論文 - 丸山 治彦
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A delayed diagnosis of fascioliasis: The importance of appropriate fecal diagnostic method. 査読あり
Kosaka S, Shimizu S, Nakayamada S, Nawata A, Shimono N, Tanaka M, Maruyama H, Osada Y, Tanaka Y
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 30 ( 5 ) 454 - 458 2023年11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：Journal of Infection and Chemotherapy
Fascioliasis, a zoonotic helminthiasis, occurs sporadically in Japan. In this report, we describe a case of fascioliasis that was initially difficult to diagnose because the fecal examination method was negative for the Fasciola sp. eggs. A 64-year-old man living in Shimonoseki City, Japan, presented with fatigue and anorexia. Laboratory tests showed hepatic dysfunction and eosinophilia. Abdominal dynamic contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography suggested intrahepatic biliary cysts. Thereafter, fever and night sweats persisted, and positron emission tomography and biopsy of the porta hepatis lymph node were performed on suspicion of malignancy. However, histopathological diagnosis found non-specific inflammation. As fascioliasis was suspected due to eosinophilia and the multiple hepatic masses, fecal egg examination was performed by an external private laboratory, which adopted the flotation method and reported the absence of parasite eggs. However, fecal examination was retried in our laboratory using the formalin-ether concentration method, and we detected Fasciola sp. eggs. This case suggests that misdiagnosis may occur depending on the fecal examination method; thus, it is necessary to choose a suitable method for certain parasite species.
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Four cases of gnathostomiasis due to the ingestion of raw Salangichthys microdon. 査読あり
Abe T, Hida T, Kamiya T, Ebata K, Sugita S, Kaneko R, Tanaka M, Maruyama H, Suzuki A, Uhara H
The Journal of dermatology 51 ( 2 ) e59 - e60 2023年10月
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Maekawa K, Nagayasu E, Hata Y, Hanamure F, Maruyama H, Yamashita A
Pathology international 73 ( 8 ) 373 - 376 2023年8月
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Ko PP, Haraguchi M, Hara T, Hieu DD, Ito A, Tanaka R, Tanaka M, Suzumura T, Ueda M, Yoshida A, Maruyama H, Nagayasu E
Parasitology international 92 102663 2023年2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：Parasitology International
Strongyloides is a genus of parasitic nematodes of vertebrates comprising approximately 50 documented species, each with various host ranges. Among these, three species (S. stercoralis, S. fuelleborni, and S. cebus) are known to infect primate hosts. S. fuelleborni typically infects non-human primates in the Old World. To complement the existing information on the global genetic structure of this species, we conducted a genotyping study of S. fuelleborni samples collected from rhesus macaques in Myanmar, Japanese macaques in Japan, and some zoo-kept primates. This study identified a novel haplotype group in isolates from the Myanmar rhesus macaques. Subsequently, we obtained the complete or nearly complete mitochondrial genome sequences of S. fuelleborni, S. cebus (Strongyloides of New World monkeys), and S. vituli (Strongyloides of cattle). Phylogenetic analysis based on concatenated mitochondrial protein sequences of various Strongyloides species indicated a close relationship between S. fuelleborni, S. vituli and S. papillosus (Strongyloides in sheep and cattle). S. cebus is quite distantly related to both S. fuelleborni and S. stercoralis, which led to the hypothesis that the three primate Strongyloides species evolved independently as parasites of primates.
