2022/03/27 更新

写真a

タナカ アキヒト
田中 章仁
TANAKA Akihito
所属
医学部附属病院 卒後臨床研修・キャリア形成支援センター 病院助教
職名
病院助教

学位 1

  1. 博士(医学) ( 2014年3月   名古屋大学 ) 

 

論文 19

  1. Abnormal magnesium levels and their impact on death and acute kidney injury in critically ill children

    Morooka Hikaru, Tanaka Akihito, Kasugai Daisuke, Ozaki Masayuki, Numaguchi Atsushi, Maruyama Shoichi

    PEDIATRIC NEPHROLOGY     2021年10月

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    記述言語:日本語   出版者・発行元:Pediatric Nephrology  

    Background: The prevalence of magnesium imbalance in critically ill children is very high. However, its significance in the development of acute kidney injury (AKI) and mortality remains unknown. Methods: In this retrospective observational study from 2010 to 2018, the pediatric-specific intensive care database was analyzed. We included critically ill children aged > 3 months and those without chronic kidney disease. Patients were diagnosed with AKI, according to the Kidney Disease Improving Global Outcomes (KDIGO) study. We calculated the initial corrected magnesium levels (cMg) within 24 h and used a spline regression model to evaluate the cut-off values for cMg. We analyzed 28-day mortality and its association with AKI. The interaction between AKI and magnesium imbalance was evaluated. Results: The study included 3,669 children, of whom 105 died within 28 days, while 1,823 were diagnosed with AKI. The cut-off values for cMg were 0.72 and 0.94 mmol/L. Both hypermagnesemia and hypomagnesemia were associated with 28-day mortality (odds ratio [OR] = 2.99, 95% confidence interval [CI] = 1.89–4.71, p < 0.001; OR = 2.80, 95% CI = 1.60–4.89, p < 0.001). Hypermagnesemia was associated with AKI (OR = 1.52, 95% CI = 1.27–1.82, p < 0.001), while neither hypermagnesemia nor hypomagnesemia interacted with the AKI stage on the 28-day mortality. Conclusions: Abnormal magnesium levels were associated with 28-day mortality in critically ill children. AKI and hypermagnesemia had a strong association. Graphical abstract: “A higher resolution version of the Graphical abstract is available as Supplementary information”. [Figure not available: see fulltext.]

    DOI: 10.1007/s00467-021-05331-1

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  2. Clustering phosphate and iron-related markers and prognosis in dialysis patients 査読有り

    Hikaru Morooka, Akihito Tanaka, Daijo Inaguma, Shoichi Maruyama

    Clin Kidney J   15 巻 ( 2 ) 頁: 328 - 337   2021年10月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1093/ckj/sfab207.

  3. Development of entrustable professional activities for residents rotating nephrology department in a Japanese university hospital: a Delphi study

    Tanaka A, et al.

    BMJ Open   11 巻 ( 8 ) 頁: e047923   2021年8月

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    担当区分:筆頭著者, 責任著者  

  4. Utility of glomerular Gd-IgA1 staining for indistinguishable cases of IgA nephropathy or Alport syndrome.

    Ishiko S, Tanaka A, Takeda A, Hara M, Hamano N, Koizumi M, Ueno T, Hayashi H, Kondo A, Nagai S, Aoto Y, Sakakibara N, Nagano C, Horinouchi T, Yamamura T, Ninchoji T, Shima Y, Nakanishi K, Yoshikawa N, Iijima K, Nozu K

    Clinical and experimental nephrology   25 巻 ( 7 ) 頁: 779 - 787   2021年7月

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    記述言語:英語   出版者・発行元:Clinical and Experimental Nephrology  

    Background: Pathological findings in Alport syndrome frequently show mesangial proliferation and sometimes incidental IgA deposition, in addition to unique glomerular basement membrane (GBM) changes including thin basement membrane and/or lamellation. However, similar GBM abnormalities are also often observed in IgA nephropathy. Both diseases are also known to show hematuria, proteinuria, and sometimes macrohematuria when associated with viral infection. Therefore, it can be difficult to make a differential diagnosis, even based on clinical and pathological findings. Some recent articles demonstrated that galactose-deficient IgA1 (Gd-IgA1)-specific monoclonal antibody (KM55) could potentially enable incidental IgA deposition to be distinguished from IgA nephropathy. Methods: We performed comprehensive gene screening and glomerular Gd-IgA1 and type IV collagen α5 chain immunostaining for five cases with both IgA deposition and GBM changes to confirm that Gd-IgA1 can help to distinguish these two diseases. Results: Four of the cases were genetically diagnosed with Alport syndrome (Cases 1–4) and one was IgA nephropathy with massive GBM changes, which had a negative gene test result (Case 5). In Cases 1–4, glomerular Gd-IgA1 deposition was not detected, although there was positivity for IgA in the mesangial area. In Case 5, glomerular Gd-IgA1 deposition was observed. Conclusion: Gd-IgA1 expression analysis could clearly differentiate these two disorders. This approach can be applied to identify these two diseases showing identical clinical and pathological findings.

