Updated on 2025/03/13

写真a

 
KANDA Tatsuo
 
Organization
University Medical and Dental Hospital Uonuma Institute of Community Medicine Specially Appointed Professor
Title
Specially Appointed Professor
Contact information
メールアドレス
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Degree

  • 学士(医学) ( 1991.3   新潟大学 )

  • 博士(医学) ( 1999.3   千葉大学 )

Research Interests

  • 消化器内科学

  • Viral hepatitis, acute liver failure, autoimmune liver diseases, liver cancer, cirrhosis

  • Hepatology

  • Development of antivirals and vaccines

  • Hepatitis A and E viruses

Research Areas

  • Life Science / Virology  / ウイルス性肝炎

  • Life Science / Gastroenterology  / Gastroenterology and Hepatology

Research History (researchmap)

  • Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital   Division of of Gastroenterology and Hepatology   Professor

    2024.4

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    Country:Japan

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  • Uonuma Kikan Hospital   Division of Gastroenterology and Hepatology   Professor

    2024.4

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    Country:Japan

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  • Nihon University School of Medicine   Division of Gastroenterology and Hepatology, Department of Medicine   Professor, Clinical

    2019.4 - 2024.3

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    Country:Japan

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  • Chiba University   Visiting Associate Professor

    2018.3 - 2024.2

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    Country:Japan

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  • Nihon University, School of Medicine   Division of Gastroenterology and Hepatology, Department of Internal Medicine   Associate Professor

    2017.8 - 2024.3

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    Country:Japan

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  • Chiba University, Graduate School of Medicine   Department of Gastroenterology   Associate Professor

    2017.7

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    Country:Japan

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  • Nihon University, School of Medicine   Division of Gastroenterology and Hepatology, Department of Internal Medicine   Associate Professor

    2017.6 - 2017.7

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    Country:Japan

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  • Chiba University, Graduate School of Medicine   Department of Gastroenterology   Associate Professor

    2017.4 - 2017.6

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    Country:Japan

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  • Chiba University, Graduate School of Medicine   Department of Gastroenterology and Nephrology   Associate Professor

    2013.2 - 2017.3

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  • Chiba University, Graduate School of Medicine   Department of Gastroenterology and Nephrology   Associate Professor

    2012.7 - 2013.1

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  • Chiba University, Graduate School of Medicine   Department of Medicine and Clinical Oncology   Associate Professor

    2008.12 - 2012.6

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  • Saint Louis University, School of Medicine, St. Louis, MO, USA   Department of Pathology   Faculty

    2005.7 - 2008.6

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    Country:United States

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  • Chiba University   Safety and Health Organization   Assistant Professor

    2004.4 - 2005.6

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  • Chiba University   医学部附属病院   Assistant Professor

    2000.12 - 2005.6

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  • Chiba University   Health Science Center   Assistant Professor

    2000.12 - 2004.3

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Research History

  • Niigata University   UONUMA CHIIKI IRYO KYOIKU CENTER, University Medical and Dental Hospital   Specially Appointed Professor

    2024.4

Education

  • Chiba University Graduate School of Medicine   医学研究科   Department of Clinical Oncology

    1995.4 - 1999.3

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    Country: Japan

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  • Niigata University   School of Medicine   医学科

    1985.4 - 1991.3

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    Country: Japan

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Professional Memberships

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Committee Memberships

  • 一般社団法人 日本肝臓学会   評議員選出委員  

    2022.7 - 2024.7   

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    Committee type:Academic society

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  • 日本消化器病学会   学会評議員  

    2015.1   

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  • 一般社団法人日本肝臓学会   倫理委員会委員  

    2014.6 - 2018.7   

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  • 一般社団法人 日本肝臓学会   評議員(代議員)  

    2014.5   

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  • 日本高齢消化器病学会   評議員  

    2013   

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    Committee type:Academic society

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  • 日本消化器病学会   支部評議員  

    2011.1   

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  • 一般社団法人日本肝臓学会   東支部評議員  

    2009.10   

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Studying abroad experiences

  • Saint Louis University School of Medicine, St. Louis, MO, USA   Faculty

    2005.7 - 2008.6

 

Papers

  • Pruritus in Chronic Cholestatic Liver Diseases, Especially in Primary Biliary Cholangitis: A Narrative Review. Reviewed

    Tatsuo Kanda, Reina Sasaki-Tanaka, Naruhiro Kimura, Hiroyuki Abe, Tomoaki Yoshida, Kazunao Hayashi, Akira Sakamaki, Takeshi Yokoo, Hiroteru Kamimura, Atsunori Tsuchiya, Kenya Kamimura, Shuji Terai

    International Journal of Molecular Sciences.   26 ( 5 )   1883   2025.2

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)  

    DOI: 10.3390/ijms26051883

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  • Acute-on-chronic liver failure (ACLF): the ‘Kyoto Consensus’—steps from Asia Reviewed

    Ashok Choudhury, Anand V. Kulkarni, Vinod Arora, A. S. Soin, Abdul Kadir Dokmeci, Abhijeet Chowdhury, Abraham Koshy, Ajay Duseja, Ajay Kumar, Ajay Kumar Mishra, Ajay Kumar Patwa, Ajit Sood, Akash Roy, Akash Shukla, Albert Chan, Aleksander Krag, Amar Mukund, Ameet Mandot, Amit Goel, Amna Subhan Butt, Amrish Sahney, Ananta Shrestha, Andrés Cárdenas, Angelo Di Giorgio, Anil Arora, Anil Chandra Anand, Anil Dhawan, Ankur Jindal, Anoop Saraya, Anshu Srivastava, Anupam Kumar, Apichat Kaewdech, Apurva Pande, Archana Rastogi, Arun Valsan, Ashish Goel, Ashish Kumar, Ashwani K. Singal, Atsushi Tanaka, Audrey Coilly, Ayaskanta Singh, Babu Lal Meena, Barath Jagadisan, Barjesh Chander Sharma, Bikrant Bihari Lal, C. E. Eapen, Cesar Yaghi, Chandan Kumar Kedarisetty, Chang Wook Kim, Charles Panackel, Chen Yu, Chetan R. Kalal, Chhagan Bihari, Chien Hao Huang, Chitranshu Vasishtha, Christian Jansen, Christian Strassburg, Chun Yen Lin, Constantine J. Karvellas, Cosmas Rinaldi Adithya Lesmana, Cyriac Abby Philips, Debbie Shawcross, Dharmesh Kapoor, Dhiraj Agrawal, Diana Alcantara Payawal, Dibya Lochan Praharaj, Dinesh Jothimani, Do Seon Song, Dong Joon Kim, Dong-Sik Kim, Duan Zhongping, Fazal Karim, Francois Durand, Gamal E. Shiha, Gennaro D’Amico, George K. Lau, Girish Kumar Pati, Graciela Elia Castro Narro, Guan-Huei Lee, Gupse Adali, Guru Prasad Dhakal, Gyongyi Szabo, H. C. Lin, Hai Li, Hari Kumar Nair, Harshad Devarbhavi, Harshvardhan Tevethia, Hasmik Ghazinian, Hemamala Ilango, Hong Ling Yu, Irsan Hasan, J. Fernandez, Jacob George, Jaideep Behari, James Fung, Jasmohan Bajaj, Jaya Benjamin, Jennifer C. Lai, Jidong Jia, Jin Hua Hu, Jin Jun Chen, Jin Lin Hou, Jin Mo Yang, Johannes Chang, Jonel Trebicka, Jörg C. Kalf, Jose D. Sollano, Joy Varghese, Juan Pablo Arab, Jun Li, K. Rajender Reddy, Kaiser Raja, Kalpana Panda, Kamal Kajal, Karan Kumar, Kaushal Madan, Kemal Fariz Kalista, Kessarin Thanapirom, Khin Maung Win, Ki Tae Suk, Krishnadas Devadas, Laurentius A. Lesmana, Lubna Kamani, Madhumita Premkumar, Madunil A. Niriella, Mamun Al Mahtab, Man Fung Yuen, Manal HEl Sayed, Manasa Alla, Manav Wadhawan, Manoj Kumar Sharma, Manoj Sahu, Manya Prasad, Mark Dhinesh Muthiah, Martin Schulz, Meenu Bajpai, Mettu Srinivas Reddy, Michael Praktiknjo, Ming Lung Yu, Mithra Prasad, Mithun Sharma, Mohamed Elbasiony, Mohammed Eslam, Mohd. Golam Azam, Mohd. Rela, Moreshwar S. Desai, Mukul Vij, Nadim Mahmud, Narendra Singh Choudhary, Navin Kumar Marannan, Necati Ormeci, Neeraj Saraf, Nipun Verma, Nobuaki Nakayama, Norifumi Kawada, Oidov Baatarkhuu, Omesh Goyal, Osamu Yokosuka, P. N. Rao, Paolo Angeli, Pathik Parikh, Patrick S. Kamath, Paul J. Thuluvath, Philipp Lingohr, Piyush Ranjan, Prashant Bhangui, Pravin Rathi, Puja Sakhuja, Puneet Puri, Qin Ning, R. K. Dhiman, Rahul Kumar, Rajan Vijayaraghavan, Rajeev Khanna, Rakhi Maiwall, Ravi Mohanka, Richard Moreau, Rino Alvani Gani, Rohit Loomba, Rohit Mehtani, Ruveena Bhavani Rajaram, S. S. Hamid, Sachin Palnitkar, Sadhna Lal, Sagnik Biswas, Sakkarin Chirapongsathorn, Samagra Agarwal, Sanjeev Sachdeva, Sanjiv Saigal, Santhosh E. Kumar, Sargsyan Violeta, Satender Pal Singh, Satoshi Mochida, Saurabh Mukewar, Seema Alam, Seng Gee Lim, Shahinul Alam, Shalimar, Shantan Venishetty, Shikha S. Sundaram, Shiran Shetty, Shobna Bhatia, Shweta A. Singh, Shyam Kottilil, Simone Strasser, S. M. Shasthry, Soe Thiha Maung, Soek Siam Tan, Sombat Treeprasertsuk, Sonal Asthana, Steffen Manekeller, Subhash Gupta, Subrat Kumar Acharya, Sudhamshu K.C., Sudhir Maharshi, Sumeet Asrani, Sunil Dadhich, Sunil Taneja, Suprabhat Giri, Surender Singh, Tao Chen, Tarana Gupta, Tatsuo Kanda, Tawesak Tanwandee, Teerha Piratvishuth, Ulrich Spengler, V. G. Mohan Prasad, Vandana Midha, Venera Rakhmetova, Vicente Arroyo, Vikrant Sood, Vinay Kumar BR, Vincent Wai-Sun Wong, Viniyendra Pamecha, Virendra Singh, Vishwa Mohan Dayal, Vivek A. Saraswat, WRay Kim, Wasim Jafri, Wenyi Gu, Wong Yu Jun, Xiaolong Qi, Yogesh K. Chawla, Yoon Jun Kim, Yu Shi, Zaigham Abbas, Guresh Kumar, Shuichiro Shiina, Lai Wei, Masao Omata, Shiv Kumar Sarin

    Hepatology International   2025.2

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    Abstract

    Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplantation. There have been various definitions proposed worldwide. The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set in 2004 on ACLF was published in 2009, and the “APASL ACLF Research Consortium (AARC)” was formed in 2012. The AARC database has prospectively collected nearly 10,500 cases of ACLF from various countries in the Asia–Pacific region. This database has been instrumental in developing the AARC score and grade of ACLF, the concept of the ‘Golden Therapeutic Window’, the ‘transplant window’, and plasmapheresis as a treatment modality. Also, the data has been key to identifying pediatric ACLF. The European Association for the Study of Liver-Chronic Liver Failure (EASL CLIF) and the North American Association for the Study of the End Stage Liver Disease (NACSELD) from the West added the concepts of organ failure and infection as precipitants for the development of ACLF and CLIF-Sequential Organ Failure Assessment (SOFA) and NACSELD scores for prognostication. The Chinese Group on the Study of Severe Hepatitis B (COSSH) added COSSH-ACLF criteria to manage hepatitis b virus-ACLF with and without cirrhosis. The literature supports these definitions to be equally effective in their respective cohorts in identifying patients with high mortality. To overcome the differences and to develop a global consensus, APASL took the initiative and invited the global stakeholders, including opinion leaders from Asia, EASL and AASLD, and other researchers in the field of ACLF to identify the key issues and develop an evidence-based consensus document. The consensus document was presented in a hybrid format at the APASL annual meeting in Kyoto in March 2024. The ‘Kyoto APASL Consensus’ presented below carries the final recommendations along with the relevant background information and areas requiring future studies.

