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Antiviral immune response against HTLV-1 invalidates T-SPOT.TB® results in patients with HTLV-1-positive rheumatic diseases 査読あり
Masatoshi Kimura
Frontiers in Immunology 2024年10月
担当区分：筆頭著者 掲載種別：研究論文（学術雑誌）
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Differences in muscle magnetic resonance imaging findings between anti-signal recognition particle antibody-positive myopathy and anti-aminoacyl-tRNA synthetase antibody-positive myositis 査読あり
Masatoshi Kimura
clinical and experimental rheumatology 2024年2月
担当区分：筆頭著者 掲載種別：研究論文（学術雑誌）
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岩尾 千紘, 梅北 邦彦, 木村 賢俊, 工藤 理紗, 川口 剛, 中井 陸運, 宮崎 泰可
Rheumatology advances in practice 10 ( 2 ) rkag046 2026年4月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Oxford University Press
Objective
To investigate whether human T cell leukaemia virus type 1 (HTLV-1) infection increases the risk of respiratory complications in patients with RA, focusing on high-resolution computed tomography (HRCT) findings and clinical features.
Methods
We retrospectively analysed 30 HTLV-1-positive patients with RA enrolled in the HTLV-1 RA Miyazaki Registry who had undergone chest HRCT. For each patient, three age- and sex-matched HTLV-1-negative RA patients (n = 90) were recruited as controls. We compared pulmonary abnormalities on HRCT, RA disease activity, medication use and systemic complications between the groups. In the HTLV-1-positive group, we also assessed the relationship between HTLV-1 proviral load (PVL) and pulmonary findings.
Results
Although age and disease duration were similar between groups at the time of HRCT, HTLV-1-positive patients had significantly higher disease activity (CDAI: 6.4 vs 3.3, P = 0.01; SDAI: 7.28 vs 3.46, P = 0.01), greater glucocorticoid use (70% vs 36%) and lower biologics use (33% vs 61%). Abnormal pulmonary findings were observed in ≈50% of both groups; however, bronchiolitis was more frequent in HTLV-1-positive patients, while interstitial lung disease patterns were comparable. HTLV-1 PVL did not differ significantly based on the presence or absence of pulmonary lesions.
Conclusion
HTLV-1 infection may link to an increased prevalence of airway lesions, such as bronchiolitis and bronchiectasis, in RA patients. These findings suggest that screening for HTLV-1 should be considered in RA patients, especially those with respiratory symptoms or complications. -
川口 剛, 北村 瑛子, 木村 賢俊, 力武 雄幹, 岩尾 千紘, 岩尾 浩昭, 住吉 誠, 仮屋 裕美, 松田 基弘, 梅北 邦彦, 高城 一郎, 盛口 清香, 山下 篤, 宮崎 泰可
Journal of Infection and Chemotherapy 31 ( 1 ) 102534 2025年1月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Elsevier BV
Treating disseminated cryptococcosis in people with human immunodeficiency virus (HIV) is challenging due to the limited availability of effective antifungals. Although isavuconazole has antifungal activity against Cryptococcus neoformans, clinical evidence is sparse because this new drug has not been approved for the treatment of cryptococcosis in the US or Europe. Here, we report a case of HIV-associated cryptococcal meningitis that relapsed during maintenance therapy with fluconazole. A Japanese man in his 20s was diagnosed with HIV-1 infection and cryptococcal meningitis. The patient was intolerant to flucytosine and was treated with liposomal amphotericin B monotherapy for 2 weeks as induction therapy, followed by fluconazole (400 mg/day) for 3 months as consolidation therapy. Four months after starting maintenance therapy with fluconazole (200 mg/day), the patient presented with fever and cough, leading to readmission to our hospital. Biopsies of a nodule in the left lung and a left cervical lymph node led to the diagnosis of disseminated cryptococcosis (pulmonary cryptococcosis and cryptococcal lymphadenitis). Although a combination of fluconazole and liposomal amphotericin B was ineffective, the patient was successfully treated with an induction therapy combining isavuconazole and liposomal amphotericin B, followed by a maintenance therapy with isavuconazole. The patient received isavuconazole orally except for loading doses, achieving stable blood concentration levels. Moreover, we observed that blood levels of amphotericin B increased gradually with repeated administration. Therefore, isavuconazole may have a potential role in the treatment of cryptococcosis, and clinical trials involving larger numbers of cases are needed to confirm its efficacy and safety.
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Human granulocytic anaplasmosis with rash and rhabdomyolysis: A case report 査読あり
川口 剛, 力武 雄幹, 力武 真央, 木村 賢俊, 岩尾 千紘, 岩尾 浩昭, 相澤 彩子, 住吉 誠, 仮屋 裕美, 松田 基弘, 宮内 俊一, 梅北 邦彦, 高城 一郎, 宮崎 泰可
Journal of Infection and Chemotherapy 30 ( 12 ) 1309 - 1314 2024年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Elsevier BV
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.