研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

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Comparison of Oral and Esophageal Microbiota in Patients with Achalasia Before and After Peroral Endoscopic Myotomy. 国際誌

Kazuya Takahashi, Hiroki Sato, Takeshi Mizusawa, Kentaro Tominaga, Satoshi Ikarashi, Kazunao Hayashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Shuji Terai

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology 32 ( 1 ) 42 - 52 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: Patients with achalasia have a high incidence of esophageal squamous cell carcinoma (ESCC), which may be associated with alterations in oral and esophageal microbiota caused by food stasis. This study compared the oral and esophageal microbiota of patients with achalasia before and after peroral endoscopic myotomy (POEM). It also compared patients with achalasia to those with ESCC. MATERIALS AND METHODS: The study prospectively examined 6 patients with achalasia and 14 with superficial ESCC. Oral samples obtained from the buccal mucosa using a swab and esophageal samples obtained from the mid-esophagus using a brush via endoscopy were analyzed by 16S rRNA metagenome sequencing. Additionally, endoscopic and histological findings of patients with achalasia before and after POEM were prospectively compared. RESULTS: In patients with achalasia, Streptococcus was most abundant in both the oral and the esophageal microbiota, and these microbiota were significantly different. Although the overall structure of the oral and esophageal microbiota did not change after POEM, the relative abundance rate of Haemophilus and Neisseria increased in the esophagus, and endoscopic findings of inflammation improved after POEM (P = .04). The relative abundance of microbiota was not different among patients with achalasia from those with ESCC. CONCLUSIONS: The oral and esophageal microbiota were significantly different in patients with achalasia, and some of the composition of the esophageal microbiota changed after POEM. However, these findings and disease-specific microbiota should be further evaluated in large-scale studies.

DOI： 10.5152/tjg.2020.19995

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Sofosbuvir plus velpatasvir treatment for hepatitis C virus in patients with decompensated cirrhosis: a Japanese real-world multicenter study.

Yuki Tahata, Hayato Hikita, Satoshi Mochida, Norifumi Kawada, Nobuyuki Enomoto, Akio Ido, Hitoshi Yoshiji, Daiki Miki, Yoichi Hiasa, Yasuhiro Takikawa, Ryotaro Sakamori, Masayuki Kurosaki, Hiroshi Yatsuhashi, Ryosuke Tateishi, Yoshiyuki Ueno, Yoshito Itoh, Taro Yamashita, Tatsuya Kanto, Goki Suda, Yasunari Nakamoto, Naoya Kato, Yasuhiro Asahina, Kentaro Matsuura, Shuji Terai, Kazuhiko Nakao, Masahito Shimizu, Taro Takami, Norio Akuta, Ryoko Yamada, Takahiro Kodama, Tomohide Tatsumi, Tomomi Yamada, Tetsuo Takehara

Journal of gastroenterology 56 ( 1 ) 67 - 77 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Real-world data on the efficacy and safety of sofosbuvir plus velpatasvir (SOF/VEL) treatment for patients with hepatitis C virus (HCV)-related decompensated cirrhosis are limited in Japan. METHODS: A total of 190 patients with compensated (108) or decompensated (82) cirrhosis who initiated direct-acting antiviral (DAA) treatment between February 2019 and August 2019 were enrolled. Sustained virologic response (SVR) was defined as undetectable serum HCV-RNA at 12 weeks after the end of treatment (EOT). RESULTS: The SVR12 rates were 92.6% in patients with compensated cirrhosis and 90.2% in patients with decompensated cirrhosis (p = 0.564), and the treatment completion rates were 98.1% and 96.3%, respectively (p = 0.372). In patients with decompensated cirrhosis, 3 patients discontinued treatment and 2 patients died because of liver-related events. In patients with decompensated cirrhosis with SVR12, 50% of patients with Child-Pugh class B at baseline showed improvement to class A at SVR12, and 27% and 9% of patients with Child-Pugh class C at baseline showed improvement to class B and class A at SVR12, respectively. Patients who achieved SVR12 showed elevated serum albumin levels at the EOT, which were further elevated at SVR12, but no elevated serum albumin levels after the EOT were observed in patients with baseline serum albumin levels less than 2.8 g/dl. CONCLUSIONS: Real-world efficacy of SOF/VEL treatment for patients with decompensated cirrhosis was similar to Japanese phase 3 study, although treatment discontinuation and death related to liver disease occurred. In patients with poor hepatic reserve, whether it improves continuously after viral clearance requires further evaluation.