    DOI: 10.1007/s12072-024-10773-4

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    Other Link: https://link.springer.com/article/10.1007/s12072-024-10773-4/fulltext.html

  • Combination therapies with immune checkpoint inhibitor-based combination therapies for hepatocellular carcinoma with major vascular invasion Invited Reviewed

    Tatsuo Kanda, Reina Sasaki-Tanaka, Shuji Terai

    Hepatology International   2025.2

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s12072-025-10784-9

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    Other Link: https://link.springer.com/article/10.1007/s12072-025-10784-9/fulltext.html

  • Hepatitis B virus infection and its treatment in Eastern Ethiopia Reviewed

    Tatsuo Kanda, Reina Sasaki-Tanaka, Atsunori Tsuchiya, Shuji Terai

    World Journal of Hepatology   17 ( 1 )   99209   2025.1

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    Hepatitis B virus (HBV) infection causes acute and chronic hepatitis, compensated and decompensated cirrhosis, and hepatocellular carcinoma worldwide. The actual status of HBV infection and its treatment in certain regions of Asian and African countries, including Ethiopia, has not been well-documented thus far. Antiviral therapy for HBV infection can prevent the progression of HBV-related liver diseases and decrease the HBV-related symptoms, such as abdominal symptoms, fatigue, systemic symptoms and others. In Eastern Ethiopia, HBV-infected patients with cirrhosis were found to be positive for the HBV e antigen and to have a higher viral load than those without cirrhosis. Notably, 54.4% of patients practiced khat chewing and 18.1% consumed excessive amounts of alcohol. Tenofovir disoproxil fumarate effectively suppressed HBV DNA in those infected with HBV. It is important to elucidate the actual status of HBV infection in Eastern Ethiopia to eliminate HBV infection worldwide by 2030. HBV vaccination and the educational programs for Health Science students that provide practical strategies could help to reduce HBV infection in Eastern Ethiopia.

    DOI: 10.4254/wjh.v17.i1.99209

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  • A型肝炎について Invited

    神田達郎

    新潟県医師会報   ( 895 )   2 - 7   2024.10

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    Authorship:Lead author, Last author, Corresponding author   Language:Japanese  

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  • Inflammation of the liver, HCC development and HCC establishment Invited Reviewed

    Tatsuo Kanda, Reina Sasaki-Tanaka, Shuji Terai

    Hepatology International   2024.6

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s12072-024-10707-0

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    Other Link: https://link.springer.com/article/10.1007/s12072-024-10707-0/fulltext.html

  • A global survey on the use of the international classification of diseases codes for metabolic dysfunction-associated fatty liver disease Reviewed