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臨床的に肝蛭症と診断し，トリクラベンダゾール内服後に抗体が陽転した1例 査読あり
谷口 昌史, 阪上 順一, 原 祐, 服部 知恵, 住吉 翔元, 酒井 浩明, 岡 浩平, 岩井 直人, 辻 俊史, 奥田 隆史, 小牧 稔之, 香川 惠造, 丸山 治彦
感染症学雑誌 97 ( 1 ) 32 - 37 2023年1月
担当区分：最終著者 記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本感染症学会
We report the case of a Vietnamese man in his twenties who presented with a few days' history mild fever and severe pain in the right hypochondrium. Laboratory findings showed elevated levels of the hepatobiliary enzymes and marked peripheral blood eosinophilia. Abdominal computed tomography (CT) showed map-like low density areas with unclear boundaries under the liver capsule. Suspecting a parasitic infection, we conducted enzyme linked immunosorbent assay (ELISA) for a panel of parasite antigens, including <i>Fasciola</i> antigen. However, no positive results for any parasites were obtained. Re-examination by contrast-enhanced CT revealed that the hepatic mass had moved and findings suggestive of perihepatic inflammation. Fascioliasis was suspected, and the ELISA for <i>Fasciola</i> antigen was repeated again after a period of time, but the result was again negative. Despite the negative test result, the patient was diagnosed as having fascioliasis, based on the severe pain in the right abdomen, persistent eosinophilia, and mobile liver mass, all of which are characteristic symptoms of fascioliasis. For the treatment with triclabendazole (TCB), he was referred to a hospital in the Research Group on Chemotherapy of Tropical Diseases, Japan, which imports nationally unlicensed medicines, including TCB. After the patient received treatment with TCB (10mg/kg), the symptoms disappeared, and the eosinophil counts decreased. Serological testing at 4 weeks after the TCB administration revealed positive antibody results for crude as well as recombinant <i>Fasciola</i> antigen. Fascioliasis is a relatively rare disease, with only few cases per year reported in Japan. There are no worm eggs in the feces in the acute phase, and serological analysis (such as antibody testing) is the basis for the diagnosis. However, in this case, tests for the <i>fasciola</i> antibody initially remained negative. It should be noted that serological analysis can be negative in the early stage of the disease.
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Sasaki J, Matsuoka M, Kinoshita T, Horii T, Tsuneyoshi S, Murata D, Takaki R, Tominaga M, Tanaka M, Maruyama H, Kawayama T, Hoshino T
Medicina (Kaunas, Lithuania) 59 ( 1 ) 2023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：Medicina (Lithuania)
Paragonimiasis caused by trematodes belonging to the genus Paragonimus is often accompanied by chronic respiratory symptoms such as cough, the accumulation of sputum, hemoptysis, and chest pain. Prolonged symptoms, including respiratory symptoms, after coronavirus disease 2019 infection (COVID-19) are collectively called post-COVID-19 conditions. Paragonimiasis and COVID-19 may cause similar respiratory symptoms. We encountered five cases of paragonimiasis in patients in Japan for whom diagnoses were delayed due to the initial characterization of the respiratory symptoms as a post-COVID-19 condition. The patients had consumed homemade drunken freshwater crabs together. One to three weeks after consuming the crabs, four of the five patients were diagnosed with probable COVID-19. The major symptoms reported included cough, dyspnea, and chest pain. The major imaging findings were pleural effusion, pneumothorax, and nodular lesions of the lung. All the patients were diagnosed with paragonimiasis based on a serum antibody test and peripheral blood eosinophilia (560–15,610 cells/μL) and were treated successfully with 75 mg/kg/day praziquantel for 3 days. Before diagnosing a post-COVID-19 condition, it is necessary to consider whether other diseases, including paragonimiasis, may explain the symptoms. Further, chest radiographic or blood tests should be performed in patients with persistent respiratory symptoms after being infected with COVID-19 to avoid overlooking the possibility of infection.
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Sakakura S, Yamaguchi F, Abe T, Cho H, Shimizu S, Mase A, Shikama Y, Maruyama H
Infection and drug resistance 16 2429 - 2432 2023年
担当区分：最終著者 記述言語：英語 掲載種別：症例報告 出版者・発行元：Infection and Drug Resistance
The Paragonimus westermani infection is a parasitic foodborne infection that induces systemic symptoms with eosinophilia in humans. Here, we described pneumothorax in addition to pulmonary opacities with eosinophilia in a man with a positive P. westermani serology. He was misdiagnosed with chronic eosinophilic pneumonia (CEP) during the initial phase. Paragonimiasis can share similar clinical findings with CEP in cases where the worm is confined to the lungs. The findings of the current study suggest that paragonimiasis and CEP can be distinguished from each other by the presence of various symptoms. Notably, eosinophilia with pneumothorax should be an important diagnostic factor for paragonimiasis.
