研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

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健診での生活歴から考察したNAFLD症例に対する新しい生活指導法の提案

横尾健, 中野応央樹, 佐藤公俊, 冨永顕太郎, 橋本哲, 高村昌昭, 寺井崇二

肝臓 61 ( Suppl.1 ) A454 - A454 2020年4月

肝発癌進展研究の最前線肝発癌,治療抵抗性にかかわるHHM遺伝子のDNA損傷応答メカニズムの解析

上村顕也, 丹羽佑輔, 寺井崇二

肝臓 61 ( Suppl.1 ) A44 - A44 2020年4月

臓器間ネットワークと肝疾患自律神経経路を介する肝-脳-消化管軸の非アルコール性脂肪肝炎の病態への関与

上村顕也, 大脇崇史, 寺井崇二

肝臓 61 ( Suppl.1 ) A182 - A182 2020年4月

An unusual case of esophageal motility disorder. 査読国際誌

Youhei Koseki, Hiroki Sato, Shuji Terai

Gastroenterology 159 ( 3 ) 838 - 841 2020年3月

Secondary Achalasia in Myotonic Dystrophy May Have a Different Pathology and Management. 査読

Hiroki Sato, Ken-Ichi Mizuno, Satoru Hashimoto, Masafumi Takatsuna, Shuji Terai

Internal medicine (Tokyo, Japan) 59 ( 6 ) 875 - 875 2020年3月

Variations of small bowel transit time on capsule endoscopy 査読国際誌

Tominaga K, Sato H, Yokomichi H, Tsuchiya A, Yoshida T, Kawata Y, Yokoyama J, Terai S

Annals of Translational Medicine in Press ( 6 ) 348 - 348 2020年3月

Rare gastric outlet obstruction owing to ectopic pancreas: a case report and literature review. 国際誌

Kunihiko Yokoyama, Hiroki Sato, Yuichi Sato, Jun Watanabe, Atsuo Nakamura, Shuji Terai

Annals of translational medicine 8 ( 5 ) 252 - 252 2020年3月

記述言語：英語

The ectopic pancreas is often observed in the gastrointestinal tract, and is typically asymptomatic. A 28-year-old woman was referred to our hospital following repeated vomiting after every meal. Following gastroscopy, contrast-enhanced computed tomography (CE-CT), and endoscopic ultrasonography (EUS), she was diagnosed with gastric outlet obstruction, also known as pyloric obstruction, caused by a giant submucosal cystic tumor. The condition was successfully treated with EUS-guided cystic drainage, and she was diagnosed with a cystic tumor originating from the ectopic pancreas. The tumor shrank following EUS-guided cystic drainage, and her obstructive symptoms resolved. In cases with overgrowth of the ectopic pancreas, the differential diagnosis of malignancy is important but challenging. Herein, we report a unique final pathology of this rare case and discuss the findings with a literature review.

DOI： 10.21037/atm.2020.01.64

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Percutaneous Gastrojejunostomy Catheter Placement Using a Slow-Leak Balloon through the Reconstructed Gastric Tube after Esophagectomy. 国際誌

Shinichi Morita, Yasuaki Arai, Shunsuke Sugawara, Miyuki Sone, Koji Tomita, Hiroaki Ishii, Shuji Terai

Journal of vascular and interventional radiology : JVIR 31 ( 3 ) 478 - 481 2020年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

Twelve patients who had undergone esophageal reconstruction because of cancer and in whom conventional percutaneous radiologic or endoscopic gastrostomy was considered difficult are reported. These patients underwent placement of a percutaneous gastrojejunostomy catheter through the reconstructed gastric tube using a slow-leak balloon that had been developed for percutaneous transesophageal gastrotubing. Retrospective evaluation showed successful outcomes without severe complications in all patients. Eight (66.6%) were able to resume oral intake, which allowed gastrojejunostomy catheter withdrawal in 3 (25%). This technique is feasible with acceptable clinical outcomes for patients who have undergone gastric tube reconstruction after esophagectomy.