    Huai Zhang, Giovanni Targher, Christopher D. Byrne, Seung Up Kim, Vincent Wai-Sun Wong, Luca Valenti, Myer Glickman, Jaime Ponce, Christos S. Mantzoros, Javier Crespo, Henning Gronbaek, Wah Yang, Mohammed Eslam, Robert J. Wong, Mariana Verdelho Machado, Ming-Lung Yu, Omar M. Ghanem, Takeshi Okanoue, Jun-Feng Liu, Yong-ho Lee, Xiao-Yuan Xu, Qiuwei Pan, Meili Sui, Amedeo Lonardo, Yusuf Yilmaz, Li-Yong Zhu, Christophe Moreno, Luca Miele, Monica Lupsor-Platon, Lei Zhao, Teresa LeAnn LaMasters, Robert G. Gish, Huijie Zhang, Marius Nedelcu, Wah Kheong Chan, Ming-Feng Xia, Fernando Bril, Jun-Ping Shi, Christian Datz, Stefano Romeo, Jian Sun, Dan Liu, Silvia Sookoian, Yi-Min Mao, Nahum Méndez-Sánchez, Xiao-Yan Wang, Nikolaos T. Pyrsopoulos, Jian-Gao Fan, Yasser Fouad, Dan-Qin Sun, Cosimo Giannini, Jin Chai, Ze-Feng Xia, Dae Won Jun, Guo-Jing Li, Sombat Treeprasertsuk, Ying-Xu Li, Tan To Cheung, Faming Zhang, George Boon-Bee Goh, Masato Furuhashi, Wai-Kay Seto, Hui Huang, Anna Di Sessa, Qing-Hong Li, Evangelos Cholongitas, Le Zhang, Themis Reverbel Silveira, Giada Sebastiani, Leon A. Adams, Wei Chen, Xiaolong Qi, Ivan Rankovic, Victor De Ledinghen, Wen-Jie Lv, Masahide Hamaguchi, Radwan Kassir, Dirk Müller-Wieland, Manuel Romero-Gomez, Ying Xu, Yi-Cong Xu, Shi-Yao Chen, Mohammad Kermansaravi, Mohammad Shafi Kuchay, Sander Lefere, Chetan Parmar, Gregory Y. H. Lip, Chun-Jen Liu, Fredrik Åberg, George Lau, Jacob George, Shiv Kumar Sarin, Jing-Ya Zhou, Ming-Hua Zheng, Huai Zhang, Giovanni Targher, Christopher D. Byrne, Seung Up Kim, Vincent Wai-Sun Wong, Luca Valenti, Myer Glickman, Jaime Ponce, Christos S. Mantzoros, Javier Crespo, Henning Gronbaek, Wah Yang, Mohammed Eslam, Robert J. Wong, Mariana Verdelho Machado, Ming-Lung Yu, Omar M. Ghanem, Takeshi Okanoue, Jun-Feng Liu, Yong-ho Lee, Xiao-Yuan Xu, Qiuwei Pan, Meili Sui, Amedeo Lonardo, Yusuf Yilmaz, Li-Yong Zhu, Christophe Moreno, Luca Miele, Monica Lupsor-Platon, Lei Zhao, Teresa LeAnn LaMasters, Robert G. Gish, Huijie Zhang, Marius Nedelcu, Wah Kheong Chan, Ming-Feng Xia, Fernando Bril, Jun-Ping Shi, Christian Datz, Stefano Romeo, Jian Sun, Dan Liu, Silvia Sookoian, Yi-Min Mao, Nahum Méndez-Sánchez, Xiao-Yan Wang, Nikolaos T. Pyrsopoulos, Jian-Gao Fan, Yasser Fouad, Dan-Qin Sun, Cosimo Giannini, Jin Chai, Ze-Feng Xia, Dae Won Jun, Guo-Jing Li, Sombat Treeprasertsuk, Ying-Xu Li, Tan To Cheung, Faming Zhang, George Boon-Bee Goh, Masato Furuhashi, Wai-Kay Seto, Hui Huang, Anna Di Sessa, Qing-Hong Li, Evangelos Cholongitas, Le Zhang, Themis Reverbel Silveira, Giada Sebastiani, Leon A. Adams, Wei Chen, Xiaolong Qi, Ivan Rankovic, Victor De Ledinghen, Wen-Jie Lv, Masahide Hamaguchi, Radwan Kassir, Dirk Müller-Wieland, Manuel Romero-Gomez, Ying Xu, Yi-Cong Xu, Shi-Yao Chen, Mohammad Kermansaravi, Mohammad Shafi Kuchay, Sander Lefere, Chetan Parmar, Gregory Y. H. Lip, Chun-Jen Liu, Fredrik Åberg, George Lau, Jacob George, Shiv Kumar Sarin, Jing-Ya Zhou, Ming-Hua Zheng, Zaigham Abbas, Sherief Abd-Elsalam, Ludovico Abenavoli, Adel Karim Abou-Mrad, Adam Abu-Abeid, Débora Acín-Gándara, Sandeep Aggarwal, Golo Ahlenstiel, Fardah Akil, Shahinul Alam, Mohamed Alboraie, Nawal Mehdi Firhan Alkhalidi, Maytham Hameed Al-Qanbar, Laith Alrubaiy, Mario Reis Alvares-da-Silva, Antonio Alves, Bassem Amr, Prooksa Ananchuensook, Nikolaos-Andreas Theodoros Anastasopoulos, Vladimir Andreevski, Marco Anselmino, Shadike Apaer, Maria Teresa Arias-Loste, Juan Armendariz-Borunda, Anil Kumar Arora, Ambika P. Ashraf, Rabah Hiab Asreah, Rahmatullah Athar, Dina Attia, Selmy Sabry Awad, Oidov Baatarkhuu, Flora Bacopoulou, Hong-Lian Bai, Fei-Yun Bai, sandra Maria Barbalho, Ilaria Barchetta, Jaideep Behari, Estuardo J. Behrens, Francesco Bellanti, Francesco Bellinato, Muhammad Begawan Bestari, Saptarshi Bhattacharya, Hua Bian, Quentin Binet, Ruth Elisa Blackham, Joost Boeckmans, Ivo Boskoski, Carlos Brotons, Guillermo Cabrera-Alvarez, Cristina Cadenas-Sanchez, Da-Chuan Cai, Giuliano Peixoto Campelo, Zhu-Jun Cao, Hai-Xia Cao, Yu-Rui Cao, Jose-Manuel Carrascosa, Francesca Carubbi, Thomas Carus, Alfredo Caturano, Xiang-Yuan Cha, Anwar A. Chahal, Daniel Leonard Chan, Lawrence Wing Chi Chan, Man Pan Chan, Siew Pheng Chan, Yun-Peng Chang, Yoosoo Chang, Phunchai Charatcharoenwitthaya, Norberto C. Chavez-Tapia, Mark Chang Chuen Cheah, Yu Chen, Hui-Ting Chen, Jing Chen, Li-Li Chen, Tao Chen, Lan-Lan Chen, Jin Chen, Yuan-Wen Chen, Yu Chen, Li Chen, Hai-Tao Chen, En-Qiang Chen, Jing-She Chen, Liang-Miao Chen, Shun-Ping Chen, Yong-Ping Chen, Gang Chen, Yun-Zhi Chen, Qin-Fen Chen, Kang-Jie Chen, Xu Chen, Qiang Chen, Yuan Cheng, Ngai Wah Cheung, Ramsey Cheung, Xiao-Ling Chi, Sonja Chiappetta, Bogdan Augustin Chis, Kee Huat Chuah, Stefano Ciardullo, Nicholas Cocomello, Li Cong, Adryana Cordeiro, Omero Pereira Costa Filho, Harry G. Crane, Ian Homer Yee Cua, Kai Dai, Zhi-Juan Dai, Andrea Dalbeni, Shuang-Suo Dang, Andy Darma, Amir Hossein Davarpanah Jazj, Ruth Maria Lucia De Bruyne, Nadia De Falco, Robert J. de Knegt, Maurizio De Luca, Marianne Anastasia De Roza, Coskun Ozer Demirtas, Hong Deng, Cun-Liang Deng, Fu-Sheng Di, Anna Elizabeth Di Bartolomeo, Hui-Guo Ding, Feng Ding, Yang Ding, Yin-Lu Ding, Ran Ding, Johanna DiStefano, A.Kadir-Dokmeci, Jin-Ling Dong, Zhi-Yong Dong, Shi-Ming Dong, Li Dong, Rui-Qing Dong, Xiao-Guang Dou, Mu-Long Du, Qing-Wei Du, Qin-Jiang Duan, Xu Duan, Xiao-Hua Duan, Robin Pieter Dullaart, Dan Lucian Dumitrascu, Agustin Duro, Amr Ahmed El-Arabey, Maged Tharwat Elghannam, Haitham Mostafa Elmaleh, Mortada Hassan Fakhri El-Shabrawi, Enzo Emanuele, Jose Marcus Raso Eulalio, Gian Paolo Fadini, Eleonora Druve Tavares Fagundes, Yu-Chen Fan, Xing-Liang Fan, Yi-Ling Fan, Ling-Juan Fang, Eduardo Fassio, Alessandro Federico, Matyas Fehervari, Daniel Moritz Felsenreich, Wen-Huan Feng, Gong Feng, Qin Feng, Maria Fortofoiu, Jun-Liang Fu, Xing-Jiao Fu, Jian-Jun Fu, Qing-Chun Fu, Li-Yun Fu, Marat Fudim, Ozimo Pereira Gama Filho, Shubash Shander Ganapathy, Yu-Feng Gao, Rong Gao, Feng Gao, Jose Eduardo Garcia Flores, Diego Garcia-Compean, Antonio Gasbarrini, Sandro Gentile, Daniel Gero, Hasmik Levon Ghazinyan, Cameron Gofton, Ling Gong, Jordi Gracia-Sancho, Yitka Graham, Antonietta Gerarda Gravina, Guang-Xiang Gu, Tian-Wei Gu, Xue-Mei Gu, Yan Gu, Lizbeth Guilbert Vertiz, Pramendra Prasad Gupta, Jorge Gutiérrez Cuevas, Yeonjung Ha, Adamos Andreas Hadjipanayis, Nissar Hussain Hamdani, Saeed Sadiq Hamid, Ju-Qiang Han, Jia-Gang Han, Xue-Ji Han, Jian-Li Han, Xiao-Dong Han, Yu Han, Mohamed Hany, Kun-Yan Hao, Zhi-Hui Hao, Ying-Li He, Peter Hegyi, Fatima Higuera-de-la-Tijera, Gao Hong, Li Hong, Liang Hong, Wan-Dong Hong, Tanvir Hossain, Jessica Howell, Hai-Jun Hu, Bing Hu, Yang-Xi Hu, Xiao-Li Hu, Yan Hu, Xiao-Yu Hu, Xiao-Hong Hu, Ai-Rong Hu, Ting Hu, Xiang Hu, Jing Hua, Rui Huang, Ang Huang, Jiao-Feng Huang, Yu-Li Huang, Yan-Lin Huang, Ming-Xing Huang, Yan Huang, Shan-Shan Huang, Chen-Xiao Huang, Jee-Fu Huang, Hannah Xiaoyan Hui, Rex Wan-Hin Hui, Farah Anwari Husain, Ignacio Garcia-Juarez Ignacio, Angelo Lossa, Taryel Omarov Isgender, Vincent W. V. Jaddoe, Chyntia Olivia Maurine Jasirwan, Benjamin Anderschou Holbech Jensen, Vivekanand Jha, Dong Ji, Fan-Pu Ji, Ben-Li Jia, Xiao-Li Jia, Ji-Dong Jia, Tao Jiang, Shu-Jun Jiang, Ya-Kun Jiang, Hong Jiang, Jing-Jing Jiang, Qing-Long Jin, Qian Jin, Jie Jin, Jian-Hong Jin, Xi Jin, Pappachan M. Joseph, Shashank R. Joshi, Sherlot Juan Song, Eva Juárez-Hernández, Apichat Kaewdech, Abd-Elfattah Morsi Kalmoush, Sanjay Kalra, Naglaa M. Kamal, Lubna Kamani, Mehmet Kanbay, Tatsuo Kanda, Yunkoo Kang, Jia-Horng Kao, Nitin Kapoor, Pal Novak Kaposi, Thomas Karlas, Eda Kaya, Shelley E. Keating, Mohit Kehar, William Wilson Kemp, Bernardo Mazzinia Ketzer, Amir Ul haq Khan, Nidhi Kamlesh Khandelwal, Bekkhan Khatsiev, Haris Khwaja, Hyeon Chang Kim, Won Kim, Ali Kirik, Rahul Kumar, Juferdy Kurniawan, Qin-Tao Lai, Jimmy Che To Lai, Quirino Lai, Jinping Lai, Panagiotis Lainas, Gavin Lambert, Naomi Franziska Lange, Nicolas Lanthier, Way Seah Lee, Yeong Yeh Lee, Guan-Huei Lee, Wei Jei Lee, Si-Yi Lei, Cosmas Rinaldi Adithya Lesmana, Dong-Dong Li, Lu Li, Wen-Gang Li, Jing Li, Li Li, Hai-Long Li, Min Li, Jun-Feng Li, Qiang Li, Xin-Hua Li, Zhen-Zhen Li, Chong Li, Jin-Liang Li, Zhen Li, Chun-Ming Li, Jiang-Tao Li, Ping Li, Yi-Ling Li, Gang Li, Jin Li, Hui-Qi Li, Hai Li, Ping Li, Jia Li, Hai Li, Hong-Shan Li, Jing-Wei Li, Jian-Jun Li, Min Lian, Hui-Qing Liang, Xu-Jing Liang, Hui Liang, Xiao-Yu Liang, Lee-Ling Lim, Moabe Rezende Lima, Su Lin, Zhong-Hua Lin, Shu-Mei Lin, Biao-Yang Lin, Xiangping Lin, Han-Chieh Lin, Feng Liu, Yan-Min Liu, Zhao-Hui Liu, Ya-Ming Liu, Yong Liu, Jun-Ping Liu, Wei Liu, Chuan Liu, Yu Liu, Xiao-Lin Liu, Jie Liu, Feng-Hua Liu, Fu-Hui Liu, Shao-Zhuang Liu, You-De Liu, Jin-Feng Liu, Cheng-Hai Liu, Chang-Hai Liu, Jing Liu, Feng Liu, Shirley Yuk-Wah Liu, Lgnatios Lkonomidis, Yahve Ivan Lopez Mendez, Jian-Jun Lou, Zhong-hua Lu, Qing-Hua Lu, Yan Lu, Feng-Bin Lu, Rashid Lui, Kai-Zhong Luo, Jiao-Jian Lv, Li-Juan Ma, An-Lin Ma, Le-Ping Ma, Luca Maccioni, Maria Paula Macedo, Hamidreza Mahboobi, Mamun Al Mahtab, Piotr Major, Avik Majumdar, Lung Yi Mak, Diana Gabriela Maldonado Pintado, Zhong-Qi Mao, Ri-Cheng Mao, Doglas Gobbi Marchesi, Claude Marcus, Adil Mardinoglu, Vanderlei Martinelo, Maria L. Martinez Chantar, Pierluigi Marzuillo, Mario Masarone, Samer Gamil Mattar, Samantha Maurotti, Hua Meng, Souraia Mezhoud, Qing Miao, Lei Miao, Kai-Wen Miao, Vladimir Milivojevic, Anoop Misra, Takao Miwa, Teruki Miyake, Mahaneem Mohamed, Hugo Christian Monroy-Ramirez, Magdalene Katharina Montgomery, Rachel Lynn Moore, Kengo Moriyama, Nezha Mouane, Anna Mrzljak, Francesk Mulita, Kate Rebecca Muller, Benjamin H. Mullish, Giovanni Musso, Syifa Mustika, Hayato Nakagawa, Carlos Roberto Naufel, Aleksandr Neimark, Stephen Ka Kei Ng, Nicholas Beng Hui Ng, Yan Ni, Biao Nie, Dafina Nikolova, Madunil Anuk Niriella, Wen-Zhong Niu, Takumi Noda, Patrick Noel, Ahmed Abd Alwahab Nugud, Ponsiano Ocama, Necati Örmeci, Oral B. Ospanov, Motoyuki Otsuka, Tugce Ozlu Karahan, Eduardo Garcia Pacheco, Mariano Palermo, Jin-Shui Pan, Yi-Min Pan, Xiao-Yan Pan, Qiong Pan, Athanasios G. Pantelis, Gabriella Par, Beniamino Pascotto, Daniele Pastori, Diana Alcantara Payawal, Jie Peng, Xia Peng, Nilanka Perera, Marina Perez, Juan M. Pericàs, Silvana Perretta, Marcello Persico, Cyriac Abby Philips, Tadeja Pintar, Anna Edyta Platek, Adisa Poljo, Francesca Romana Ponziani, Gilda Porta, Piero Portincasa, Dimitri J. Pournaras, Sjaak Pouwels, Arun Prasad, Hery Djagat Purnomo, Ke-Min Qi, Xing-Shun Qi, Li-Na Qian, Liang Qiao, Rong Qin, Jun Quan, Reynu Rajan, Ruveena Bhavani Rajaram, Raghu Ramanathan, Anis Safura Ramli, Hui-Ying Rao, Jaideepraj Rao, Federico Ravaioli, Sayantan Ray, Thomas Reiberger, Andrian Ostapovych Reity, Hong-Mei Ren, Wan-Hua Ren, Karl Peter Rheinwalt, Rui José Da Silva Ribeiro, Joana Rigor, Stuart Keith Roberts, Andrew Gerard Robertson, Federico Bernhardo Roesch Dietlen, Qing-Jing Ru, Ding Rui, Elena Ruiz-Úcar, Kushila Rupasinghe, Eka Rusdi, Andrea Ruzzenente, Marno Celeste Ryan, Seungho Ryu, Nasse Sakran, Darwin Sangcap Salonga, Madhusudana Girija Sanal, Isabel Sánchez Pedrique, Ana Sandoval-Rodriguez, Emidio Scarpellini, Dimitrios Schizas, Markus Peter Schlaich, John David Scott, KongHan Ser, Shahab Shahabi Shahmiri, Inass F. Shaltout, Paramesh Shamanna, Michael David Shapiro, Manoj Kumar Sharma, Barjesh Chander Sharma, Li-Shui Shen, Hua-Jiang Shen, Jian-Wen Sheng, Hui-Lian Shi, Yi-wen Shi, Cui-Cui Shi, Li Shi, Yu Shi, Gamal Shiha, Michio Shimabukuro, Manjunath Siddaiah-Subramanya, James Skinovsky, Abhasnee Sobhonslidsuk, Virend Kristen Somers, Jang Won Son, Yu-Hu Song, Yong-Feng Song, Yu Song, Maria Sotiropoulou, Mohammadjavad Sotoudeheian, Vanessa Souza-Mello, Ana Despot Starcevic, Catherine A. Stedman, Philippe Gabriel Steg, Christine Karolina Stirr, Simone I. Strasser, Andri Sanityoso Sulaiman, Ying Sun, Ya-Meng Sun, Xi-Tai Sun, Jing Sun, Chao Sun, Li-Hua Sun, Jinyue Sun, Lin Tan, You-Wen Tan, Wen Tan, Soek-Siam Tan, Nguan Soon Tan, Jie-Ting Tang, Shan-Hong Tang, Shi-Yue Tang, Tawesak Tanwandee, Halit Eren Taskin, Ryosuke Tateishi, Hoi-Poh Tee, Luis Téllez, Gianni Testino, Omar Thaher, Kessarin Thanapirom, Panagiotis Theofilis, Hu Tian, Claudio Tiribelli, Katsutoshi Tokushige, Salvatore Tolone, Xiao-Fei Tong, Aldo Torre, Zaher Toumi, Meri Trajkovska, Serap Turan, Roberto Jr Tussi, Michail Vailas, Stan F. J. Van De Graaf, Dennis Van Der Meer, Laurens A. Van Kleef, Bart Alexander Van Wagensveld, Ronnal Patricio Vargas, Cruz Vargas-De-León, Ramon Vilallonga, Nadia Waheed, Shu-Zhen Wang, Qi Wang, Qian-Yi Wang, Jun-Jiang Wang, Cun-Chuan Wang, Fei Wang, Ke Wang, Shao-Yong Wang, Yun Wang, Wen-Hu Wang, Xi-Jin Wang, Gong-Chen Wang, Yan Wang, Bing-Yuan Wang, Yong Wang, Hui Wang, Feng-Ling Wang, Ning-Jian Wang, Bing Wang, Qi-Xia Wang, Xiao-Lin Wang, Meng-Yu Wang, Yan Wang, Jing Wang, Ming-Wei Wang, Ting-Yao Wang, Jie Wang, Liang Wang, Bo Wang, Han Wang, Chia Chi Wang, Ram Weiss, Martin Weltman, Qian-Jun Wen, Biao Wen, David C. Wheeler, I. Dewa Nyoman Wibawa, Mohamed-Naguib Wifi, Alan J. Wigg, Grace L. H. Wong, Ping Foo Wong, Chi-Ming Wong, Li-Sheng Wu, Xiao-Ning Wu, Jian-Di Wu, Li-Xian Wu, Hui-Ling Wu, Yi Wu, Xiao-Ping Wu, Kai-Chun Wu, Dong-Bo Wu, Bian Wu, Qing-Song Wu, Gui-Cheng Wu, Yong-Sheng Xia, Tian-Xin Xiang, Xiao-Gang Xiang, Qian Xiang, Huan-Ming Xiao, Tie Xiao, Wen Xie, Ming Xie, Lin Xie, Qing Xie, Yong-Ning Xin, Yan-Qing Xing, Qing-Fang Xiong, Ming Xiong, Xue-Lian Xiong, He-Xiang Xu, Jing-Hang Xu, Yan-Huang Xu, Long Xu, Dong-Sheng Xu, Xu Xu, Wei-Guo Xu, Liang Xu, Yu-Shan Xu, Lan-Man Xu, Zhang Xu, Xiao-Wei Xu, Jing Xu, Xiu-Lan Xue, Yun-Hao Xun, Jie Yan, Hong-Mei Yan, Yong-Ping Yang, Song Yang, Ling Yang, Li Yang, Hui Yang, Wei Yang, Yan-Ling Yang, Wen-Zhuo Yang, Rui-Xu Yang, Fan Yang, Nai-Bin Yang, Qiao Yang, Qi-Yuan Yao, Ying Yao, Jun-Zhao Ye, Xiao-Li Ye, Jian-Ping Ye, Wei Ye, Feng Ye, Chen-Hui Ye, Hua Ye, Wei-Jiang Ye, Aaron Justin Yeoh, Kuo Chao Yew, Xin Yin, Xi Yin, Terry Cheuk-Fung Yip, Vesri Yoga, Masato Yoneda, Miao Yu, Ping Yu, Lei Yu, Yong-Tao Yu, Hong-Yan Yu, Zuo-Chun Yu, Wei-Hua Yu, Ming-Whei Yu, Xi-Wei Yuan, Bao-Hong Yuan, Hai-Yang Yuan, Ping-Ge Yuan, Fauzi Yusuf, Yan-Li Zeng, Qing-Lei Zeng, Sheng Zeng, Jing Zeng, Xin Zeng, Yan-Bo Zeng, Xu-Fen Zeng, Meng-Hua Zeng, Chi Zhang, Hua-Bing Zhang, Jing Zhang, Ji-Yuan Zhang, Ting Zhang, Neng-Wei Zhang, Peng Zhang, Xiao-Yong Zhang, Si-Yu Zhang, Yi-Min Zhang, Qiang Zhang, Bin Zhang, Song-Hai Zhang, Jian-Cheng Zhang, Dong-Mei Zhang, Fan Zhang, Qun Zhang, Shu Zhang, Yan-Liang Zhang, Yao Zhang, Rui-Nan Zhang, Wei-Wei Zhang, Jing Zhang, Yue-Xin Zhang, Bin-Bin Zhang, Shuang-Shuang Zhang, Jin-Shun Zhang, Dian-Bao Zhang, Xiang Zhang, Xinrong Zhang, Wen Zhao, Jing-Jie Zhao, Yu Zhao, Xiang-Wen Zhao, Dan-Dan Zhao, Su-Xian Zhao, Wei-Feng Zhao, Li-Li Zhao, Qiang Zhao, Jian Zhao, Yu-Bao Zheng, Jia-Lian Zheng, Wen Zheng, Chao Zheng, Jian-Kai Zhong, Jian-Hong Zhong, Yan-Dan Zhong, Ling Zhou, Li-Ru Zhou, Hong-Wen Zhou, Yu-Jie Zhou, Yu-Ping Zhou, Yong-Hai Zhou, Qing Zhou, Xiao-Dong Zhou, Xiao-Dong Zhou, Yue-Yong Zhu, Xiao-Cheng Zhu, Jiang-Fan Zhu, Sheng-Hao Zhu, Yong-Fen Zhu, Jian-Sheng Zhu, Zheng-Sheng Zou, Zi-Yuan Zou, Zhuo-Lin Zou