DOI： 10.1007/s00535-020-01733-4

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The development of mesenchymal stem cell therapy in the present, and the perspective of cell-free therapy in the future. 国際誌

Yusuke Watanabe, Atsunori Tsuchiya, Shuji Terai

Clinical and molecular hepatology 27 ( 1 ) 70 - 80 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Cirrhosis is a chronic condition that can lead to liver failure. Currently, the viable option for decreasing mortality is liver transplantation. However, transplant surgery is highly invasive. Therefore, cell-based therapy has been developed as an alternative. Based on promising findings from preclinical research, some new trials have been registered. One of them was autologous bone marrow cell infusion therapy and found that ameliorating liver fibrosis activated liver regeneration. Now, majority of trials focus on low-immunogenicity mesenchymal stem cells (MSCs) appropriate for allogeneic administration. However, despite about 20 years of research, only a limited number of cell-based therapies have entered routine practice. Furthermore, potential shortcomings of cell-based therapy include a limit on the number of cells, which may be administered, as well as their failure to infiltrate target organs. On the other hand, these research show that MSCs act as "conducting cells" and regulate host cells including macrophages via extracellular vesicles (EVs) or exosome signals, leading to ameliorate liver fibrosis and promote regeneration. Therefore, the concept of cell-free therapy, which makes use of cell-derived EVs or exosomes, is attracting attention. Cell-free therapies may be safely administered in large doses and are able to infiltrate target organs. However, development of cell-free therapy exhibits its own set of challenges and such therapy may not be completely curative in the context of liver disease. This review describes the history of cell-based therapy research and recent advances in cell-free therapy, as well as discussing the need for more effective therapies.

DOI： 10.3350/cmh.2020.0194

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【新しい肝硬変診療〜ガイドライン2020を紐解く〜】肝硬変診療の課題と今後の展望

寺井崇二, 坂牧僚

日本消化器病学会雑誌 118 ( 1 ) 41 - 45 2021年1月

Visceral Adipose Tissue Index and Hepatocellular Carcinoma Are Independent Predictors of Outcome in Patients with Cirrhosis Having Endoscopic Treatment for Esophageal Varices. 査読国際誌

Naruhiro Kimura, Atsunori Tsuchiya, Chiyumi Oda, Atsushi Kimura, Kazunori Hosaka, Kentaro Tominaga, Kazunao Hayashi, Junji Yokoyama, Shuji Terai

Digestive diseases (Basel, Switzerland) 39 ( 1 ) 58 - 65 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The relationship between the amount of adipose tissue and advanced-stage liver cirrhosis with esophageal varices (EV) is unknown. We aimed to reveal the prognostic significance of adipose tissues in patients with liver cirrhosis. METHODS: We enrolled 87 patients with EV who received initial endoscopic treatment and underwent scheduled treatments in our hospital. Computed tomography (CT) images were obtained of a 5-mm slice at the umbilical level. We evaluated the effect of mortality based on the visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue ratio (VSR). RESULTS: Cox hazard multivariate analysis showed that the presence of hepatocellular carcinoma (HCC; hazard ratio [HR]: 4.650, 95% confidence interval [CI]: 1.750-12.353, p = 0.002), γ-GTP (HR: 1.003, 95% CI: 1.001-1.006, p = 0.026), and VATI (HR: 1.057, 95% CI: 1.030-1.085, p < 0.001) significantly affected mortality. Cox hazard multivariate analysis for liver-related death was also significantly affected by HCC (HR: 1.057, 95% CI: 1.030-1.085, p < 0.001) and VATI (HR: 1.052, 95% CI: 1.019-1.086, p = 0.002). The difference between the Child-Pugh scores 12 months after treatment and that during initial treatment were significantly positively correlated with VATI (r = 0.326, p = 0.027). Patients with high VATI had a significantly higher frequency of HCC after EV treatment by Kaplan-Meier analysis (p = 0.044). CONCLUSION: Our findings suggest that VATI measured by CT could significantly predict mortality in cirrhosis patients through decreasing liver function and increasing HCC frequency, and appropriately controlling VATI could improve their prognosis.

DOI： 10.1159/000508867

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[Problems and future questions in the clinical practice of liver cirrhosis].

Shuji Terai, Akira Sakamaki

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 118 ( 1 ) 41 - 45 2021年

Increase in muscle mass associated with the prebiotic effects of 1-kestose in super-elderly patients with sarcopenia.