DOI： 10.1016/j.jvir.2019.09.009

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肝悪性腫瘍との鑑別に苦慮した原発性肝放線菌症の1例

本田博樹, 野澤優次郎, 高村昌昭, 上村博輝, 土屋淳紀, 寺井崇二

肝臓 61 ( 3 ) 109 - 115 2020年3月

記述言語：日本語出版者・発行元：(一社)日本肝臓学会

症例は71歳男性。近医で胆道系酵素の上昇を指摘され、2011年6月に新潟大学医歯学総合病院消化器内科を紹介受診した。腹部CTでは、肝右葉に10cm大の嚢胞成分と充実成分からなる腫瘤が指摘され、末梢の肝内胆管拡張を伴っていた。また肝門部から大動脈周囲に多発するリンパ節腫大がみられた。肝膿瘍を併発した肝内胆管癌を考えたが、外科的切除の適応外であり、化学療法導入前の組織学的診断のため、2011年8月経皮経肝的肝生検を施行したが腫瘍細胞は認められなかった。その後肝膿瘍に対する抗生剤治療および経皮経肝的ドレナージ術を行ったが、膿瘍腔の十分な縮小には至らなかった。後日、肝病理組織から放線菌を確認し、肝放線菌症と診断して抗生剤をペニシリンに変更したところ、病変の著明な縮小を認めた。肝悪性腫瘍と鑑別を要した肝放線菌症の一例を経験したので報告する。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00263&link_issn=&doc_id=20200310120008&doc_link_id=10.2957%2Fkanzo.61.109&url=https%3A%2F%2Fdoi.org%2F10.2957%2Fkanzo.61.109&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

【間葉系幹細胞の基礎と臨床応用】疾患治療他家脂肪組織由来間葉系幹細胞投与療法の開発

寺井崇二, 土屋淳紀

医学のあゆみ 272 ( 10 ) 1032 - 1039 2020年3月

記述言語：日本語出版者・発行元：医歯薬出版(株)

肝は再生能力の高い臓器として知られているが、肝障害が遷延し進行した肝硬変に進展すると、その再生能力は落ち、現在、根本的な治療は肝移植のみである。しかし、肝移植はドナーの不足という深刻な状態に直面している。現在、肝硬変の線維化改善、再生促進をめざした新規治療の開発が世界中で展開されているが、細胞治療もそのひとつである。本稿では、著者らが現在まで開発してきた間葉系幹細胞(MSC)の臨床展開(自己骨髄細胞投与療法の開発、自己・他家間葉系幹細胞投与療法)の開発までの道のり、また明らかにしてきた幹細胞の"指揮細胞"としての機能を概説する。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00060&link_issn=&doc_id=20200309030011&doc_link_id=%2Faa7ayuma%2F2020%2F027210%2F012%2F1032-1039%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faa7ayuma%2F2020%2F027210%2F012%2F1032-1039%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Effect of Diphtheria Toxin-Based Gene Therapy for Hepatocellular Carcinoma. 査読国際誌

Kenya Kamimura, Takeshi Yokoo, Hiroyuki Abe, Norihiro Sakai, Takuro Nagoya, Yuji Kobayashi, Masato Ohtsuka, Hiromi Miura, Akira Sakamaki, Hiroteru Kamimura, Norio Miyamura, Hiroshi Nishina, Shuji Terai