    Hepatology International   2024.6

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s12072-024-10702-5

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    Other Link: https://link.springer.com/article/10.1007/s12072-024-10702-5/fulltext.html

  • Recent advances in hepatitis E virus research and the Japanese clinical practice guidelines for hepatitis E virus infection. Reviewed

    Kanda T, Li TC, Takahashi M, Nagashima S, Primadharsini PP, Kunita S, Sasaki-Tanaka R, Inoue J, Tsuchiya A, Nakamoto S, Abe R, Fujiwara K, Yokosuka O, Suzuki R, Ishii K, Yotsuyanagi H, Okamoto H, AMED HAV, HEV Study Group

    Hepatol Res.   2024.6

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    DOI: 10.1111/hepr.14062

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  • Liver Diseases: From Bench to Bedside Invited Reviewed

    Tatsuo Kanda, Reina Sasaki-Tanaka, Shuji Terai

    International Journal of Molecular Sciences   25 ( 10 )   5454   2024.5

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    DOI: 10.3390/ijms25105454

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  • Liver biopsy as a useful diagnostic tool for hepatic sarcoidosis: A case report Reviewed

    Uehara K, Kanda T, Arima S, Totsuka M, Honda M, Masuzaki R, Sasaki‐tanaka R, Matsumoto N, Ogawa M, Kogure H

    Medicine International   4   2024.5

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)  

    DOI: 10.3892/mi.2024.162

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  • Elderly patient with unresectable advanced‑stage hepatocellular carcinoma who received atezolizumab plus bevacizumab and achieved a complete response: A case report Reviewed

    Shuhei Arima, Tatsuo Kanda, Mai Totsuka, Masayuki Honda, Shini Kanezawa, Reina Sasaki‑Tanaka, Naoki Matsumoto, Ryota Masuzaki, Hiroaki Yamagami, Masahiro Ogawa, Hirofumi Kogure

    Medicine International   4 ( 3 )   2024.3

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Spandidos Publications  

    DOI: 10.3892/mi.2024.147

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  • Severe hepatitis E virus genotype 3b in a patient with alcohol‑associated liver disease: A case report Reviewed

    Tatsuo Kanda, Shuhei Arima, Reina Sasaki‑Tanaka, Mai Totsuka, Masayuki Honda, Ryota Masuzaki, Naoki Matsumoto, Masahiro Ogawa, Masaharu Takahashi, Hiroaki Okamoto, Hirofumi Kogure

    Medicine International   4 ( 3 )   2024.3

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    DOI: 10.3892/mi.2024.146

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  • 十二指腸静脈瘤に対し初回BRTO, 5年後再発に対してCARTO-IIを施行した1例 Reviewed

    有間修平, 松岡俊一, 金子朋弘, 十束茉衣, 本田真之, 石井大雄, 松本直樹, 増﨑亮太, 山上裕晃, 小川眞広, 神田達郎, 木暮宏史

    日本門脈圧亢進症学会雑誌   30 ( 1 )   52 - 58   2024.3

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  • ウイルス性肝炎(HBV, HCV) Invited

    神田達郎, 早川智

    臨床婦人科産科   78 ( 1 )   72 - 78   2024.1

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  • Hepatitis E Virus Infection Caused Elevation of Alanine Aminotransferase Levels in a Patient with Chronic Hepatitis B and Choledocholithiasis Reviewed

    Rei Hirano, Tatsuo Kanda, Masayuki Honda, Shuhei Arima, Mai Totsuka, Ryota Masuzaki, Shini Kanezawa, Reina Sasaki-Tanaka, Naoki Matsumoto, Hiroaki Yamagami, Tomotaka Ishii, Masahiro Ogawa, Shuzo Nomura, Mariko Fujisawa, Kei Saito, Masaharu Takahashi, Hiroaki Okamoto, Hirofumi Kogure

    Reports   6 ( 4 )   55 - 55   2023.11

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    Hepatitis E virus (HEV) genotypes 3 and 4 are zoonotic strains that are primarily transmitted through the consumption of undercooked pork or game meat. They also cause asymptomatic infections, acute hepatitis, acute-on-chronic liver failure, chronic hepatitis, and extrahepatic manifestations. Here, we report a man in his 80s who had chronic hepatitis B, took entecavir for it, and presented with higher levels of alanine aminotransferase (ALT) and jaundice. An abdominal computed tomography scan revealed choledocholithiasis with cholecystolithiasis. Although endoscopic papillary balloon dilatation was performed for the removal of a common bile duct stone, the abnormal liver function tests, including jaundice, were prolonged. After other viral hepatitis and other causes of the liver injury were ruled out, as his serum was positive for immunoglobulin A anti-HEV and HEV genotype 3b RNA, we diagnosed him as having acute hepatitis E. In this case, with chronic hepatitis B and a common bile duct stone, the prolonged abnormal results for the liver function tests seemed to be caused by HEV infection. In conclusion, in cases with high ALT levels after removing choledocholithiasis, other factors, including HEV infection, should be considered to determine the cause of abnormal liver function test results. The further examination of hepatitis D virus infection and high ALT levels may be needed in HBV-infected individuals.

    DOI: 10.3390/reports6040055

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  • Recent advances in hepatitis A virus (HAV) research and clinical practice guidelines for HAV infection in Japan Reviewed

    Tatsuo Kanda, Reina Sasaki‐Tanaka, Koji Ishii, Ryosuke Suzuki, Jun Inoue, Atsunori Tsuchiya, Shingo Nakamoto, Ryuzo Abe, Keiichi Fujiwara, Osamu Yokosuka, Tian‐Cheng Li, Satoshi Kunita, Hiroshi Yotsuyanagi, Hiroaki Okamoto

    Hepatology Research   2023.10

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    Abstract

    In 2018, there was a hepatitis A outbreak in Japan, and HAV infection is considered a sexually transmitted disease. In general, patients with hepatitis A should be given attention, and this disease should be prevented more than ever. The Japan Agency for Medical Research and Development (AMED) Hepatitis A and E viruses (HAV and HEV) Study Group has worked on the project to create “Recent Advances in Hepatitis A Virus (HAV) Research and Clinical Practice Guidelines for HAV Infection in Japan”. The group consists of expert hepatologists and virologists who gathered at virtual meeting on 5 August 2023. Data about the pathogenesis, infection routes, diagnosis, complications, several factors for the severities, vaccination, and current and future treatments for hepatitis A were discussed and debated for a draft version. The participants assessed the quality of cited studies. The finalized recommendations are presented in this review. The recent advances in HAV research and clinical practice for HAV infection in Japan, have been reviewed by the AMED HAV and HEV Study Group.

    DOI: 10.1111/hepr.13983

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  • Involvement of proliferation of atypical hepatocytes and CDT 1 in the liver cancer of rats administered the diethylnitrosamine.

    Ogawa M, Masuzaki R, Kanda T, Matsumura H, Nakamura H, Yamazaki M, Shibata T, Kogure H, Moriyama M

    Journal of clinical biochemistry and nutrition   2023.9

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    We have reported that extent of proliferation of atypical hepatocytes (POAH) in non-cancerous liver in hepatocellular carcinoma and chromatin licensing and DNA replication factor 1 (CDT1) are associated with postoperative recurrence. Here, we investigated whether extent of POAH and expression of CDT1 in liver are also associated with chemically induced liver cancer in rats. Male Fisher strain rats were orally administered diethylnitrosamine (DEN) in their drinking water and sacrificed at 6, 8, 12, or 14 weeks after start of DEN administration. We serially monitored changes in extent of POAH, CDT1 expression by immunohistochemistry (IHC), and <i>CDT1</i> mRNA expression in liver by real-time quantitative PCR. The extent of POAH in liver progressed in a time-dependent manner after start of DEN administration. CDT1 expression was higher at 8 weeks than at 6 weeks by IHC, suggesting that CDT1 expression may be a marker of POAH severity. <i>CDT1</i> mRNA expression in liver was significantly higher at 12 weeks than at 6 weeks (<i>p</i><0.0001). We found that extent of POAH and the expression of CDT1 are also important factors in the development of chemical carcinogen-induced hepatocarcinogenesis. Furthermore, the association with POAH and CDT1 expression in carcinogenic process is important regardless of the cause of hepatocarcinogenesis.

    DOI: 10.3164/jcbn.13-16

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  • Muscle Cramps in Outpatients with Liver Diseases in Tokyo, Japan Reviewed

    Tatsuo Kanda, Reina Sasaki-Tanaka, Naoki Matsumoto, Shuhei Arima, Shini Kanezawa, Masayuki Honda, Mai Totsuka, Tomotaka Ishii, Ryota Masuzaki, Masahiro Ogawa, Hiroaki Yamagami, Hirofumi Kogure

    Medicina   59 ( 9 )   1506 - 1506   2023.8

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    Background and Objectives: Muscle cramps are often observed in patients with liver diseases, especially advanced liver fibrosis. The exact prevalence of muscle cramps in outpatients with liver diseases in Japan is unknown. Patients and Methods: This study examined the prevalence of, and therapies for, muscle cramps in outpatients with liver diseases in Tokyo, Japan. A total of 238 outpatients with liver diseases were retrospectively examined. We investigated whether they had muscle cramps using a visual analog scale (VAS) (from 0, none, to 10, strongest), and also investigated their therapies. Results: Muscle cramps were observed in 34 outpatients with liver diseases (14.3%); their mean VAS score was 5.53. A multivariate analysis demonstrated that older age (equal to or older than 66 years) was the only significant factor as-sociated with muscle cramps. The prevalence of muscle cramps among patients with liver diseases seemed not to be higher. The problem was that only 11 (32.4%) of 34 outpatients received therapy for their muscle cramps. Conclusions: Only age is related to muscle cramps, which is rather weak, and it is possible that this common symptom may not be limited to liver disease patients.

    DOI: 10.3390/medicina59091506

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  • E型肝炎の予防 (ウイルス性肝炎学2023 -最新の病態・診断・治療情報- V.各論) Invited

    神田達郎, 田中佐々木玲奈

    日本臨床   81 ( S7 )   516 - 521   2023.7

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  • Masitinib Inhibits Hepatitis A Virus Replication Reviewed

    Reina Sasaki-Tanaka, Toshikatsu Shibata, Mitsuhiko Moriyama, Hirofumi Kogure, Asuka Hirai-Yuki, Hiroaki Okamoto, Tatsuo Kanda

    International Journal of Molecular Sciences   24 ( 11 )   9708 - 9708   2023.6

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    The hepatitis A virus (HAV) infection causes acute hepatitis. HAV also induces acute liver failure or acute-on-chronic liver failure; however, no potent anti-HAV drugs are currently available in clinical situations. For anti-HAV drug screening, more convenient and useful models that mimic HAV replication are needed. In the present study, we established HuhT7-HAV/Luc cells, which are HuhT7 cells stably expressing the HAV HM175-18f genotype IB subgenomic replicon RNA harboring the firefly luciferase gene. This system was made by using a PiggyBac-based gene transfer system that introduces nonviral transposon DNA into mammalian cells. Then, we investigated whether 1134 US Food and Drug Administration (FDA)-approved drugs exhibited in vitro anti-HAV activity. We further demonstrated that treatment with tyrosine kinase inhibitor masitinib significantly reduced both HAV HM175-18f genotype IB replication and HAV HA11-1299 genotype IIIA replication. Masitinib also significantly inhibited HAV HM175 internal ribosomal entry-site (IRES) activity. In conclusion, HuhT7-HAV/Luc cells are adequate for anti-HAV drug screening, and masitinib may be useful for the treatment of severe HAV infection.

    DOI: 10.3390/ijms24119708

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  • Molecular Mechanisms, Diagnosis and Treatments in Digestive Malignancy

    Tatsuo Kanda, Ryota Masuzaki, Reina Sasaki-Tanaka, Hirofumi Kogure, Mitsuhiko Moriyama

    International Journal of Molecular Sciences   24 ( 7 )   6471 - 6471   2023.3

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    In this Special Issue, “Molecular Mechanisms, Diagnosis and Treatments in Digestive Malignancy”, of the International Journal of Molecular Sciences, a total of 10 impactful articles have been published [...]

    DOI: 10.3390/ijms24076471

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  • Molecular Mechanism of Chronic Viral and Non-Viral Liver Diseases Invited Reviewed International journal

    Tatsuo Kanda

    International Journal of Molecular Sciences   2023.3

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    DOI: 10.3390/ijms24076218

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  • Successful Identification of a Novel Therapeutic Compound for Hepatocellular Carcinoma Through Screening of ADAM9 Inhibitors. Reviewed International journal

    Ogawa K, Chiba T, Nakamura M, Arai J, Zhang J, Ma Y, Qiang NA, Ao J, Yumita S, Ishino T, Kan M, Iwanaga T, Nakagawa M, Fujiwara K, Sakuma T, Kanzaki H, Koroki K, Kusakabe Y, Kobayashi K, Kanogawa N, Kiyono S, Kondo T, Nakagawa R, Ogasawara S, Muroyama R, Nakamoto S, Kanda T, Maruyama H, Kato J, Matsumoto S, Arai T, Motohashi S, Kato N.