Kentaro Tominaga, Atsunori Tsuchiya, Oki Nakano, Yasutoshi Kuroki, Kentaro Oka, Ayaka Minemura, Asami Matsumoto, Motomichi Takahashi, Yoshihiro Kadota, Takumi Tochio, Yusuke Niwa, Tomoaki Yoshida, Masatoshi Sato, Takeshi Yokoo, Satoru Hashimoto, Junji Yokoyama, Jun Matsuzawa, Katsuya Fujimori, Shuji Terai

Bioscience of microbiota, food and health 40 ( 3 ) 150 - 155 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

Sarcopenia causes functional disorders and decreases the quality of life. Thus, it has attracted substantial attention in the aging modern world. Dysbiosis of the intestinal microbiota is associated with sarcopenia; however, it remains unclear whether prebiotics change the microbiota composition and result in the subsequent recovery of muscle atrophy in elderly patients with sarcopenia. This study aimed to assess the effects of prebiotics in super-elderly patients with sarcopenia. We analyzed the effects of 1-kestose on the changes in the intestinal microbiota and body composition using a next-generation sequencer and a multi-frequency bioimpedance analysis device. The Bifidobacterium longum population was significantly increased in the intestine after 1-kestose administration. In addition, in all six patients after 12 weeks of 1-kestose administration, the skeletal muscle mass index was greater, and the body fat percentage was lower. This is the first study to show that administration of a prebiotic increased the population of B. longum in the intestinal microbiota and caused recovery of muscle atrophy in super-elderly patients with sarcopenia.

DOI： 10.12938/bmfh.2020-063

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Novel Strategy for Diagnosis of Focal Nodular Hyperplasia Using Gadolinium Ethoxybenzyl Diethylenetriaminepentaacetic Acid: Enhanced Magnetic Resonance Imaging and Magnetic Resonance Elastography

Nobutaka Takeda, Atsunori Tsuchiya, Kazuki Natsui, Yui Ishii, Yoshihisa Arao, Naruhiro Kimura, Kentaro Tominaga, Suguru Takeuchi, Kazunao Hayashi, Masaaki Takamura, Shuji Terai

CASE REPORTS IN GASTROENTEROLOGY 15 ( 2 ) 507 - 512 2021年

Clinical characteristics of immunoglobulin IgG4-related sclerosing cholangitis: Comparison of cases with and without autoimmune pancreatitis in a large cohort

Naitoh, I., Kamisawa, T., Tanaka, A., Nakazawa, T., Kubota, K., Takikawa, H., Unno, M., Masamune, A., Kawa, S., Nakamura, S., Okazaki, K., Furumatsu, K., Sawai, S., Goto, T., Okumura, T., Suzuki, D., Otsuka, M., Kobori, I., Tamano, M., Koizumi, M., Hiasa, Y., Kawabe, N., Hirooka, Y., Yamamoto, S., Asano, Y., Inui, K., Horiguchi, A., Watanabe, H., Toya, D., Hatayama, K., Ueki, T., Kinoshita, N., Sugimoto, M., Ohira, H., Mukai, T., Tomita, E., Iwata, K., Shimizu, S., Suetsugu, J., Shimizu, M., Tsuji, K., Ishida, R., Ito, M., Furukawa, R., Sakamoto, N., Araki, M., Tanno, S., Sakamoto, Y., Ito, T., Takai, S., Ikeya, S., Yamada, T., Kudara, N., Shimizu, A., Hanada, K., Ichiki, Y., Kitada, H., Hifumi, M., Kimura, H., Kurosaki, M., Izumi, N., Sumi, H., Haruta, J.-I., Hayashi, K., Harada, R., Inoue, M., Nakamura, S., Ito, T., Tomishima, K., Isayama, H., Oura, K., Masaki, T., Shimokawahara, N., Tanoue, S., Maemura, K., Ido, A., Mizushima, I., Kawano, M., Yoshida, K., Naganuma, M., Murata, M., Nishio, A., Fujita, Y., Teratani, T., Matsubara, S., Tamai, H., Yoshida, Y., Azemoto, R., Kamata, K., Watanabe, T., Kurosu, T., Koizumi, W., Fujita, J., Seki, H., Ueda, Y., Fukumoto, T., Kousaki, T., Uchida, K., Ochiai, T., Kawasaki, T., Tanaka, M., Ishida, E., Notohara, K., Mori, H., Mori, T., Kawabata, H., Miyata, M., Sakagami, J., Itoh, Y., Shiokawa, M., Seno, H., Watanabe, N., Kataoka, H., Aoki, T., Fujishiro, M., Niihara, T., Nishimata, H., Mitoro, A., Yoshiji, H., Yoshida, M., Ikeda, M., Tomita, K., Hokari, R., Hayasaka, K., Amano, Y., Shioji, K., Hayashi, K., Terai, S., Nakajima, M., Yamahana, J., Matsumoto, R., Kikuchi, H., Kanamori, A., Kiriyama, S., Iwatsu, S., Kato, Y., Horiguchi, S., Yagi, T., Okada, H., Ohkawa, K., Hirao, M., Hiramatsu, N., Oza, N., Imamura, H., Baba, T., Nakano, S., Shinobi, T., Ryozawa, S., Motoya, M., Nakase, H., Kinoshita, N., Ito, K., Miyake, T., Kohge, N., Tobita, H., Joshita, S., Umemura, T., Kawaguchi, S., Ohno, K., Sonobe, K., Satoh, A., Shimosegawa, T., Miura, F., Yagi, M., Sano, K., Kin, T., Katanuma, A., Koike, K., Miura, S., Kawashima, Y., Kagawa, T., Azuma, S., Watanabe, M., Honjyo, M., Itoi, T., Honda, A., Kobayashi, K., Asano, T., Mizuno, S., Nishino, T., Taniguchi, H., Tajiri, K., Yasuda, I., Tanaka, Y., Oe, S., Harada, M., Kurata, M., Fukasawa, M., Enomoto, N., Kawaji, Y., Kitano, M., Nishise, Y., Hirakawa, H., Ishizawa, T., Ueno, Y., Kaino, M., Fujimoto, Y., Sakaida, I.