Cancers 12 ( 2 ) 2020年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Hepatocellular carcinoma (HCC) is a major global malignancy, responsible for >90% of primary liver cancers. Currently available therapeutic options have poor performances due to the highly heterogeneous nature of the tumor cells; recurrence is highly probable, and some patients develop resistances to the therapies. Accordingly, the development of a novel therapy is essential. We assessed gene therapy for HCC using a diphtheria toxin fragment A (DTA) gene-expressing plasmid, utilizing a non-viral hydrodynamics-based procedure. The antitumor effect of DTA expression in HCC cell lines (and alpha-fetoprotein (AFP) promoter selectivity) is assessed in vitro by examining HCC cell growth. Moreover, the effect and safety of the AFP promoter-selective DTA expression was examined in vivo using an HCC mice model established by the hydrodynamic gene delivery of the yes-associated protein (YAP)-expressing plasmid. The protein synthesis in DTA transfected cells is inhibited by the disappearance of tdTomato and GFP expression co-transfected upon the delivery of the DTA plasmid; the HCC cell growth is inhibited by the expression of DTA in HCC cells in an AFP promoter-selective manner. A significant inhibition of HCC occurrence and the suppression of the tumor marker of AFP and des-gamma-carboxy prothrombin can be seen in mice groups treated with hydrodynamic gene delivery of DTA, both 0 and 2 months after the YAP gene delivery. These results suggest that DTA gene therapy is effective for HCC.

DOI： 10.3390/cancers12020472

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On-line HDFを急性肝不全の患者に施行する際の診療ガイド

井上和明, 織田成人, 安部隆三, 滝川康裕, 中山伸朗, 加藤直也, 藤原慶一, 安井伸, 寺井崇二, 井戸章雄, 坂井田功, 玄田拓哉, 清水雅仁, 持田智, 滝川一

肝臓 61 ( 2 ) 47 - 60 2020年2月

Septicemic listeriosis during adalimumab- and golimumab-based treatment for ulcerative colitis: case presentation and literature review. 査読

Ryoko Horigome, Hiroki Sato, Terasu Honma, Shuji Terai

Clinical journal of gastroenterology 13 ( 1 ) 22 - 25 2020年2月

記述言語：英語

Listeria monocytogenes is a common bacterium that can trigger an episode of amphixenosis from the consumption of contaminated food. It survives in the host as an intracellular parasite and can get reactivated when the host's immune system is compromised. The use of anti-tumor necrosis factor-α (TNF-α) blockers is reported to increase the risk of L. monocytogenes infections. In the field of gastroenterology, the use of TNF-α blockers is on the rise due to remarkable efficacy in select patients with inflammatory bowel diseases (IBDs) such as ulcerative colitis and Crohn's disease and the rise in the incidence and prevalence of IBDs. There are few case reports on this topic, despite the rapid development of novel TNF-α blockers. Here, we report two cases of septicemic listeriosis encountered during treatment with the more recent TNF-α blockers, namely, adalimumab and golimumab, in ulcerative colitis and review the published literature on the topic.

DOI： 10.1007/s12328-019-01005-6

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Rare paradoxical adverse event in Crohn's disease: a case report. 査読国際誌

Marina Okoshi, Hiroki Sato, Terasu Honma, Shuji Terai

Annals of translational medicine 8 ( 4 ) 133 - 133 2020年2月

記述言語：英語

An 18-year-old male adolescent diagnosed with ileocolitis-type Crohn's disease received therapy involving an anti-tumor necrosis factor-α (TNF-α) blocker, which resulted in remission for 2 years. The patient presented with fever, stomatitis, and cough with respiratory distress. Chest radiography revealed bilateral hilar lymphadenopathy; bronchoalveolar lavage showed high lymphocyte level: 40.8% and CD4/8 value: 3.9. Transbronchial lung biopsy identified multiple non-caseating granulomas fused to each other with connective tissue septa, leading to the diagnosis of sarcoidosis. The sarcoidosis was defined as a paradoxical adverse event (PAE) due to the use of TNF-α blocker; therefore, cessation of TNF-α blocker administration was sufficient to induce remission. We report a rare case of PAE on Crohn's disease. The characteristics and distinguishing histologies of PAE and Crohn's disease are described. Biological agent therapy has been reported to cause several PAEs during the treatment of immune-mediated inflammatory disorders. PAEs are defined as pathological conditions that occur during biological agent therapy usually effective in treatment. The laboratory, radiography, and histological findings shown in this case are useful for differential diagnosis and management of PAE.