    Anticancer Res.   43 ( 3 )   1043 - 1052   2023.3

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    Attiki, Greece : International Institute of Anticancer Research

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  • Drug Screening for Hepatitis A Virus (HAV): Nicotinamide Inhibits c-Jun Expression and HAV Replication Reviewed International journal

    Reina Sasaki-Tanaka, Ryota Masuzaki, Hiroaki Okamoto, Toshikatsu Shibata, Mitsuhiko Moriyama, Hirofumi Kogure, Tatsuo Kanda

    Journal of Virology   e0198722   2023.2

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    Hepatitis A virus (HAV) infection often causes acute hepatitis, which results in a case fatality rate of 0.2% and fulminant hepatitis in 0.5% of cases. However, no specific potent anti-HAV drug is available on the market to date. In the present study, we focused on inhibition of HAV internal ribosomal entry site (IRES)-mediated translation and investigated novel therapeutic drugs through drug repurposing by screening for inhibitors of HAV IRES-mediated translation and cell viability using a reporter assay and cell viability assay, respectively. The initial screening of 1,158 drugs resulted in 77 candidate drugs. Among them, nicotinamide significantly inhibited HAV HA11-1299 genotype IIIA replication in Huh7 cells. This promising drug also inhibited HAV HM175 genotype IB subgenomic replicon and HAV HA11-1299 genotype IIIA replication in a dose-dependent manner. In the present study, we found that nicotinamide inhibited the activation of activator protein 1 (AP-1) and that knockdown of c-Jun, which is one of the components of AP-1, inhibited HAV HM175 genotype IB IRES-mediated translation and HAV HA11-1299 genotype IIIA and HAV HM175 genotype IB replication. Taken together, the results showed that nicotinamide inhibited c-Jun, resulting in the suppression of HAV IRES-mediated translation and HAV replication, and therefore, it could be useful for the treatment of HAV infection. <b>IMPORTANCE</b> Drug screening methods targeting HAV IRES-mediated translation with reporter assays are attractive and useful for drug repurposing. Nicotinamide (vitamin B3, niacin) has been shown to effectively inhibit HAV replication. Transcription complex activator protein 1 (AP-1) plays an important role in the transcriptional regulation of cellular immunity or viral replication. The results of this study provide evidence that AP-1 is involved in HAV replication and plays a role in the HAV life cycle. In addition, nicotinamide was shown to suppress HAV replication partly by inhibiting AP-1 activity and HAV IRES-mediated translation. Nicotinamide may be useful for the control of acute HAV infection by inhibiting cellular AP-1 activity during HAV infection processes.

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  • Gut-Microbiota Dysbiosis in Stroke-Prone Spontaneously Hypertensive Rats with Diet-Induced Steatohepatitis Reviewed International journal

    Shini Kanezawa, Mitsuhiko Moriyama, Tatsuo Kanda, Akiko Fukushima, Ryota Masuzaki, Reina Sasaki-Tanaka, Akiko Tsunemi, Takahiro Ueno, Noboru Fukuda, Hirofumi Kogure

    International Journal of Molecular Sciences   24 ( 5 )   4603   2023.2

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    Metabolic-dysfunction-associated fatty-liver disease (MAFLD) is the principal worldwide cause of liver disease. Individuals with nonalcoholic steatohepatitis (NASH) have a higher prevalence of small-intestinal bacterial overgrowth (SIBO). We examined gut-microbiota isolated from 12-week-old stroke-prone spontaneously hypertensive-5 rats (SHRSP5) fed on a normal diet (ND) or a high-fat- and high-cholesterol-containing diet (HFCD) and clarified the differences between their gut-microbiota. We observed that the <i>Firmicute/Bacteroidetes (F/B)</i> ratio in both the small intestines and the feces of the SHRSP5 rats fed HFCD increased compared to that of the SHRSP5 rats fed ND. Notably, the quantities of the 16S rRNA genes in small intestines of the SHRSP5 rats fed HFCD were significantly lower than those of the SHRSP5 rats fed ND. As in SIBO syndrome, the SHRSP5 rats fed HFCD presented with diarrhea and body-weight loss with abnormal types of bacteria in the small intestine, although the number of bacteria in the small intestine did not increase. The microbiota of the feces in the SHRSP5 rats fed HFCD was different from those in the SHRP5 rats fed ND. In conclusion, there is an association between MAFLD and gut-microbiota alteration. Gut-microbiota alteration may be a therapeutic target for MAFLD.

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  • Miglustat, a glucosylceramide synthase inhibitor, mitigates liver fibrosis through TGF-β/Smad pathway suppression in hepatic stellate cells. Reviewed International journal

    Iwanaga T, Chiba T, Nakamura M, Kaneko T, Ao J, Qiang N, Ma Y, Zhang J, Kogure T, Yumita S, Ishino T, Ogawa K, Kan M, Nakagawa M, Fujiwara K, Fujita N, Sakuma T, Kanzaki H, Koroki K, Kusakabe Y, Inoue M, Kobayashi K, Kanogawa N, Kiyono S, Kondo T, Nakagawa R, Ogasawara S, Nakamoto S, Muroyama R, Kato J, Kanda T, Maruyama H, Mimura N, Honda T, Murayama T, Nakamura H, Kato N.

    Biochem Biophys Res Commun.   642   192 - 200   2023.1

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    Transforming growth factor (TGF)-β/Smad pathway is implicated in the pathogenesis of liver fibrosis, a condition characterized by excessive deposition of extracellular matrix (ECM) proteins such as collagen in response to chronic inflammation. It has been reported that ceramide regulates collagen production through TGF-β/Smad pathway activation. In this study, we examined whether miglustat, an inhibitor of glucosylceramide synthase, can suppress liver fibrosis by reducing TGF-β/Smad pathway activity. Human hepatic stellate cells (HHSteCs) were cultured with TGF-β and multiple miglustat concentrations to examine dose-dependent effects on the expression levels of ECM-related genes and Smad proteins. To evaluate the efficacy of miglustat for fibrosis mitigation, C57BL/6 mice were treated with carbon tetrachloride (CCl<sub>4</sub>) for 4 weeks to induce liver fibrosis, followed by combined CCl<sub>4</sub> plus miglustat for a further 2 weeks. To examine if miglustat can also prevent fibrosis, mice were treated with CCl<sub>4</sub> for 2 weeks, followed by CCl<sub>4</sub> plus miglustat for 2 weeks. Miglustat dose-dependently downregulated expression of α-smooth muscle actin and ECM components in TGF-β-treated HHSteCs. Both phosphorylation and nuclear translocation of Smad2 and Smad3 were also suppressed by miglustat treatment. Sirius-Red staining and hydroxyproline assays of model mouse liver samples revealed that miglustat reduced fibrosis, an effect accompanied by decreased expression of ECM. Our findings suggest that miglustat can both prevent and reverse liver fibrosis by inhibiting TGF-β/Smad pathway.

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  • Chronic Hepatitis C: Acute Exacerbation and Alanine Aminotransferase Flare. Reviewed International journal

    Kanda T, Matsumoto N, Ishii T, Arima S, Shibuya S, Honda M, Sasaki-Tanaka R, Masuzaki R, Kanezawa S, Nishizawa T, Gon Y, Ogawa M, Kogure H.

    Viruses   15 ( 1 )   183   2023.1

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    The hepatitis C virus (HCV) causes acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma, as well as extrahepatic manifestations such as malignant lymphoma. Currently, direct-acting antiviral agents (DAAs) against HCV infection can lead to a sustained virological response (SVR) in almost all HCV-infected patients. In this review article, we discuss acute exacerbation and alanine aminotransferase (ALT) flare in patients with chronic HCV infection. Although acute liver failure caused by HCV infection is rare, careful attention should be paid to the cases with ALT elevation during the natural course of chronic HCV infection. HCV genotype 2 infection, the use of rituximab, and a higher dose of corticosteroid are factors associated with HCV acute exacerbation and ALT flare. Treatment regimens for cancer have been interrupted or changed due to ALT flare due to HCV infection in some patients undergoing chemotherapy for cancer. The pathogenesis of HCV acute exacerbation and ALT flare could involve cellular as well as humoral immune responses. In the DAA era, the earlier introduction of DAAs may prevent chronic HCV-infected patients with acute exacerbation and ALT flare from developing into a more severe form, although DAAs may not be effective for all of them.

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  • Thirty-two years' experience of treating fulminant hepatitis in a Japanese single center. Reviewed International journal

    Keiichi Fujiwara, Shin Yasui, Takayuki Kondo, Masato Nakamura, Makoto Arai, Tatsuo Kanda, Osamu Yokosuka, Masayuki Ohtsuka, Ryuzo Abe, Naoya Kato

    Hepatology research : the official journal of the Japan Society of Hepatology   2022.12

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    AIM: The prognosis of patients with acute liver failure has improved dramatically in the past three decades due to advances in medical critical care and use of liver transplantation (LT) in Western countries, where the etiology of acute liver failure is different from that in Japan. We analyzed patients with fulminant hepatitis (FH) and late-onset hepatic failure (LOHF) admitted to our unit over a 32-year period to clarify the nature of Japanese patients with FH and LOHF. METHODS: A total of 137 Japanese patients with FH and LOHF between 1986 and 2017 were analyzed for etiologies, disease types, treatment protocols, and outcome. RESULTS: Of 137 patients, 124 were FH (53 acute type and 71 subacute type) and 13 LOHF. The major etiology was due to viral infections in 48% of patients. A total of 23.4% of patients recovered without LT, 7.3% received LT, and 69.3% died without LT. The number of patients showed rise and fall without an evident decrease during the period. Patients with autoimmune hepatitis increased after the establishment of autoimmune hepatitis criteria in 1999 (p < 0.001), and that with indeterminate cause decreased (p < 0.01). The mean age was older in the last decade than in the first decade (p = 0.036). Spontaneous and overall survival rates were not different during the period. CONCLUSIONS: The prognosis of our patients with FH and LOHF has not improved, probably because of aging and the increasing proportion of etiologies with poor prognosis and difficult-to-treat patients without response to medications regardless of advancement of clinical management, including artificial liver support devices and LT.

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  • Tumor stiffness measurement using magnetic resonance elastography can predict recurrence and survival after curative resection of hepatocellular carcinoma. Reviewed International journal

    Abe H, Shibutani K, Yamazaki S, Kanda T, Moriyama M, Okada M, Sugitani M, Tsuji S, Takayama T, Okamura Y.

    Surgery   173 ( 2 )   450 - 456   2022.12

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    BACKGROUND: Tumor stiffness measurement using magnetic resonance elastography can assess tumor mechanical properties and predict hepatocellular carcinoma recurrence. This study aimed to investigate preoperative tumor stiffness on magnetic resonance elastography as a predictor of overall survival and recurrence-free survival in patients with solitary nodular hepatocellular carcinoma who underwent curative resection. METHODS: Seventy-eight patients with solitary nodular hepatocellular carcinoma who underwent preoperative magnetic resonance elastography and curative resection were retrospectively analyzed. Potential associations of tumor stiffness and other clinicopathological variables with overall survival and recurrence-free survival were analyzed in both univariate and multivariate Cox proportional hazards analyses. The optimal tumor stiffness cutoff value was determined using the minimal P value approach. RESULTS: In multivariate analysis, tumor stiffness (hazard ratio 1.31; 95% confidence interval, 1.07-1.59; P = .008) and vascular invasion (hazard ratio 2.62; 95% confidence interval, 1.27-5.17; P = .010) were independent predictors of recurrence-free survival. For overall survival, tumor stiffness (hazard ratio, 1.33; 95% confidence interval, 1.02-1.76; P = .037) was the only independent predictor. The optimal tumor stiffness cutoff value was 5.81 kPa for both overall survival and recurrence-free survival. Patients with tumor stiffness ≥5.81 kPa had a significantly greater risk of death (hazard ratio 6.10; 95% confidence interval, 2.11-21.90; P < .001) than those with tumor stiffness <5.81 kPa. CONCLUSION: Preoperative tumor stiffness as measured by magnetic resonance elastography was a predictor of overall survival and recurrence-free survival in hepatocellular carcinoma patients who underwent curative resection. Higher tumor stiffness was associated with higher risk of recurrence and death.