    DOI: 10.1007/s10157-021-02054-3

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  5. Relationship between mortality and use of sodium bicarbonate at the time of dialysis initiation: a prospective observational study

    Morooka Hikaru, Yamamoto Junichiro, Tanaka Akihito, Inaguma Daijo, Maruyama Shoichi

    BMC NEPHROLOGY   22 巻 ( 1 ) 頁: 118   2021年4月

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    記述言語:日本語   出版者・発行元:BMC Nephrology  

    Background: Patients with chronic kidney disease often experience metabolic acidosis. Whether oral sodium bicarbonate can reduce mortality in patients with metabolic acidosis has been debated for years. Hence, this study was conducted to evaluate the utility of sodium bicarbonate in patients who will undergo dialysis therapy. In this study, we investigated the effect of oral sodium bicarbonate therapy on mortality in patients with end-stage kidney disease (ESKD) initiated on dialysis therapy. Methods: We conducted an observational study of patients when they started dialysis therapy. There were 17 centres participating in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis. Data were available on patients’ sex, age, use of sodium bicarbonate, drug history, medical history, vital data, and laboratory data. We investigated whether patients on oral sodium bicarbonate for more than three months before dialysis initiation had a better prognosis than those without sodium bicarbonate therapy. The primary outcome was defined as all-cause mortality. Results: The study included 1524 patients with chronic kidney disease who initiated dialysis between October 2011 and September 2013. Among them, 1030 were men and 492 women, with a mean age of 67.5 ± 13.1 years. Of these, 677 used sodium bicarbonate and 845 did not; 13.6% of the patients in the former group and 21.2% of those in the latter group died by March 2015 (p < 0.001). Even after adjusting for various factors, the use of sodium bicarbonate independently reduced mortality (p < 0.001). Conclusions: The use of oral sodium bicarbonate at the time of dialysis initiation significantly reduced all-cause mortality in patients undergoing dialysis therapy.

    DOI: 10.1186/s12882-021-02330-0

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  6. Peripheral artery disease at the time of dialysis initiation and mortality: a prospective observational multicenter study

    Morooka Hikaru, Tanaka Akihito, Inaguma Daijo, Maruyama Shoichi

    BMJ OPEN   10 巻 ( 12 )   2020年12月

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    出版者・発行元:BMJ Open  

    DOI: 10.1136/bmjopen-2020-042315

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  7. Prognostic Impact of Parameters of Metabolic Acidosis in Critically Ill Children with Acute Kidney Injury: A Retrospective Observational Analysis Using the PIC Database

    Morooka Hikaru, Kasugai Daisuke, Tanaka Akihito, Ozaki Masayuki, Numaguchi Atsushi, Maruyama Shoichi

    DIAGNOSTICS   10 巻 ( 11 )   2020年11月

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    記述言語:日本語   出版者・発行元:Diagnostics  

    Acute kidney injury (AKI) is a major complication of sepsis that induces acid-base imbalances. While creatinine levels are the only indicator for assessing the prognosis of AKI, prognostic importance of metabolic acidosis is unknown. We conducted a retrospective observational study by analyzing a large China-based pediatric critical care database from 2010 to 2018. Participants were critically ill children with AKI admitted to intensive care units (ICUs). The study included 1505 children admitted to ICUs with AKI, including 827 males and 678 females. The median age at ICU admission was 22 months (interquartile range 7–65). After a median follow-up of 10.87 days, 4.3% (65 patients) died. After adjusting for confounding factors, hyperlactatemia, low pH, and low bicarbonate levels were independently associated with 28-day mortality (respective odds ratio: 3.06, 2.77, 2.09; p values: <0.01, <0.01, <0.01). The infection had no interaction with the three parameters. The AKI stage negatively interacted with bicarbonate and pH but not lactate. The current study shows that among children with AKI, hyperlactatemia, low pH, and hypobicarbonatemia are associated with 28-day mortality.