DOI： 10.2147/IDR.S402392
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症例 感染源が不明であったドロレス顎口虫による皮膚爬行症の1例 査読あり
熊田 大樹, 猪爪 隆史, 栗田 遼二, 野呂瀬 一美, 彦坂 健児, 丸山 治彦, 松江 弘之
皮膚科の臨床 64 ( 10 ) 1727 - 1730 2022年9月
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症例 抗顎口虫抗体陽性で診断,イベルメクチン内服が奏効したCreeping Diseaseの1例
齋藤 麗子, 太田 瑞穂, 冲津 成実, 徳山 道生, 近藤 章生, 栄枝 重典, 橘 裕司, 石井 則久, 丸山 治彦, 馬渕 智生
皮膚科の臨床 64 ( 6 ) 1129 - 1133 2022年5月
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[Current real-world treatments for Japanese patients with eosinophilic esophagitis].
Fujiwara Y, Tanaka F, Nakata R, Kakiya Y, Yamamura M, Tanoue K, Sawada A, Higashimori A, Nishida Y, Maruyama H, Ominami M, Nadatani Y, Fukunaga S, Otani K, Hosomi S, Kamata N, Nagami Y, Taira K
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 119 ( 10 ) 929 - 936 2022年
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大腿に生じたSpirometra decipiensによる孤虫症の1例 査読あり
與語 晶子, 今村 桜子, 永井 貴子, 原田 佳代, 長安 英治, 丸山 治彦, 占部 和敬
西日本皮膚科 83 ( 5 ) 477 - 477 2021年10月
記述言語：日本語 掲載種別：症例報告 出版者・発行元：日本皮膚科学会-西部支部
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Takaki Y, Kadekaru S, Takami Y, Yoshida A, Maruyama H, Une Y, Nagayasu E
Parasitology international 84 102399 2021年10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：Parasitology International
Strongyloides is a genus of parasitic nematodes of vertebrates that contains over 50 species, each with a variable host range. A recent molecular phylogenetic analysis on this genus showed that Strongyloides spp. from various carnivore hosts form a strongly supported clade together with Strongyloides stercoralis, a major pathogen of humans and dogs (named the “stercoralis/procyonis group”). In the present study, we obtained DNA sequencing data of Strongyloides sp. isolated from an imported meerkat (Suricata suricatta). Based on the phylogenetic analysis, we considered this a new member of the stercoralis/procyonis group. This study represents the first isolation and molecular characterization of a Strongyloides species from hosts belonging to the family Herpestidae (mongooses and meerkat). However, whether the meerkat serves as a natural host of this Strongyloides species remains to be investigated.
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Clinico-radiologic Characteristics of Pulmonary Visceral Larva Migrans Caused by Ascaris suum. 査読あり
Matsumoto N, Tsubouchi H, Setoguchi K, Horiguchi T, Shigekusa T, Tsuchida S, Matsuo A, Oda Y, Yanagi S, Maruyama H, Nakazato M
Internal medicine (Tokyo, Japan) 60 ( 18 ) 2899 - 2903 2021年9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：Internal Medicine
Objective Visceral larva migrans (VLM) caused by Ascaris suum is a major health problem in pig farming regions. The clinical characteristics of pulmonary VLM caused by A. suum, however, are unclear. We assessed the clinico-radiologic features of this disease. Methods Medical records, including the results of chest radiography and high-resolution computed tomography (HRCT), were retrospectively reviewed from January 2000 through June 2019, at the University of Miyazaki Hospital and Kyoritsuiin Hospital in Miyazaki Prefecture, Japan. Results Seven patients with VLM caused by A. suum were identified. All seven patients had a unique habit of consuming raw foods, such as organic vegetables, chicken, turkey, wild boar, and venison. All but one patient, who had eosinophilic pneumonia with a fever and severe fatigue, had only mild or no respiratory symptoms. All 7 patients had remarkable eosinophilia (median, 1,960/μL) and high serum IgE levels (median, 1,346 IU/mL). Chest HRCT revealed multiple nodules and multiple nodular ground-glass opacities in 57% and 29% of the patients, respectively. The pulmonary lesions were located predominantly in subpleural areas. All seven patients were treated with albendazole, which led to improvement within two to three months. Neither eggs nor parasites were detected in the feces or sputum of any patient. Conclusion Consumption of raw organic vegetables or raw meat is a possible route of A. suum infection. Infected patients exhibit mild respiratory symptoms, and multiple nodules with a halo in the subpleural area are a common finding on chest HRCT. Treatment with albendazole was effective in these cases.