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  • Liver Transplantation from a Human Leukocyte Antigen-Matched Sibling Donor: Effectiveness of Direct-Acting Antiviral Therapy against Hepatitis C Virus Infection Reviewed International journal

    Tatsuo Kanda, Naoki Matsumoto, Tomotaka Ishii, Shuhei Arima, Shinji Shibuya, Masayuki Honda, Reina Sasaki-Tanaka, Ryota Masuzaki, Shini Kanezawa, Masahiro Ogawa, Shintaro Yamazaki, Osamu Aramaki, Hirofumi Kogure, Yukiyasu Okamura

    Reports   5 ( 4 )   49   2022.12

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    <jats:p>Through living-donor liver transplantation (LDLT) from a human leukocyte antigen (HLA)-matched sibling donor, it may be possible to stop the use of immunosuppressants. It is possible that acute antibody-mediated rejection and chronic active antibody-mediated rejection through the positivity of donor-specific anti-HLA antibodies and/or T cell-mediated rejection may affect the prognosis of liver transplantation. The etiologies of liver diseases of the recipient may also affect the post-transplantation course. Herein, we report on the successful re-treatment with direct-acting antiviral (DAA) therapy against hepatitis C virus (HCV) infection in a patient who underwent a LDLT from HLA-matched sibling donor. After liver transplantation for HCV-related liver diseases, it is easy for HCV to re-infect the graft liver under a lack of immunosuppressants. DAA therapy against HCV re-infection immediately after transplantation should be commenced, and it is important to eradicate HCV for better prognosis of the recipients in LDLT for HCV-related liver diseases.</jats:p>

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  • The proliferation of atypical hepatocytes and CDT1 expression in noncancerous tissue are associated with the postoperative recurrence of hepatocellular carcinoma. Reviewed International journal

    Moriyama M, Kanda T, Midorikawa Y, Matsumura H, Masuzaki R, Nakamura H, Ogawa M, Matsuoka S, Shibata T, Yamazaki M, Kuroda K, Nakayama H, Higaki T, Kanemaru K, Miki T, Sugitani M, Takayama T.

    Scientific Reports   12 ( 1 )   20508   2022.11

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    Recently, we reported that extent of proliferation of atypical hepatocytes (atypical hepatocytes) was most important histological risk factor for development of hepatocellular carcinoma (HCC) from chronic hepatitis C or liver cirrhosis. Here, we aimed to clarify whether the atypical hepatocytes in noncancerous sections is also involved in postoperative recurrence. Furthermore, we investigated significant genes involved in the atypical hepatocytes. Association between the extent of atypical hepatocytes in noncancerous tissue and postoperative recurrence was validated in 356 patients with HCC. Next, we identified putative signature genes involved in extent of atypical hepatocytes. First, atypical hepatocytes or hepatocytes other than the atypical hepatocyte in noncancerous sections of 4 HCC patients were selectively collected by laser capture microdissection (LCM). Second, the gene expression profiles of the selected hepatocyte populations were compared using Ion AmpliSeq Transcriptome Human Gene Expression Kit (Thermo Fisher SCIENTIFIC, Waltham, MA, USA) analysis. Finally, we validated the mRNA expression of the extracted genes in noncancerous frozen liver tissue from 62 patients with HCC by RT-qPCR to identify the signature genes involved in both the extent of atypical hepatocytes and postoperative recurrence. Furthermore, the extent of atypical hepatocytes and CDT1 expression in noncancerous sections from 8 patients with HCC were also validated by selectively collecting samples using LCM. The extent of atypical hepatocytes was associated with postoperative recurrence. Of the genes that showed significant differences in expression levels between two populations, the expression of the chromatin licensing and DNA replication factor 1 (CDT1) gene was most strongly associated with the extent of atypical hepatocytes and was also associated with postoperative recurrence. Furthermore, CDT1-positive cells that exhibited stronger expression resembled those morphologically considered to be atypical hepatocytes. CDT1 and Ki-67 were colocalized in the nuclei of both hepatocytes and cancer cells. The hepatocytes in noncancerous livers were not uniform in each hepatocyte population, suggesting that the accumulation of genetic abnormalities was variable. We found that the strong degree of atypical hepatocytes and high CDT1 mRNA expression represent a high carcinogenic state of the liver. Thus, we consider the evaluation of degree of these could support the personalized medicine.

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  • Amantadine and Rimantadine Inhibit Hepatitis A Virus Replication through the Induction of Autophagy Reviewed International journal

    Reina Sasaki-Tanaka, Toshikatsu Shibata, Mitsuhiko Moriyama, Hiroaki Okamoto, Hirofumi Kogure, Tatsuo Kanda

    Journal of Virology   e0064622   2022.9

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    Hepatitis A virus (HAV) infection is a major cause of acute viral hepatitis worldwide. Furthermore, HAV causes acute liver failure or acute-on-chronic liver failure. However, no potent anti-HAV drugs are currently available in the clinical situations. There have been some reports that amantadine, a broad-spectrum antiviral, suppresses HAV replication <i>in vitro</i>. Therefore, we examined the effects of amantadine and rimantadine, derivates of adamantane, on HAV replication, and investigated the mechanisms of these drugs. In the present study, we evaluated the effects of amantadine and rimantadine on HAV HM175 genotype IB subgenomic replicon replication and HAV HA11-1299 genotype IIIA replication in cell culture infection systems. Amantadine and rimantadine significantly inhibited HAV replication at the post-entry stage in Huh7 cells. HAV infection inhibited autophagy by suppressing the autophagy marker light chain 3 and reducing number of lysosomes. Proteomic analysis on HAV-infected Huh7 cells treated by amantadine and rimantadine revealed the changes of the expression levels in 42 of 373 immune response-related proteins. Amantadine and rimantadine inhibited HAV replication, partially through the enhancement of autophagy. Taken together, our results suggest a novel mechanism by which HAV replicates along with the inhibition of autophagy and that amantadine and rimantadine inhibit HAV replication by enhancing autophagy. <b>IMPORTANCE</b> Amantadine, a nonspecific antiviral medication, also effectively inhibits HAV replication. Autophagy is an important cellular mechanism in several virus-host cell interactions. The results of this study provide evidence indicating that autophagy is involved in HAV replication and plays a role in the HAV life cycle. In addition, amantadine and its derivative rimantadine suppress HAV replication partly by enhancing autophagy at the post-entry phase of HAV infection in human hepatocytes. Amantadine may be useful for the control of acute HAV infection by inhibiting cellular autophagy pathways during HAV infection processes.

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  • Effects of Let-7c on the processing of hepatitis B virus associated liver diseases Reviewed International coauthorship International journal

    Zhang L, Jiang X, Wang G, Kanda T, Yokosuka O, Zhai C, Zhang L, Liu P, Zhao Z, Li Z

    Infect Agent Cancer   17 ( 1 )   46   2022.9

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    <h4>Background</h4>The most common type of cancer of the digestive system is hepatocellular carcinoma. In China, many patients harbour HBV. The lin28B/Let-7c/MYC axis is associated with the occurrence of many cancers. Therefore, we aimed to illuminate the function of the lin28B/Let-7c/MYC axis in hepatocellular carcinoma. We aimed to evaluate the critical involvement of lin28B and Let-7c in the carcinogenesis of human hepatocellular carcinoma (B-HCC).<h4>Methods</h4>Data from the GEO database were used to analyse differentially expressed genes and IRGs. A protein - protein interaction (PPI) network and Venn diagram were generated to analyse relationships. Real-time RT-PCR, Western blotting, and cell counting kit-8 assays were used to examine the association of lin28B, Let-7c, and MYC with cell proliferation.<h4>Results</h4>A total of 2552 functionally annotated differentially expressed RNAs were analysed in HBV patients from the GSE135860 database. In addition, 46 let-7c target genes were screened in HBV patients, and the interactions were analysed through PPI network analysis. The results confirmed that Let-7c and its target genes play a key role in HBV-related diseases. Next, we discovered a gradual decrease in Let-7c expression during the progression from HBV-associated chronic hepatitis (B-CH) and HBV-associated liver cirrhosis (B-LC) to B-HCC. We found evidence for a negative association between lin28B expression and Let-7c expression. The expression of MYC was obviously upregulated when Let-7c was inhibited.<h4>Conclusion</h4>Our results highlight that Let-7c and lin28B participate in the carcinogenesis of HBV-associated diseases through the lin28B/Let-7c/MYC axis.

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  • 肝機能が比較的安定していたが肝発癌を認めたB型肝炎症例について

    神田 達郎, 森山 光彦, 有間 修平, 本田 真之, 石井 大雄, 松本 直樹, 佐々木 玲奈, 増崎 亮太, 木暮 宏史, 小川 眞広

    日本がん検診・診断学会誌   30 ( 2 )   65 - 65   2022.9

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  • No increased risk of hepatocellular carcinoma after eradication of hepatitis C virus by direct-acting antivirals, compared with interferon-based therapy. Reviewed

    215.Korenaga M, Murata K, Izumi N, Tamaki N, Yokosuka O, Takehara T, Sakamoto N, Suda G, Nishiguchi S, Enomoto H, Ikeda F, Yanase M, Toyoda H, Genda T, Umemura T, Yatsuhashi H, Yamazaki K, Ide T, Toda N, Kanda T, Nirei K, Ueno Y, Haga H, Nishigaki Y, Nakane K, Omata M, Mochizuki H, Aoki Y, Imamura M, Kanto T.

    Glob Health Med.   4 ( 4 )   216 - 224   2022.8

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    It is well-known that sustained virological response (SVR) by interferon (IFN)-based therapy against hepatitis C virus (HCV) infection reduced the incidence of hepatocellular carcinoma (HCC). However, whether IFN-free direct-acting antivirals reduce the risk of HCC is controversial. Therefore, this study aims to compare the incidence of HCC after the achievement of SVR between sofosbuvir combined with ledipasvir (SOF/LDV) and simeprevir with pegylated interferon plus ribavirin (Sim+IFN). Japanese patients with HCV infection (genotype 1) who achieved SVR between January 2013 and December 2014 by SOF/LDV (NCT01975675, n = 320) or Sim+IFN (000015933, n = 289) therapy in two nationwide, multicenter, phase III studies were prospectively monitored for the development of HCC by ultrasonography for 5 years after the end of treatment (EOT). No HCC was detected before the treatment. HCC was detected in 9 and 7 patients in the SOF/LDV and the Sim+IFN group in 5 years, respectively. The cumulative incidences of HCC rates 1, 3, and 5 years after EOT were similar between the two groups (1.5%, 2.7%, and 3.2% for the SOF/LDV and 1.8%, 2.8%, and 3.0% for the Sim+IFN group, respectively). No HCC was developed 3.5 years after EOT. Interestingly, a retrospective careful review of imaging taken before therapy revealed hepatic nodules in 50% of HCC patients, suggesting HCC was pre-existed before therapy. In conclusion, we could not find any differences in the incidence of HCC after the HCV eradication between the two therapeutic regimens, suggesting no enhancement of HCC development by DAA.

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  • Molecular Changes in Relation to Alcohol Consumption and Hepatocellular Carcinoma Invited Reviewed International coauthorship International journal

    Reina Sasaki-Tanaka, Ranjit Ray, Mitsuhiko Moriyama, Ratna Ray, Tatsuo Kanda

    International Journal of Molecular Sciences   23 ( 17 )   9679   2022.8

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    Alcohol is the one of the major causes of liver diseases and promotes liver cirrhosis and hepatocellular carcinoma (HCC). In hepatocytes, alcohol is converted to acetaldehyde, which causes hepatic steatosis, cellular apoptosis, endoplasmic reticulum stress, peroxidation, production of cytokines and reduces immune surveillance. Endotoxin and lipopolysaccharide produced from intestinal bacteria also enhance the production of cytokines. The development of hepatic fibrosis and the occurrence of HCC are induced by these alcohol metabolites. Several host genetic factors have recently been identified in this process. Here, we reviewed the molecular mechanism associated with HCC in alcoholic liver disease.

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  • Acute Liver Failure and Acute-on-Chronic Liver Failure in COVID-19 Era. Reviewed International journal

    Tatsuo Kanda, Reina Sasaki-Tanaka, Tomotaka Ishii, Hayato Abe, Masahiro Ogawa, Hirayuki Enomoto

    Journal of clinical medicine   11 ( 14 )   2022.7

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    Acute liver failure (ALF) and acute-on-chronic liver failure (ACLF), respectively, occur in patients with normal liver and patients with chronic liver diseases, including cirrhosis [...].

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  • The RNA-Binding Protein ELAVL1 Regulates Hepatitis B Virus Replication and Growth of Hepatocellular Carcinoma Cells. Reviewed International journal

    Hiroaki Kanzaki, Tetsuhiro Chiba, Tatsuya Kaneko, Junjie Ao, Motoyasu Kan, Ryosuke Muroyama, Shingo Nakamoto, Tatsuo Kanda, Hitoshi Maruyama, Jun Kato, Yoh Zen, Ai Kotani, Kazuma Sekiba, Motoyuki Otsuka, Masayuki Ohtsuka, Naoya Kato

    International journal of molecular sciences   23 ( 14 )   2022.7

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    Previous RNA immunoprecipitation followed by proteomic approaches successfully demonstrated that Embryonic Lethal, Abnormal Vision, Drosophila-Like 1 (ELAVL1) interacts with hepatitis B virus (HBV)-derived RNAs. Although ELAVL family proteins stabilize AU-rich element (ARE)-containing mRNAs, their role in HBV transcription remains unclear. This study conducted loss-of-function assays of ELAVL1 for inducible HBV-replicating HepAD38 cells and HBx-overexpressed HepG2 cells. In addition, clinicopathological analyses in primary hepatocellular carcinoma (HCC) surgical samples were also conducted. Lentivirus-mediated short hairpin RNA knockdown of ELAVL1 resulted in a decrease in both viral RNA transcription and production of viral proteins, including HBs and HBx, probably due to RNA stabilization by ELAVL1. Cell growth of HepAD38 cells was more significantly impaired in ELAVL1-knockdown than those in the control group, with or without HBV replication, indicating that ELAVL1 is involved in proliferation by factors other than HBV-derived RNAs. Immunohistochemical analyses of 77 paired HCC surgical specimens demonstrated that diffuse ELAVL1 expression was detected more frequently in HCC tissues (61.0%) than in non-tumor tissues (27.3%). In addition, the abundant expression of ELAVL1 tended to affect postoperative recurrence in HBV-related HCC patients. In conclusion, ELAVL1 contributes not only to HBV replication but also to HCC cell growth. It may be a potent therapeutic target for HBV-related HCC treatment.