Digestive and Liver Disease 53 ( 10 ) 2021年

Liver cirrhosis with ruptured splenic artery aneurysm leading to hepatitis c treatment: A case report

Hojo, Y., Kamimura, H., Owaki, T., Kimura, R., Iwasawa, T., Watanabe, Y., Takatsuna, M., Ikarashi, S., Takamura, M., Setsu, T., Arao, Y., Horii, Y., Sato, T., Terai, S.

Kanzo/Acta Hepatologica Japonica 62 ( 11 ) 2021年

Predicting Cervical Lymph Node Metastasis Following Endoscopic Surgery in Superficial Head and Neck Carcinoma. 国際誌

Ryuichi Okabe, Yushi Ueki, Riuko Ohashi, Manabu Takeuchi, Satoru Hashimoto, Takeshi Takahashi, Ryusuke Shodo, Keisuke Yamazaki, Hiroshi Matsuyama, Hajime Umezu, Shuji Terai, Yoichi Ajioka, Arata Horii

Frontiers in surgery 8 813260 - 813260 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Early detection of head and neck carcinoma (HNC) as superficial HNC (SHNC) identified using recently developed optical techniques, such as magnifying endoscopy and narrow-band imaging (NBI), in combination with endoscopic surgeries enables minimally invasive treatment with favorable outcomes for HNC. This study aimed to identify the predictive factors for the rare but important clinical issue of SHNC, namely cervical lymph node metastasis (CLNM), following endoscopic resection. METHODS: Sixty-nine patients with SHNC who underwent endoscopic resection were enrolled in the study. Clinical data, preoperative endoscopic findings, pathological findings, and treatment outcomes were retrospectively reviewed. Because the pharyngeal mucosa lacks the muscularis mucosa, we measured tumor thickness in permanent pathology as an alternative to the depth of invasion. Correlations with the occurrence of CLNM were statistically examined. RESULTS: The 5-year disease-specific survival rate was 100%. Of 69 patients, 3 (4.3%) developed CLNM. All had subepithelial but not epithelial tumors. The 0-IIa type in the macroscopic findings, type B2/B3 vessels in narrow-band imaging, tumors ≥ pathological stage T2, lymphatic invasion, positive surgical margins, and tumor thickness >1,000 μm showed significant correlations with CLNM following endoscopic resection. Furthermore, the classification of type B vessels was significantly associated with tumor thickness. CONCLUSION: The treatment outcomes following endoscopic resection for SHNC were favorable. The risk of CLNM following endoscopic resection in SHNC can be predicted by several preoperative endoscopic and postoperative pathological findings. Among them, the classification of type B vessels, which correlated with both tumor thickness and CLNM, might be a useful predictive factor.

DOI： 10.3389/fsurg.2021.813260

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Outcomes of endoscopic ultrasound-guided biliary drainage in a general hospital for patients with endoscopic retrograde cholangiopancreatography-difficult transpapillary biliary drainage

Kuraoka, N., Hashimoto, S., Matsui, S., Terai, S.

Journal of Clinical Medicine 10 ( 18 ) 2021年

Unresectable primary hepatic adenosquamous carcinoma successfully treated with systemic and transcatheter hepatic arterial injection chemotherapies followed by conversion surgery: a case report and literature review

Watanabe, Y., Osaki, A., Kimura, K., Yakubo, S., Takaku, K., Sato, M., Hashidate, H., Waguri, N., Terai, S.