    DOI: 10.3390/diagnostics10110937

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  8. クロスマッチ陽性生体腎移植の臨床的検討

    藤田 高史, 加藤 真史, 栃木 宏介, 石田 昇平, 舟橋 康人, 松川 宜久, 田中 章仁, 齋藤 尚二, 安田 宣成, 丸山 彰一

    移植   55 巻 ( 0 ) 頁: 397_1 - 397_1   2020年

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    記述言語:日本語   出版者・発行元:一般社団法人 日本移植学会  

    <p>DSAは抗体関連型拒絶反応のリスク因子であり、①CDC陽性②FCXM陽性③FCXM陰性でDSA陽性の順にDSAの力価が高いと考えられている。クロスマッチ陽性腎移植における脱感作療法後のAMR発生率は12-60%と報告されているが、DSAの力価によりAMRの発生率は異なる。今回われわれは2011年から2019年までに当院で施行された生体腎移植の77例を対象として、FCXM陽性(グループ①、26例)、FCXM陰性でDSA陽性(グループ②、3例)、FCXM陰性(グループ③、48例)に分けて拒絶反応の発生率、CMV抗原血症、生着率について検討した。輸血、妊娠、移植の感作歴はグループ①、②、③でそれぞれ53.8%、33.3%、20.8%、DSAはグループ①に3例、グループ②に3例確認された。脱感作療法としてリツキシマブはグループ①、②、③でそれぞれ65.4%、100%、35.4%に投与されていた。AMRの発生率はグループ①、②、③でそれぞれ15.4%、33.3%、2.1%であった。CMV抗原血症に対してVGCの投与を要した症例はグループ①、②、③でそれぞれ15.3%、33.3%、29.2%であった。3年生着率はグループ①、②、③でそれぞれ100%、100%、92.4%であった。FCXM陽性例およびDSA陽性例はFCXM陰性例に比較するとAMRの発生率は高いが、短期生着率に差は認めなかった。</p>

    DOI: 10.11386/jst.55.Supplement_397_1

  9. Effect of Low-Density Lipoprotein Apheresis for Nephrotic Idiopathic Membranous Nephropathy as Initial Induction Therapy

    Therapeutic Apheresis and Dialysis   23 巻 ( 6 ) 頁: 575 - 583   2019年12月

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    出版者・発行元:Therapeutic Apheresis and Dialysis  

    DOI: 10.1111/1744-9987.12811

    Scopus

  10. Incidence rate of atrial fibrillation after dialysis initiation and its relationship with cardiovascular events

    Tanaka A, et al.

    Acta Cardiologica   74 巻 ( 6 ) 頁: 527 - 535   2019年11月

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    出版者・発行元:Acta Cardiologica  

    DOI: 10.1080/00015385.2018.1530085

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  11. Prediction model for cardiovascular events or all-cause mortality in incident dialysis patients

    Inaguma Daijo, Morii Daichi, Kabata Daijiro, Yoshida Hiroyuki, Tanaka Akihito, Koshi-Ito Eri, Takahashi Kazuo, Hayashi Hiroki, Koide Shigehisa, Tsuboi Naotake, Hasegawa Midori, Shintani Ayumi, Yuzawa Yukio

    PLOS ONE   14 巻 ( 8 )   2019年8月

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    出版者・発行元:PLoS ONE  

    DOI: 10.1371/journal.pone.0221352

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  12. Efficacy of Long‐Term Treatment With Tolvaptan to Prolong the Time Until Dialysis Initiation in Patients With Chronic Kidney Disease and Heart Failure

    Tanaka A, Hiramatsu E, Watanabe Y, Ito C, Shinjo H, Otsuka Y, Takeda A.

    Therapeutic Apheresis and Dialysis     2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  13. Successful treatment of peritoneal dialysis-related peritonitis caused by Dermacoccus nishinomiyaensis

    Tanaka A, Watanabe Y, Ito C, et al.

    CEN Case Reports     2019年8月

  14. Successful treatment of peritoneal dialysis-related peritonitis caused by Dermacoccus nishinomiyaensis.

    Tanaka A, Watanabe Y, Ito C, Murata M, Shinjo H, Otsuka Y, Takeda A

    CEN case reports   8 巻 ( 3 ) 頁: 183 - 187   2019年8月

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    記述言語:英語  

    DOI: 10.1007/s13730-019-00388-2

    PubMed

  15. Relationship Between Mortality and Cancer-Bearing Status in Patients With Chronic Kidney Disease Who Attended an Educational Program.