DOI： 10.21037/atm.2019.12.122

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肝癌に対する局所療法としての放射線療法の安全性と有効性の検証

大越麻理奈, 上村顕也, 柴田修, 森田慎一, 坂牧僚, 田中裕登, 小関洋平, 寺井崇二

日本内科学会雑誌 109 ( Suppl. ) 155 - 155 2020年2月

Ghrelin-insulin-like growth factor-1 axis is activated via autonomic neural circuits in the non-alcoholic fatty liver disease. 査読国際誌

Takuro Nagoya, Kenya Kamimura, Ryosuke Inoue, Masayoshi Ko, Takashi Owaki, Yusuke Niwa, Norihiro Sakai, Toru Setsu, Akira Sakamaki, Takeshi Yokoo, Hiroteru Kamimura, Yuka Nakamura, Masaki Ueno, Shuji Terai

Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society 32 ( 5 ) e13799 2020年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The correlation of the growth hormone (GH) and insulin-like growth factor-1 (IGF-1) with non-alcoholic fatty liver disease (NAFLD) has been reported in epidemiological studies. However, the mechanisms of molecular and inter-organ systems that render these factors to influence on NAFLD have not been elucidated. In this study, we examined the induction of ghrelin which is the GH-releasing hormone and IGF-1, and involvement of autonomic neural circuits, in the pathogenesis of NAFLD. METHODS: The expression of gastric and hypothalamic ghrelin, neural activation in the brain, and serum IGF-1 were examined in NAFLD models of choline-deficient defined l-amino-acid diet-fed, melanocortin 4 receptor knockout mice, and partial hepatectomy mice with or without the blockades of autonomic nerves to test the contribution of neural circuits connecting the brain, liver, and stomach. KEY RESULTS: The fatty changes in the liver increased the expression of gastric ghrelin through the autonomic pathways which sends the neural signals to the arcuate nucleus in the hypothalamus through the afferent vagal nerve which reached the pituitary gland to release GH and then stimulate the IGF-1 release from the liver. In addition, high levels of ghrelin expression in the arcuate nucleus were correlated with NAFLD progression regardless of the circuits. CONCLUSIONS: Our study demonstrated that the fatty liver stimulates the autonomic nervous signal circuits which suppress the progression of the disease by activating the gastric ghrelin expression, the neural signal transduction in the brain, and the release of IGF-1 from the liver.

DOI： 10.1111/nmo.13799

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Prostaglandin E2 and its receptor EP2 trigger signaling that contributes to YAP-mediated cell competition. 査読国際誌

Erika Ishihara, Yuya Nagaoka, Toshiaki Okuno, Satoshi Kofuji, Mari Ishigami-Yuasa, Hiroyuki Kagechika, Kenya Kamimura, Shuji Terai, Takehiko Yokomizo, Yukihiko Sugimoto, Yasuyuki Fujita, Akira Suzuki, Hiroshi Nishina

Genes to cells : devoted to molecular & cellular mechanisms 25 ( 3 ) 197 - 214 2020年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Cell competition is a biological process by which unfit cells are eliminated from "cell society." We previously showed that cultured mammalian epithelial Madin-Darby canine kidney (MDCK) cells expressing constitutively active YAP were eliminated by apical extrusion when surrounded by "normal" MDCK cells. However, the molecular mechanism underlying the elimination of active YAP-expressing cells was unknown. Here, we used high-throughput chemical compound screening to identify cyclooxygenase-2 (COX-2) as a key molecule triggering cell competition. Our work shows that COX-2-mediated PGE2 secretion engages its receptor EP2 on abnormal and nearby normal cells. This engagement of EP2 triggers downstream signaling via an adenylyl cyclase-cyclic AMP-PKA pathway that, in the presence of active YAP, induces E-cadherin internalization leading to apical extrusion. Thus, COX-2-induced PGE2 appears a warning signal to both abnormal and surrounding normal cells to drive cell competition.

