for the pX region but lower PVLs for the pol region showed that four had single nucleotide polymorphisms of proviral genomes for the pol region and three had HTLV-1-infected cells with defective provirus. Three carriers with defective provirus showed high PVLs at their initial screens, and PVLs increased after a 10- to 12-year interval in two carriers. Southern blot assay showed clonal expansion of HTLV-1-infected cells, and the predominant clones changed during the observation period. These data suggest that although HTLV-1-infected cells with defective provirus may have a growth advantage, the predominant clones of HTLV-1-infected cells do not always survive for many years in asymptomatic carriers. Copyright © 2010 UICC.
DOI： 10.1002/ijc.25450
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A case of intubation granuloma treated with steroid inhalation Reviewed
MIYAUCHI Shun-ichi, NAGATOMO Yasuhiro, KUBO Kazuyoshi, UMEKITA Kunihiko, UENO Shirou, TAKAJOU Ichirou, KAI Yasufumi, OKAYAMA Akihiko
48 ( 7 ) 488 - 491 2010.7
Language：English Publishing type：Research paper (scientific journal)
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A case of intubation granuloma treated with steroid inhalation Reviewed
Miyauchi S., Nagatomo Y., Kubo K., Umekita K., Ueno S., Takajou I., Kai Y., Okayama A.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society 48 ( 7 ) 488 - 491 2010.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
A 36-year-old woman was given a diagnosis of hemophagocytic syndrome associated with systemic lupus erythematosus, and was treated with high-dose methylprednisolone and etoposide. She needed endotracheal intubation for mechanical ventilation because of respiratory failure. She developed hoarseness and stridor 69 days after extubation. A pedunculated mass under her glottis was observed by the laryngoscopy. Development of a laryngeal granuloma due to long-term contact with the endotracheal tube was considered, although she was continuously given oral prednisolone (22.5 mg/day) even after extubation. She was treated with inhalation of fluticasone propionate and her symptoms, e.g. hoarseness, decreased. Disappearance of the polypoid lesion was seen on day 26. A laryngeal granuloma due to intubation developed, even with the systemic administration of steroids; but it was successfully treated with steroid inhalation.
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Overwhelming Postsplenectomy Infection 22 Years After Splenectomy Reviewed
KUSUMOTO Norio, KUROKI Masayuki, UMEKITA Kunihiko, UENO Shiro, TAKAJO Ichiro, KAI Yasufumi, NAGATOMO Yasuhiro, SHIMADA Masami, HIDAKA Tomonori, KUBO Kazuyoshi, MIYAUCHI Syunnichi, OKAYAMA Akihiko
Kansenshogaku Zasshi 83 ( 3 ) 261 - 265 2009.5
Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Association for Infectious Diseases
A 25-year-old man undergoing splenectomy at 3 years of age to treat idiopathic thrombocytopenic purpura but no history of <i>Streptococcus pneumonia</i> vaccination, and reporting high fever, nausea, and headache developed purpura, confusion, and hypotension the next day and was admitted. Detailed examination showed disseminated intravascular coagulation and multiple-organ dysfunction. Chest X-ray and computed tomography (CT) showed pneumonia and pleural effusion. Blood culture was positive for <i>S. pneumoniae</i>. Gram staining of sputa yielded numerous white blood cells and gram-negative rods, and sputa culture was positive for <i>Pasteurella multocida</i> and <i>Haemophilus influenzae</i>. The medical history and presence of these organisms yielded a diagnosis of overwhelming postsplenectomy infection (OPSI), and the patient responded to treatment with a combination of benzylpenicillin, cefotaxime, and meropenem. This case suggests that patients with a history of splenectomy may benefit from vaccination for <i>S. pneumoniae</i> and adequate education on OPSI.
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KUSUMOTO Norio, KAI Yasufumi, KUBO Kazuyoshi, MIYAUCHI Syunnichi, UMEKITA Kunihiko, UENO Shiro, TAKAJO Ichiro, NAGATOMO Yasuhiro, OKAYAMA Akihiko, KAMEDA Takuro, SHIMODA Kazuya
Nihon Naika Gakkai Zasshi 98 ( 4 ) 859 - 861 2009.4
Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Internal Medicine
DOI： 10.2169/naika.98.859
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Umekita K., Hidaka T., Ueno S., Takajo I., Kai Y., Nagatomo Y., Sawaguchi A., Suganuma T., Okayama A.
Modern Rheumatology 19 ( 3 ) 265 - 272 2009.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Modern Rheumatology
Microparticles (MPs) are believed to play an important role in inflammatory diseases such as rheumatoid arthritis (RA). Leukocytapheresis (LCAP) is one of the options available for the treatment of RA. We analyzed the levels of MPs in RA, by flow cytometry, especially in relation to the effect of LCAP. Twenty female patients with RA were recruited into this study. Six of the 20 patients with RA further received LCAP. Plasma levels of platelet-derived MPs were high in patients with RA and are correlated with disease activity. LCAP significantly improved RA in all six patients. The numbers of platelet-derived MPs significantly decreased after the first session of LCAP, which was probably due to direct removal by LCAP. Mean numbers of platelet-derived MPs after four sessions of LCAP markedly decreased. The numbers of granulocyte-derived MPs, which are suggested to have an anti-inflammatory effect, were markedly increased after the first session of LCAP. These data suggest that removal of platelet-derived MPs and increase of granulocyte-derived MPs are novel mechanisms of LCAP as effective treatment in RA. © Japan College of Rheumatology 2009.
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UENO Shiro, MIYAUCHI Shunichi, UMEKITA Kunihiko, KUSUMOTO Norio, TAKAJO Ichiro, KUROKI Masayuki, KAI Yasufumi, NAGATOMO Yasuhiro, OKAYAMA Akihiko
82 ( 6 ) 644 - 649 2008.11
Language：English Publishing type：Research paper (scientific journal)