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Tanaka M, Kildemoes AO, Chadeka EA, Cheruiyot BN, Sassa M, Moriyasu T, Nakamura R, Kikuchi M, Fujii Y, de Dood CJ, Corstjens PLAM, Kaneko S, Maruyama H, Njenga SM, de Vrueh R, Hokke CH, Hamano S
Parasitology international 83 102346 2021年8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：Parasitology International
Schistosomiasis remains a worldwide public health problem, especially in sub-Saharan Africa. The World Health Organization targets the goal for its elimination as a public health problem in the 2030 Neglected Tropical Diseases (NTDs) Roadmap. Concerted action and agile responses to challenges will be necessary to achieve the targets. Better diagnostic tests can accelerate progress towards the elimination by monitoring disease trends and evaluating the effectiveness of interventions; however, current examinations such as Kato–Katz technique are of limited power to detect light-intensity infections. The point-of-care circulating cathodic antigen (POC-CCA) test shows a higher sensitivity compared to the reference standard, Kato-Katz technique, but it still lacks sufficient sensitivity with low infection intensity. In this study, we examined antibody reactions against recombinant protein antigens; Schistosoma mansoni serine protease-inhibitor (SmSerpin) and RP26, by enzyme-linked immunosorbent assay (ELISA) in plasma samples with light-intensity infection. The sensitivity using the cocktail antigen of recombinant SmSerpin and RP26 showed 83.7%. The sensitivity using S. mansoni soluble egg antigen (SmSEA) was 90.8%, but it showed poor specificity (29.7%), while the cocktail antigen presented improved specificity (61.4%). We conclude that antibody detection to the SmSerpin and RP26 protein antigens is effective to detect S. mansoni light-intensity infections. Our study indicates the potential of detecting antibody against recombinant protein antigens to monitor the transmission of schistosomiasis in low endemicity contexts.
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Tsubokawa D, Kikuchi T, Lee JM, Kusakabe T, Yamamoto Y, Maruyama H
PLoS pathogens 17 ( 6 ) e1009649 2021年6月
担当区分：最終著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：PLoS Pathogens
Parasitic helminths can reside in humans owing to their ability to disrupt host protective immunity. Receptor for advanced glycation end products (RAGE), which is highly expressed in host skin, mediates inflammatory responses by regulating the expression of pro-inflammatory cytokines and endothelial adhesion molecules. In this study, we evaluated the effects of venestatin, an EF-hand Ca2+-binding protein secreted by the parasitic helminth Strongyloides venezuelensis, on RAGE activity and immune responses. Our results demonstrated that venestatin bound to RAGE and downregulated the host immune response. Recombinant venestatin predominantly bound to the RAGE C1 domain in a Ca2+-dependent manner. Recombinant venestatin effectively alleviated RAGE-mediated inflammation, including footpad edema in mice, and pneumonia induced by an exogenous RAGE ligand. Infection experiments using S. venezuelensis larvae and venestatin silencing via RNA interference revealed that endogenous venestatin promoted larval migration from the skin to the lungs in a RAGE-dependent manner. Moreover, endogenous venestatin suppressed macrophage and neutrophil accumulation around larvae. Although the invasion of larvae upregulated the abundance of RAGE ligands in host skin tissues, mRNA expression levels of tumor necrosis factor-α, cyclooxygenase-2, endothelial adhesion molecules vascular cell adhesion protein-1, intracellular adhesion molecule-1, and E-selectin were suppressed by endogenous venestatin. Taken together, our results indicate that venestatin suppressed RAGE-mediated immune responses in host skin induced by helminthic infection, thereby promoting larval migration. The anti-inflammatory mechanism of venestatin may be targeted for the development of anthelminthics and immunosuppressive agents for the treatment of RAGE-mediated inflammatory diseases.