    Tanaka A, Inaguma D, Watanabe Y, Murata M, Shinjo H, Koike K, Otsuka Y, Takeda A

    Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy   22 巻 ( 1 ) 頁: 49 - 57   2018年2月

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    記述言語:英語   出版者・発行元:Therapeutic Apheresis and Dialysis  

    Patients with malignancy have a poorer prognosis than others do, which must be taken into consideration when treating them for chronic kidney disease (CKD). However, there are few studies investigating their prognosis. This was an observational study of 515 (394 men and 121 women) stable non-dialysis patients with CKD who attended a CKD educational program. Mean age was 68.8 ± 13.0 years. Median follow-up was 968.5 days. Mean creatinine was 3.4 ± 1.6 mg/dL. Of these, 63 had malignancy and 452 did not; 20.6% of the former and 11.9% of the latter group died by the end of the study period (P = 0.0548). Malignancy was not associated with all-cause mortality (HR: 1.3475, 95% CI: 0.7202–2.5214, P = 0.3507) but with malignancy-associated mortality (HR: 3.9477, 95% CI: 1.6348–9.5331, P = 0.0023). Renal replacement therapy was not associated with mortality. Since malignancy greatly affects the prognosis, it must be taken into consideration when treating these patients.

    DOI: 10.1111/1744-9987.12598

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  16. Relationship Between Mortality and Cancer-Bearing Status at Time of Dialysis Initiation.

    Tanaka A, Inaguma D, Shinjo H, Murata M, Takeda A

    Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy   21 巻 ( 4 ) 頁: 345 - 353   2017年8月

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    記述言語:英語   出版者・発行元:Therapeutic Apheresis and Dialysis  

    Patients with malignancy are reported to have poorer prognosis than those without malignancy. When patients with malignancy develop end-stage kidney disease, clinicians must determine treatment with consideration of prognosis. Furthermore, malignancy is sometimes found at time of dialysis initiation. However, prognosis of patients with malignancy at time of dialysis initiation has not been investigated. A total of 1524 patients with chronic kidney disease who initiated dialysis at 17 centers participating in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis were included. Patients initiated dialysis between October 2011 and September 2013. Mortality rates were compared between patients with and without malignancy. Types of malignancy and respective prognoses also were assessed. The study included 1030 men and 492 women with a mean age of 67.5 ± 13.1 years. Of these, 92 had malignancy and 1430 did not; 45.7% of the former group and 16.0% of the latter group died by March 2015 (P < 0.01). Even after adjusting for various factors, presence of malignancy remained an independent risk factor for mortality (P < 0.01). Patients with performance status (PS) of 0 had significantly lower mortality (P < 0.01). Patients with malignancy at time of dialysis initiation had poor prognosis. Therefore, presence of malignancy should be taken into consideration when patients initiate dialysis. In patients with malignancy, better PS was associated with better prognosis.

    DOI: 10.1111/1744-9987.12525

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  17. Relationship between mortality and Geriatric Nutritional Risk Index (GNRI) at the time of dialysis initiation: A prospective multicenter cohort study

    Tanaka A., Inaguma D., Shinjo H., Murata M., Takeda A.

    Renal Replacement Therapy   3 巻 ( 1 )   2017年7月

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    記述言語:日本語   出版者・発行元:Renal Replacement Therapy  

    Background: The Geriatric Nutritional Risk Index (GNRI) is a nutritional screening method primarily developed for elderly people; it is also reported to be useful for predicting mortality in patients on maintenance dialysis. However, it is unclear whether it is useful at the time of dialysis initiation, which is accompanied by large weight fluctuations and unstable nutritional status. Methods: The study included 1524 patients with chronic kidney disease who commenced dialysis therapy at 17 centers. Patients commenced dialysis between October 2011 and September 2013 and were followed up until March 2015. Results: We analyzed 1489 patients whose GNRI could be calculated and whose prognosis was clear. The mean GNRI was 87.60 (median 87.86). We divided patients based on the median value into a high (H) and low (L) group. The H group included 728 patients (mean GNRI 95.2 ± 4.9, mean age 65.8 ± 13.2 years, 69.3% men), and the L group included 761 patients (mean GNRI 80.3 ± 6.1, mean age 69.1 ± 12.8 years, 66.0% men). Mortality was significantly higher in the L group (L, 22.2% vs. H, 12.6%, P < 0.001). The rates of infection-associated death in the L group was significantly higher (L, 5.5% vs. H, 1.9%, P < 0.001), although no significant difference was observed regarding cardiovascular disease-associated death (L, 7.6% vs. H, 5.2%, P = 0.059) and malignancy-associated death (L, 3.0% vs. H, 3.0%, P = 1.000). Multivariate analysis showed an association between GNRI and all-cause mortality (HR 0.9852, 95%CI 0.9707-0.9999, P = 0.049) and infection-associated death (HR 0.9484, 95%CI 0.9191-0.9786, P < 0.001). Conclusions: GNRI is useful for predicting mortality even at the time of dialysis initiation. Among the causes of death, GNRI was strongly associated with infection-associated death.