BMC Gastroenterology 21 ( 1 ) 2021年

Choledochocele observed on direct peroral cholangioscopy using an ultra-slim endoscope.

Satoshi Ikarashi, Kazunao Hayashi, Shuji Terai

Journal of hepato-biliary-pancreatic sciences 2020年12月

Monitoring chronological change by liver-to-spleen attenuation ratio for secondary hepatic steatosis for a short term. 査読

Hiroteru Kamimura, Kunihiko Yokoyama, Shunsuke Nojiri, Yuko Komoro, Toshiko Murayama, Yu Koyama, Kenya Kamimura, Masaaki Takamura, Junji Yokoyama, Shuji Terai

Clinical journal of gastroenterology 13 ( 6 ) 1219 - 1224 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Parenteral nutrition-associated liver disease (PNALD) causes hepatic steatosis and moderate liver enzyme elevation due to lack of enteral nutrition and deficiency of some nutrients. However, the period for recovery from PNALD after a nutritional intervention is unknown with no report. Herein, we report a case of a 44-year-old Japanese woman with severe fatty infiltration of the liver due to malnutrition. Our nutritional support team administered appropriate total parenteral, especially fat and carnitine, nutrition to improve her malnutrition. Chronological changes in liver-to-spleen attenuation ratio were also considered because of her disease state. Computed tomography demonstrated improved attenuation of the liver, and the liver enzymes level normalized after 5 weeks from appropriate nutrition. Understanding the nutritional condition of a patient may help in elucidating an appropriate treatment strategy.

DOI： 10.1007/s12328-020-01165-w

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Rare case of gastric perforation due to ischemic gastropathy. 国際誌

Yui Ishii, Hiroki Sato, Shuji Terai

Gastrointestinal endoscopy 92 ( 6 ) 1266 - 1268 2020年12月

Daily Monitoring of Serum Wisteria floribunda Agglutinin-Positive Mac-2 Binding Protein Is Useful for Predicting Therapeutic Effect of Tolvaptan in Cirrhotic Ascites.

Masaaki Takamura, Akira Sakamaki, Yoshihisa Arao, Toru Setsu, Hiroteru Kamimura, Takeshi Yokoo, Kenya Kamimura, Atsunori Tsuchiya, Shuji Terai

The Tohoku journal of experimental medicine 252 ( 4 ) 287 - 296 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Wisteria floribunda agglutinin (WFA) is a lectin that binds to the sugar chain of Mac-2 binding protein (M2BP), and WFA-positive M2BP (WFA+-M2BP) has been reported as a useful marker for assessing liver fibrosis in chronic liver disease. Tolvaptan (TLV), a selective vasopressin V2 receptor antagonist, is used for cirrhotic ascites in Japan, but good predictors of treatment efficacy remain to be established. Our aim was to investigate whether WFA+-M2BP monitoring before and after TLV administration can predict treatment efficacy in patients with cirrhotic ascites. Twenty patients (10 men), with a median age of 72 years, were enrolled. Cirrhosis was caused by hepatitis B virus (n = 3), hepatitis C virus (n = 4), alcohol (n = 8), and others (n = 5). Responders were defined as having a body weight loss of ≥ 1.5 kg/week after TLV administration. Serum WFA+-M2BP levels were measured at baseline and days 1, 3, and 7 after TLV treatment. Twelve patients (60%) were responders. Baseline WFA+-M2BP levels were correlated with serum albumin levels (r = -0.544, P = 0.013). The baseline furosemide dose was lower and platelet count was higher in responders than in non-responders (P < 0.05). The ratio of WFA+-M2BP levels on day 1 after TLV administration to baseline was lower in responders than in non-responders (P < 0.05). The decrease in the ratio discriminated responders from non-responders (AUC = 0.844, P < 0.05). In conclusion, monitoring serum WFA+-M2BP is helpful for predicting the efficacy of TLV treatment in patients with cirrhotic ascites.

DOI： 10.1620/tjem.252.287

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キーワード(No.39) Leaky GUT

夏井一輝, 土屋淳紀, 寺井崇二

消化器病学サイエンス 4 ( 4 ) 227 - 227 2020年12月

アルコール性肝硬変におけるALD/NAFLD Index低値例の臨床的特徴

坂牧僚, 横山邦彦, 森田真一, 上村顕也, 高村昌昭, 寺井崇二

アルコールと医学生物学 39 96 - 97 2020年12月

急性肝炎後再生不良性貧血の1例

阿部聡司, 名古屋拓郎, 土屋淳紀, 川合弘一, 山際訓, 寺井崇二

肝臓 61 ( 12 ) 753 - 753 2020年12月

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