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  • A型肝炎の予防と治療 A型・E型肝炎の最新動向. Invited

    佐々木玲奈, 神田達郎

    週刊 医学のあゆみ   282 ( 2 )   124 - 128   2022.7

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  • Hepatitis A Virus Infection and Molecular Research Invited Reviewed International journal

    Tatsuo Kanda, Reina Sasaki-Tanaka, Shingo Nakamoto

    International Journal of Molecular Sciences   23 ( 13 )   7214 - 7214   2022.6

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    Hepatitis A virus (HAV) infection is a major cause of acute viral hepatitis globally, which can occasionally lead to acute liver failure (ALF) and acute-on-chronic liver failure (ACLF), which often result in death without liver transplantation [...].

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  • Evaluation of Potential Anti-Hepatitis A Virus 3C Protease Inhibitors Using Molecular Docking Reviewed International journal

    Reina Sasaki-Tanaka, Kalyan C. Nagulapalli Venkata, Hiroaki Okamoto, Mitsuhiko Moriyama, Tatsuo Kanda

    International Journal of Molecular Sciences   23 ( 11 )   6044 - 6044   2022.5

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    Hepatitis A virus (HAV) infection is a major cause of acute hepatitis worldwide and occasionally causes acute liver failure and can lead to death in the absence of liver transplantation. Although HAV vaccination is available, the prevalence of HAV vaccination is not adequate in some countries. Additionally, the improvements in public health reduced our immunity to HAV infection. These situations motivated us to develop potentially new anti-HAV therapeutic options. We carried out the in silico screening of anti-HAV compounds targeting the 3C protease enzyme using the Schrodinger Modeling software from the antiviral library of 25,000 compounds to evaluate anti-HAV 3C protease inhibitors. Additionally, in vitro studies were introduced to examine the inhibitory effects of HAV subgenomic replicon replication and HAV HA11-1299 genotype IIIA replication in hepatoma cell lines using luciferase assays and real-time RT-PCR. In silico studies enabled us to identify five lead candidates with optimal binding interactions in the active site of the target HAV 3C protease using the Schrodinger Glide program. In vitro studies substantiated our hypothesis from in silico findings. One of our lead compounds, Z10325150, showed 47% inhibitory effects on HAV genotype IB subgenomic replicon replication and 36% inhibitory effects on HAV genotype IIIA HA11-1299 replication in human hepatoma cell lines, with no cytotoxic effects at concentrations of 100 μg/mL. The effects of the combination therapy of Z10325150 and RNA-dependent RNA polymerase inhibitor, favipiravir on HAV genotype IB HM175 subgenomic replicon replication and HAV genotype IIIA HA11-1299 replication showed 64% and 48% inhibitory effects of HAV subgenomic replicon and HAV replication, respectively. We identified the HAV 3C protease inhibitor Z10325150 through in silico screening and confirmed the HAV replication inhibitory activity in human hepatocytes. Z10325150 may offer the potential for a useful HAV inhibitor in severe hepatitis A.

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  • Suppressors of Cytokine Signaling and Hepatocellular Carcinoma. Reviewed International coauthorship International journal

    Masuzaki R, Kanda T, Sasaki R, Matsumoto N, Nirei K, Ogawa M, Karp SJ, Moriyama M, Kogure H.

    Cancers (Basel)   14 ( 10 )   2549   2022.5

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    Cytokines are secreted soluble glycoproteins that regulate cellular growth, proliferation, and differentiation. Suppressors of cytokine signaling (SOCS) proteins negatively regulate cytokine signaling and form a classical negative feedback loop in the signaling pathways. There are eight members of the SOCS family. The SOCS proteins are all comprised of a loosely conserved N-terminal domain, a central Src homology 2 (SH2) domain, and a highly conserved SOCS box at the C-terminus. The role of SOCS proteins has been implicated in the regulation of cytokines and growth factors in liver diseases. The SOCS1 and SOCS3 proteins are involved in immune response and inhibit protective interferon signaling in viral hepatitis. A decreased expression of SOCS3 is associated with advanced stage and poor prognosis of patients with hepatocellular carcinoma (HCC). DNA methylations of SOCS1 and SOCS3 are found in HCC. Precise regulation of liver regeneration is influenced by stimulatory and inhibitory factors after partial hepatectomy (PH), in particular, SOCS2 and SOCS3 are induced at an early time point after PH. Evidence supporting the important role of SOCS signaling during liver regeneration also supports a role of SOCS signaling in HCC. Immuno-oncology drugs are now the first-line therapy for advanced HCC. The SOCS can be potential targets for HCC in terms of cell proliferation, cell differentiation, and immune response. In this literature review, we summarize recent findings of the SOCS family proteins related to HCC and liver diseases.

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  • Effect of Atezolizumab plus Bevacizumab in Patients with Hepatocellular Carcinoma Harboring CTNNB1 Mutation in Early Clinical Experience. Reviewed International journal

    213.Ogawa K, Kanzaki H, Chiba T, Ao J, Qiang N, Ma Y, Zhang J, Yumita S, Ishino T, Unozawa H, Kan M, Iwanaga T, Nakagawa M, Fujiwara K, Fujita N, Sakuma T, Koroki K, Kusakabe Y, Kobayashi K, Kanogawa N, Kiyono S, Nakamura M, Kondo T, Saito T, Nakagawa R, Ogasawara S, Suzuki E, Nakamoto S, Muroyama R, Kanda T, Maruyama H, Mimura N, Kato J, Motohashi S, Kato N.

    J Cancer.   13 ( 8 )   2656 - 2661   2022.5

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    Atezolizumab plus bevacizumab (ATZ/BV) treatment is a combined immunotherapy consisting of immune checkpoint inhibitor (ICI) and anti-vascular endothelial growth factor monoclonal antibody, which has brought a major paradigm shift in the treatment of unresectable hepatocellular carcinoma (HCC). Gain-of-function mutation of CTNNB1 contributes to resistance of ICI monotherapy through the framework of non-T-cell-inflamed tumor microenvironment. However, whether CTNNB1 mutation renders resistance to ATZ/BV similar to ICI monotherapy remains to be elucidated. In this study, a liquid biopsy sample in plasma of 33 patients with HCC treated with ATZ/BV was subjected to droplet digital PCR for detecting hotspot mutations at the exon 3 of CTNNB1 locus. A total of eight patients (24.2%) exhibited at least one CTNNB1 mutation. The objective response rate (ORR) in patients with wild-type (WT) and mutant (MT) CTNNB1 was 8.0% and 12.5%, respectively, and the disease control rate (DCR) was 68.0% and 87.5%, respectively. No significant difference in both ORR and DCR has been observed between the two groups. The median progression-free survival in patients with WT and MT CTNNB1 was 6.6 and 7.6 months, respectively (not statistically significant). Similarly, no significant difference in overall survival has been observed between patients with WT and MT CTNNB1 (13.6 vs. 12.3 months). In conclusion, the treatment effect of ATZ/BV in patients with HCC with MT CTNNB1 was comparable to those patients with WT CTNNB1. These results implicate that BV added to ATZ might improve immunosuppressive tumor microenvironment caused by CTNNB1 mutation.

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  • Contrast-enhanced ultrasonography for blood flow detection in hepatocellular carcinoma during lenvatinib therapy. Reviewed

    Matsumoto N, Ogawa M, Kaneko M, Arima S, Kumagawa M, Watanabe Y, Hirayama M, Masuzaki R, Kanda T, Moriyama M.

    J Med Ultrason (2001)   49 ( 3 )   425 - 432   2022.3

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    PURPOSE: Blood flow reduction after initiation of lenvatinib therapy may not always indicate tumor necrosis. This study aimed to compare the blood flow detectability of contrast-enhanced ultrasonography (CEUS), contrast-enhanced computed tomography (CT), and contrast-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma (HCC) during lenvatinib therapy. METHODS: A total of 12 cases underwent CEUS and contrast-enhanced CT/MRI within 2 weeks during lenvatinib therapy. Vascularity on CEUS and CT/MRI was compared. RESULTS: At the time of CEUS examination, the median period from the start of lenvatinib was 227 ± 210 (31-570) days. CEUS showed hyperenhancement in eight cases (66.7%), hypoenhancement in two cases (16.7%), and no enhancement in one case (8.3%), while CT/MRI showed hyperenhancement in one case (8.3%), ring enhancement in three cases (25.0%), and hypoenhancement in eight cases (66.7%) (p = 0.007). Transarterial chemoembolization (n = 3), radiofrequency ablation (n = 2), and stereotactic body radiation therapy (n = 2) were performed after blood flow detection by CEUS. CONCLUSIONS: The viability of the HCC should be confirmed using CEUS when contrast-enhanced CT/MRI reveals lesion hypoenhancement during lenvatinib therapy.

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  • A Case of Recent Liver Injury Induced by Benzbromarone Invited Reviewed International journal

    Tomotaka Ishii, Keijiro Hoshino, Masayuki Honda, Yoichiro Yamana, Reina Sasaki-Tanaka, Mariko Kumagawa, Shini Kanezawa, Taku Mizutani, Naoki Matsumoto, Ryota Masuzaki, Kazushige Nirei, Hiroaki Yamagami, Mitsuhiko Moriyama, Tatsuo Kanda

    Reports   5 ( 1 )   8   2022.3

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    <jats:p>A 39-year-old male had a stomachache for 10 days before abnormal liver function tests were detected by a local doctor. Then, he was referred to us and admitted to our hospital for examination and treatment of elevated transaminases. He had taken benzbromarone to treat his hyperuricemia for seven months, and we diagnosed him with benzbromarone-induced liver injury. After the termination of benzbromarone, he finally recovered from his illness. There are several reports about benzbromarone-induced liver injury. In conclusion, as periodic liver function tests seem not to be completely performed, clinicians should regularly monitor liver function tests in patients taking benzbromarone.</jats:p>

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  • Favipiravir Inhibits Hepatitis A Virus Infection in Human Hepatocytes Reviewed International journal

    Reina Sasaki-Tanaka, Toshikatsu Shibata, Hiroaki Okamoto, Mitsuhiko Moriyama, Tatsuo Kanda

    International Journal of Molecular Sciences   23 ( 5 )   2631 - 2631   2022.2

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    Hepatitis A virus (HAV) is a causative agent of acute hepatitis and can occasionally induce acute liver failure. However, specific potent anti-HAV drug is not available on the market currently. Thus, we investigated several novel therapeutic drugs through a drug repositioning approach, targeting ribonucleic acid (RNA)-dependent RNA polymerase and RNA-dependent deoxyribonucleic acid polymerase. In the present study, we examined the anti-HAV activity of 18 drugs by measuring the HAV subgenomic replicon and HAV HA11-1299 genotype IIIA replication in human hepatoma cell lines, using a reporter assay and real-time reverse transcription polymerase chain reaction, respectively. Mutagenesis of the HAV 5' untranslated region was also examined by next-generation sequencing. These specific parameters were explored because lethal mutagenesis has emerged as a novel potential therapeutic approach to treat RNA virus infections. Favipiravir inhibited HAV replication in both Huh7 and PLC/PRF/5 cells, although ribavirin inhibited HAV replication in only Huh7 cells. Next-generation sequencing demonstrated that favipiravir could introduce nucleotide mutations into the HAV genome more than ribavirin. In conclusion, favipiravir could introduce nucleotide mutations into the HAV genome and work as an antiviral against HAV infection. Provided that further in vivo experiments confirm its efficacy, favipiravir would be useful for the treatment of severe HAV infection.

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  • 特集高齢者の消化器疾患- 適切な診断法と治療法を目指して 慢性ウイルス性肝炎 Invited

    神田達郎, 石井大雄, 増﨑亮太, 松本直樹, 楡井和重, 森山光彦

    臨床消化器内科   37 ( 2 )   191 - 198   2022.2

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  • イムノクロマト法によるHBs抗原偽陰性症例に対するHBV-DNA解析

    柳田 昂平, 嵐田 恵美子, 相馬 史, 竹島 秀美, 武居 宣尚, 宮下 徹夫, 神田 達郎, 森山 光彦, 中山 智祥

    医療検査と自動化   47 ( 1 )   38 - 42   2022.2

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  • Left Gastric Vein Width is an Important Risk Factor for Exacerbation of Esophageal Varices Post Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices in Cirrhotic Patients. Reviewed International journal

    Mizutani T, Nirei K, Kanda T, Honda M, Ishii T, Arima S, Yamana Y, Matsumoto N, Matsuoka S, Moriyama M.