    DOI: 10.1186/s41100-017-0108-9

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  18. Relationship between mortality and speed of eGFR decline in the 3 months prior to dialysis initiation.

    Inaguma D, Murata M, Tanaka A, Shinjo H

    Clinical and experimental nephrology   21 巻 ( 1 ) 頁: 159 - 168   2017年2月

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    記述言語:英語  

    DOI: 10.1007/s10157-016-1262-z

    PubMed

  19. Two Patients with Familial Hypercholesterolemia Who Were Successfully Weaned from Low-density Lipoprotein Apheresis after Treatment with Evolocumab.

    Tanaka A, Inaguma D, Watanabe Y, Ito E, Kamegai N, Shimogushi H, Shinjo H, Koike K, Otsuka Y, Takeda A

    Internal medicine (Tokyo, Japan)   56 巻 ( 12 ) 頁: 1531 - 1535   2017年

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    記述言語:英語  

    DOI: 10.2169/internalmedicine.56.7958

    PubMed

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書籍等出版物 2

  1. 【基礎と臨床応用】疾患治療 脂肪由来幹細胞を用いた腎炎の治療

    田中章仁ら( 担当: 分担執筆)

  2. 【腎臓再生のup to date】脂肪由来間葉系幹細胞を用いた腎疾患治療法の開発

    古橋和拡、田中章仁ら( 担当: 分担執筆)