DOI： 10.1111/gtc.12750

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Usefulness of autotaxin for the complications of liver cirrhosis. 国際誌

Xue Shao, Haruki Uojima, Toru Setsu, Tomomi Okubo, Masanori Atsukawa, Yoshihiro Furuichi, Yoshitaka Arase, Hisashi Hidaka, Yoshiaki Tanaka, Takahide Nakazawa, Makoto Kako, Tatehiro Kagawa, Katsuhiko Iwakiri, Shuji Terai, Wasaburo Koizumi

World journal of gastroenterology 26 ( 1 ) 97 - 108 2020年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Autotaxin (ATX) has been reported as a direct biomarker for estimating the evaluation of liver fibrosis. But available data on ATX as a useful biomarker for the complications of liver cirrhosis (LC) are scant. AIM: To assess the clinical usefulness of ATX for assessing the complications of LC. METHODS: This multicenter, retrospective study was conducted at six locations in Japan. We include patients with LC, n = 400. The ATX level was evaluated separately in men and women because of its high level in female patients. To assess the clinical usefulness of ATX for the complications of LC, the area under the curve (AUC) of ATX assessing for the severe complications was analyzed in comparison with the model for end-stage liver disease score, albumin-bilirubin (ALBI) score, fibrosis-4 index, and aspartate aminotransferase-to-platelet ratio index. RESULTS: The mean age was 68.4 ± 11.4 years, 240 patients (60.0%) were male. A total of 213 (53.3%) and 187 (46.8%) patients were compensated and decompensated, respectively. The numbers of patients with varix rupture, hepatic ascites, and hepatic encephalopathy were 35 (8.8%), 131 (32.8%), and 103 (25.8%), respectively. The AUCs of ATX in men for hepatic encephalopathy, hepatic ascites, and varix ruptures were 0.853, 0.816, and 0.706, respectively. The AUCs of ATX in women for hepatic encephalopathy, hepatic ascites, and varix rupture were 0.759, 0.717, and 0.697, respectively. The AUCs of ATX in men were higher than those in women, as were all the other biomarkers used to detect encephalopathy and varix ruptures. However, for detecting ascites, the AUC of ALBI in men was more effective than using ATX. CONCLUSION: ATX in men was more effective than any other biomarkers for detecting hepatic encephalopathy and varix ruptures.

DOI： 10.3748/wjg.v26.i1.97

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Achalasia in a Patient with Myotonic Dystrophy. 査読

Hiroki Sato, Ken-Ichi Mizuno, Satoru Hashimoto, Masafumi Takatsuna, Shuji Terai

Internal medicine (Tokyo, Japan) 59 ( 1 ) 67 - 68 2020年1月

記述言語：英語

Myotonic dystrophy is a progressive disorder mainly affecting the voluntary muscles. We herein report a rare case of myotonic dystrophy complicated with high-resolution manometry-defined achalasia, the pathology of which is absent relaxation of the smooth muscles of lower esophageal sphincter (LES). In the present case, achalasia was considered a complication of myotonic dystrophy instead of sporadic achalasia, as on performing high-resolution manometry, the finding of an impaired LES relaxation (myotonic phase) changed to a totally emaciated LES function (muscle weakness phase) as myotonic dystrophy progressed.

DOI： 10.2169/internalmedicine.3360-19

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Rare Brain Metastasis From a Pancreatobiliary Subtype of Intraductal Papillary Mucinous Neoplasm. 査読国際誌

Arao Y, Kamimura K, Ikemi M, Hayashi K, Takaki M, Takahashi S, Seino S, Abe H, Tsuboguchi S, Otsu Y, Sanpei K, Kohisa J, Kondo S, Tani Y, Ito J, Toyoshima Y, Kakita A, Ajioka Y, Terai S

Pancreas 49 ( 1 ) e8 - e11 2020年1月

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