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Study Protocol for a Randomized, Double-Blind, Placebo-Controlled, Phase-II Trial: AdrenoMedullin for Ischemic Stroke Study.
Yoshimoto T, Saito S, Omae K, Hattori Y, Fukuma K, Kitamura K, Kakuta R, Kita T, Maruyama H, Yamamoto H, Ihara M
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 30 ( 6 ) 105761 2021年6月
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Nguyen YTH, Nonaka N, Maruyama H, Yoshida A
The Journal of veterinary medical science 83 ( 4 ) 671 - 674 2021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：Journal of Veterinary Medical Science
This study aimed to evaluate the sampling method for the detection of Ascaris suum larval DNA in chicken livers using real-time PCR. Chickens were inoculated with A. suum eggs of a single dose (Group A) or repeatedly low doses (Group B). White spots (WSs) were continuously observed on liver from day 3 after the last infection in Group B and day 14 in Group A. In Group A, larval DNA was detected in WS lesions (78.6%) at a significantly higher rate than in the remaining tissue samples (31.3%). In conclusion, applying WS lesions to the assay improved the detection rate of A. suum DNA in chicken livers, especially in the case of a single infection.
DOI： 10.1292/jvms.20-0404
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Abdominal paragonimiasis after consumption of wild boar meat. 査読あり 国際誌
Nakashima S, Takajo I, Maruyama H, Nagayasu E
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 105 40 - 41 2021年4月
記述言語：英語 掲載種別：症例報告 出版者・発行元：International Journal of Infectious Diseases
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Surgically resected hepatic mass caused by fascioliasis. 査読あり
Wang H, Itoh S, Matsumoto Y, Nishie A, Kurihara T, Shimagaki T, Nagao Y, Toshima T, Harada N, Kohashi K, Oda Y, Ishigami K, Maruyama H, Yoshizumi T, Mori M
Clinical journal of gastroenterology 14 ( 2 ) 662 - 667 2021年4月
記述言語：英語 掲載種別：症例報告 出版者・発行元：Clinical Journal of Gastroenterology
Fascioliasis is a parasitic infestation caused by the digenetic trematodes Fasciola hepatica and F. gigantica. It is not commonly seen in developed countries, so diagnosis there is always difficult as a result of confusion with other hepatic or biliary disorders. A 56-year-old man presented at our hospital with a hepatic mass that had been inadvertently discovered by ultrasonography. Abdominal computed tomography revealed a multi-cystic lesion distributed along the branch of the right bile duct. Endoscopic retrograde cholangiopancreatography showed serrated changes ranging from the upper level of the common bile duct to the right hepatic bile duct. Eosinophilia was not observed and tumor marker levels were within normal ranges. Following right lobectomy combined with bile duct reconstruction, a histological examination revealed cholangitis with inflammatory cell infiltration accompanied by parasite egg-like structures and Charcot–Leyden crystals. An additional serologic test was positive for F. hepatica antibodies. A diagnosis of fascioliasis was thus confirmed by histopathology and serology. Fascioliasis should be suspected if imaging findings such as multiple small hypodense lesions in the liver are observed, and serologic tests can be useful for differential diagnosis.