講演・口頭発表等 12

  1. Efficacy of plasmapheresis for patients with stiff person syndrome. Summary of case-study reports

    Hikaru Morooka, et al

  2. Relationship between Mortality and Peripheral Artery Disease at Time of Dialysis Initiation

    Hikaru Morooka, et al

  3. 統合失調症と慢性腎炎の経過を示し、遺伝子検査で常染色体優性Alport症候群と診断された姉妹例

    李ふみこら

    医学生・研修医の日本内科学会ことはじめ 2020 東京 

  4. 肺癌の治療のためアテゾリズマブを使用した後に、腎生検にて間質性腎炎・膜性腎症・半月体形成を認めた1例

    竹田悠馬ら

    第50回日本腎臓学会東部学術大会 

  5. Nail-Patella症候群が疑われ、腎生検にてIgA腎症の合併が確認された一例

    青木里菜ら

    第50回日本腎臓学会東部学術大会 

  6. 生体腎移植ドナーにおける腎提供後の腎機能予測の試み

    丹羽操ら

    第63回日本腎臓学会学術総会 

  7. Entrustable professional activity(EPA)を用いた、腎臓内科を研修する初期臨床研修医の到達目標と評価基準の作成

    田中章仁ら

    第63回日本腎臓学会学術総会 

  8. 当院へ生体腎移植目的で紹介された症例の手術中止、延期に関連する因子の検討

    田中章仁ら

    第65回日本透析医学会学術集会・総会 

  9. 手術前に低ナトリウム血症を補正して生体腎移植に臨んだ1例

    田中章仁ら

    第66回日本透析医学会学術集会・総会 

  10. 膜性腎症の経過中に抗糸球体基底膜型腎炎を発症し、速やかな単純血漿交換療法により、腎機能を保持することができた 1 例

    田中章仁ら

    第42回日本アフェレシス学会学術大会 

  11. 当院の生体腎移植術前検査における、麻疹、風疹、ムンプス、水痘帯状疱疹ウィルス抗体価の検討

    田中章仁ら

    第64回日本腎臓学会学術総会 

  12. ABO不適合生体腎移植後にisolated v lesionを認め、1年後にTCMRと診断された1例

    田中章仁ら

    第51回日本腎臓学会西部学術大会 

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共同研究・競争的資金等の研究課題 1

  1. 膜性腎症によるネフローゼ症候群に対するリツキシマブを用いた治験プロトコル作成

    研究課題番号:21lk0201132h 

    日本医療研究開発機構  臨床研究・治験推進研究事業 

科研費 3

  1. 間葉系幹細胞の微小環境での炎症制御機構に着眼した次世代型免疫・炎症制御法の創成

    研究課題/研究課題番号:21H04824  2021年4月 - 2024年3月

    丸山 彰一, 古橋 和拡, 杉浦 悠毅, 平山 明由, 榎本 篤, 田中 章仁, 石本 卓嗣, 秋山 真一

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    担当区分:研究分担者 

    既存の免疫抑制薬は過剰免疫抑制による感染症などの副作用が問題となっている。間葉系幹細胞(MSC)は、障害部位の炎症強度に応じた自律的かつ局所での炎症制御が可能なことから、次世代の免疫制御療法として期待されている。しかし、その作用機序は十分解明されておらず、その実用化に際しては課題が多い。新概念として『障害部位に到達したMSC由来細胞外小胞が炎症細胞から放出される炎症性物質と微小空間で会合した時にのみ免疫抑制物質が生成されて局所での抗炎症作用が出現する』という着想に至った。本研究では、この新概念を検証して、効果的で安全な次世代型免疫・炎症制御療法の開発に取り組む。

  2. ヒトiPS細胞由来間葉系幹細胞を用いた新規腎疾患治療法の開発

    研究課題/研究課題番号:21K08253  2021年4月 - 2024年3月

    田中 章仁, 石本 卓嗣, 丸山 彰一, 古橋 和拡

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    担当区分:研究代表者 

    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

    間葉系幹細胞(MSC)は様々な疾患に対する治療効果が示されている。しかし、MSCは品質のばらつきがあるため、治療効果の担保が大きな問題となっている。本課題では、iPS細胞からMSCを分化誘導し、腎炎に対する治療効果が安定して高いことを確認し、MSCの欠点を克服する。さらに治療効果を高める操作を加え、これまでのMSCよりも、腎炎に対して各段に高い治療効果を得る。最終的には、既存の治療法を凌駕する、難治性腎疾患に対する全く新しい細胞治療を確立する。

  3. iPS細胞由来免疫制御細胞を用いた、難治性腎疾患に対する新規治療法の開発

    研究課題/研究課題番号:19K23962  2019年8月 - 2021年3月

    科学研究費助成事業  研究活動スタート支援

    田中 章仁

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    担当区分:研究代表者 

    配分額:2860000円 ( 直接経費:2200000円 、 間接経費:660000円 )

    腎疾患に対して免疫調整性細胞が腎保護効果を示すことは報告されている。しかしながら臨床応用に用いる際には、それらの細胞が不均一であること、細胞的老化などが問題となっている。この問題点を解決するため、研究代表者は人工多能性幹細胞(iPSC)に注目した。iPSCを用いることで、治療に使用する免疫調整性細胞は性質が比較的均一となり、同細胞を安定的に供給することが可能となる。
    そこでまずはiPSCから、様々な免疫調整性細胞を効率よく分化誘導する方法を確立する。そして腎疾患モデル動物に投与し、いずれの細胞が高い腎保護効果を有するのか明らかにすることにより、難治性腎疾患の新規治療法の開発へつなげていく。
    我々は、ヒト人工多能性幹細胞(iPS細胞)から間葉系幹細胞(MSC)などの免疫制御細胞を誘導し、腎疾患モデル動物に対する治療効果を検討すべく研究を進めてきた。結果、ヒトiPS細胞からMSC誘導は比較的安定して施行できた。また腎疾患モデル動物(マウス・ラット)の確立と、誘導したMSCの投与プロトコル、治療効果評価プロトコルの確立も行った。複数の細胞株での比較、検証が必要ではあるが、難治性腎疾患に対して、ヒトiPS細胞から誘導したMSCを用いた新規治療法確立の可能性が示された。
    今回我々は、腎疾患領域における、ヒト人工多能性幹細胞(iPS細胞)を用いた新規治療法開発の可能性について検討してきた。当教室ではこれまで間葉系幹細胞(MSC)を用いた新規治療法の開発に注力してきた。しかし、MSCは採取できる量に限界があったり、均一的な性質や効果を示すとは限らず、また継代を重ねることで“細胞的老化”を示すとされてきた。今回の我々の研究では、iPS細胞からMSCを誘導することで、これまでのMSC治療の問題点を克服することにつながると考えられた。さらにiPS細胞は治療効果を高める工夫も追加しやすく、難治性腎疾患の新規治療法開発につながることが期待される。

 

担当経験のある科目 (本学) 3

  1. 医学入門(シャドーイング)

    2020

  2. 臨床実習2

    2020

  3. 臨床実習1

    2020