    Medicina   58 ( 2 )   205   2022.1

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    Background and Objectives: Balloon-occluded retrograde transvenous obliteration (BRTO) could be currently one of the best therapies for patients with gastric varices. This study examined the exacerbation rates for esophageal varices following BRTO for gastric varices in patients with hepatic cirrhosis. Materials and Methods: We enrolled 91 cirrhotic patients who underwent BRTO for gastric varices. In total, 50 patients were examined for exacerbation rates of esophageal varices following BRTO. Esophageal varices and their associated exacerbation were evaluated by upper gastrointestinal endoscopy. Patients were allocated into two groups according to the main inflow tract for gastric varices: (1) 37 patients in the left gastric vein (LGV) group with an LGV width of more than 3.55 mm, and (2) 13 patients in the non-LGV group who had short gastric vein or posterior gastric vein. Moreover, treatment outcomes were retrospectively analyzed. Results: LGV width (p < 0.01) was the major risk factor for the deterioration of esophageal varices post BRTO. In addition, LGV was the most common inflow tract, and the LGV group contained 74% (37/50) of patients. The exacerbation rates of esophageal varices at 1, 2, 3, and 4 years post BRTO were 40%, 62%, 65%, and 68%, respectively. The comparison of the exacerbation rates for esophageal varices following BRTO according to inflow tract showed that the exacerbation rates were significantly higher in the LGV group than those of the non-LGV group (p = 0.03). In more than half of the subjects, LGV was the main inflow tract for gastric varices, and this group experienced more frequent exacerbations of esophageal varices following BRTO compared to patients with different inflow tract sources. Conclusion: Careful attention should be paid to the LGV width when BRTO is performed for gastric varices.

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  • COVID-19 After Treatment With Direct-Acting Antivirals for HCV Infection and Decompensated Cirrhosis: A Case Report. Reviewed International journal

    Ikegami C, Kanda T, Ishii T, Honda M, Yamana Y, Sasaki Tanaka R, Kumagawa M, Kanezawa S, Mizutani T, Yamagami H, Matsumoto N, Masuzaki R, Hayashi K, Nirei K, Takayama T, Moriyama M.

    In Vivo   36 ( 4 )   1986 - 1993   2022

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    BACKGROUND: Eradication of hepatitis C virus (HCV) from chronic HCV-infected patients could improve liver function and prevent hepatocarcinogenesis in the long term. Eradication of HCV by direct-acting antivirals (DAAs) also leads to dynamic immunological changes. We report a case of recurrent coronavirus disease 2019 (COVID-19) that developed immediately after combination treatment with DAAs for HCV infection and decompensated cirrhosis. CASE REPORT: A 55-year-old male was started on a 12-week treatment with combination of HCV NS5A inhibitor velpatasvir and HCV NS5B polymerase inhibitor sofosbuvir. HCV RNA became undetectable after six weeks of treatment and was undetectable at the end of the treatment (EOT). Twelve days after the EOT, we diagnosed the patient with COVID-19 pneumonia, admitted him to our hospital and he was discharged two weeks later. One week after his discharge, he visited our hospital again, was diagnosed with recurrent COVID-19 pneumonia readmitted for a second time. Four days after second admission, cardiac arrest occurred, however, he recovered from severe COVID-19 and achieved sustained virological response and his liver function improved. CONCLUSION: In the COVID-19 era, while attention should be paid to the occurrence or exacerbation of infection, including COVID-19, interferon-free DAA combination therapy should be performed for HCV-infected individuals.

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  • Immune Checkpoint Inhibitor as a Therapeutic Choice for Double Cancer: A Case Series. Reviewed International journal

    Aoki H, Matsumoto N, Takahashi H, Honda M, Kaneko T, Arima S, Ishii T, Mizutani T, Masuzaki R, Nirei K, Yamagami H, Ogawa M, Kanda T, Moriyama M, Miura K.

    Anticancer Research   41 ( 12 )   6225 - 6230   2021.12

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    BACKGROUND: Hepatocellular carcinoma (HCC) occasionally presents with simultaneous or metachronous primary malignancies of other organs. Despite the limited scope of cytocidal anticancer drugs or molecular targeted agents, immune checkpoint inhibitors (ICIs) can still be used for various malignancies. Here, we present cases of double cancers including HCC treated with ICIs. CASE REPORT: Case 1: A 70-year-old man with lung cancer and 80-mm HCC underwent nivolumab therapy. The sizes of both cancers remained constant for nine months. Case 2: A 58-year-old man with pharyngeal cancer and HCC. Nivolumab was administered, but was withdrawn after one session because of progressive disease. Case 3: A 71-year-old man with a 5 cm HCC invading the inferior vena cava, and early esophageal cancer. HCC showed a significant volume reduction and esophageal cancer demonstrated slight improvement by atezolizumab and bevacizumab therapy. CONCLUSION: A combination therapy including ICI is a promising treatment option for HCC with concurrent malignancies.

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  • Efficacy of Glecaprevir/Pibrentasvir for Real-World HCV Infected Patients in the Northern Part of Tokyo, Japan. Reviewed International journal

    Yamana Y, Kanda T, Matsumoto N, Honda M, Kumagawa M, Sasaki R, Kanezawa S, Mizutani T, Yamagami H, Masuzaki R, Ishii T, Nirei K, Moriyama M.

    Journal of Clinical Medicine   10 ( 23 )   5529   2021.11

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    Hepatis virus C (HCV) infection causes liver cirrhosis and hepatocellular carcinoma (HCC) worldwide. The objective of our study was to examine the effects of the HCV nonstructural protein (NS) 3/4A inhibitor glecaprevir/NS5A inhibitor pibrentasvir on real-world HCV patients in the northern part of Tokyo, Japan. Although 106 patients were consecutively included, a total of 102 HCV-infected patients with chronic hepatitis or compensated cirrhosis, who received 8- or 12-week combination treatment with glecaprevir/pibrentasvir and were followed up to week 12 after the end of treatment were analyzed retrospectively. Only three patients discontinued treatment due to adverse events; however, they achieved a sustained virologic response at 12 weeks (SVR12). Finally, SVR rates were 99.0% (101/102). Only one patient without liver cirrhosis was a treatment relapser who received hepatic resection for HCC approximately two years after commencement of the 8-week combination treatment with glecaprevir/pibrentasvir. After the exclusion of patients with HCV genotype 1b and P32 deletion in the HCV NS5A region, a 12-week combination of glecaprevir/pibrentasvir led to SVR12 in all nine direct-acting antiviral-experienced patients. Glecaprevir/pibrentasvir had a high efficacy and an acceptable safety profile for real-world HCV patients in a single hospital in Japan.

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  • Akt inhibitor augments anti-proliferative efficacy of a dual mTORC1/2 inhibitor by FOXO3a activation in p53 mutated hepatocarcinoma cells. Reviewed International coauthorship International journal

    Patra T, Meyer K, Ray RB, Kanda T, Ray R.

    Cell death & disease   12 ( 11 )   1073   2021.11

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    Hepatocellular carcinoma (HCC) is one of the most common malignancy-related deaths. p53 mutation in HCC associates with worse clinicopathologic features including therapeutic limitation. A combination of targeted therapy may have some advantages. Akt/mTOR signaling contributes to the regulation of cell proliferation and cell death. Akt inhibitor (AZD5363) and mTORC1/2 dual inhibitor (AZD8055) are in a clinical trial for HCC and other cancers. In this study, we examined whether these inhibitors successfully induce antiproliferative activity in p53 mutant HCC cells, and the underlying mechanisms. We observed that a combination of AZD5363 and AZD8055 treatment synergizes antiproliferative activity on p53 mutated or wild-type HCC cell lines and induces apoptotic cell death. Mechanistic insights indicate that a combination of AZD5363 and AZD8055 activated FOXO3a to induce Bim-associated apoptosis in p53 mutated HCC cells, whereas cells retaining functional p53 enhanced Bax. siRNA-mediated knock-down of Bim or Bax prevented apoptosis in inhibitor-treated cells. We further observed a combination of treatment inhibits phosphorylation of FOXO3a and protects FOXO3a from MDM2 mediated degradation by preventing the phosphorylation of Akt and SGK1. FOXO3a accumulates in the nucleus under these conditions and induces Bim transcription in p53 mutant HCC cells. Combination treatment in the HCC cells expressing wild-type p53 causes interference of FOXO3a function for direct interaction with functional p53 and unable to induce Bim-associated cell death. On the other hand, Bim-associated cell death occurs in p53 mutant cells due to uninterrupted FOXO3a function. Overall, our findings suggested that a combined regimen of dual mTORC1/2 and Akt inhibitors may be an effective therapeutic strategy for HCC patients harboring p53 mutation.

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  • The Use of Electronic Medical Records-Based Big-Data Informatics to Describe ALT Elevations Higher than 1000 IU/L in Patients with or without Hepatitis B Virus Infection. Reviewed International journal

    Amano H, Kanda T, Mochizuki H, Kojima Y, Suzuki Y, Hosoda K, Ashizawa H, Miura Y, Tsunoda S, Hirotsu Y, Ohyama H, Kato N, Moriyama M, Obi S, Omata M.

    Viruses   13 ( 11 )   2216   2021.11

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    Hepatitis B virus (HBV) infection is one of the serious health problems in the world as HBV causes severe liver diseases. Moreover, HBV reactivation has occasionally been observed in patients with resolved HBV infection and patients using immunosuppression and anticancer drugs. Large-scale hospital data focused on HBV infection and severe liver function were analyzed at our hospital, located in an urban area adjacent to Tokyo, the capital city of Japan. A total of 99,932 individuals whose blood samples were taken at 7,170,240 opportunities were analyzed. The HBV surface antigen (HBsAg)-positive group had a more frequent prevalence of patients with higher transaminase elevations than the HBsAg-negative group. However, among the HBsAg-negative group, patients who were positive for anti-HBV surface antibody and/or anti-HBV core antibody, had more severe liver conditions and fatal outcomes. More careful attention should be paid to alanine transaminase (ALT) elevations higher than 1000 IU/L in patients who had current and previous HBV infection.

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  • EZH1/2 inhibition augments the anti-tumor effects of sorafenib in hepatocellular carcinoma. Reviewed International journal

    Kusakabe Y, Chiba T, Oshima M, Koide S, Rizq O, Aoyama K, Ao J, Kaneko T, Kanzaki H, Kanayama K, Maeda T, Saito T, Nakagawa R, Kobayashi K, Kiyono S, Nakamura M, Ogasawara S, Suzuki E, Nakamoto S, Yasui S, Mikata R, Muroyama R, Kanda T, Maruyama H, Kato J, Mimura N, Ma A, Jin J, Zen Y, Otsuka M, Kaneda A, Iwama A, Kato N.

    Scientific Reports   11 ( 1 )   21396 - 21396   2021.11

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    Both EZH2 and its homolog EZH1 function as histone H3 Lysine 27 (H3K27) methyltransferases and repress the transcription of target genes. Dysregulation of H3K27 trimethylation (H3K27me3) plays an important role in the development and progression of cancers such as hepatocellular carcinoma (HCC). This study investigated the relationship between the expression of EZH1/2 and the level of H3K27me3 in HCC. Additionally, the role of EZH1/2 in cell growth, tumorigenicity, and resistance to sorafenib were also analyzed. Both the lentiviral knockdown and the pharmacological inhibition of EZH1/2 (UNC1999) diminished the level of H3K27me3 and suppressed cell growth in liver cancer cells, compared with EZH1 or EZH2 single knockdown. Although a significant association was observed between EZH2 expression and H3K27me3 levels in HCC samples, overexpression of EZH1 appeared to contribute to enhanced H3K27me3 levels in some EZH2lowH3K27me3high cases. Akt suppression following sorafenib treatment resulted in an increase of the H3K27me3 levels through a decrease in EZH2 phosphorylation at serine 21. The combined use of sorafenib and UNC1999 exhibited synergistic antitumor effects in vitro and in vivo. Combination treatment canceled the sorafenib-induced enhancement in H3K27me3 levels, indicating that activation of EZH2 function is one of the mechanisms of sorafenib-resistance in HCC. In conclusion, sorafenib plus EZH1/2 inhibitors may comprise a novel therapeutic approach in HCC.

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  • Laparoscopic bypass surgery as palliative treatment for duodenal obstruction due to lymph node metastasis invasion of hepatocellular carcinoma Reviewed

    Kurosugi Akane, Chiba Tetsuhiro, Iwanaga Terunao, Unozawa Hidemi, Sakuma Takafumi, Fujita Naoto, Kanayama Kengo, Kanzaki Hiroaki, Koroki Keisuke, Kobayashi Kazufumi, Kiyono Soichiro, Nakagawa Ryo, Kanogawa Naoya, Nakamura Masato, Kondo Takayuki, Saito Tomoko, Kusakabe Yuko, Ogasawara Sadahisa, Suzuki Eiichiro, Nakamoto Shingo, Tawada Akinobu, Muroyama Ryosuke, Kato Jun, Yokota Hajime, Kanda Tatsuo, Maruyama Hitoshi, Matsubara Hisahiro, Kato Naoya

    Kanzo   62 ( 10 )   656 - 662   2021.10

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    A 70-year-old male had repeatedly undergone local treatment for recurrent hepatocellular carcinoma (HCC) for 12 years. Systemic chemotherapy with sorafenib was started because lymph node and lung metastases were noted on X−1. However, the disease continued to progress, resulting in severe duodenal stenosis due to tumor invasion from lymph node metastasis. The patient eventually underwent laparoscopic gastric and small bowel bypass surgery after thorough consultation with a gastrointestinal surgeon and providing adequate informed consent. The postoperative course was good, and the patient was capable of oral intake and was discharged home. The patient wished to receive terminal care at home and expired about 6 months later due to HCC progression. Surgical bypass may be an option for patients with gastrointestinal obstruction associated with advanced HCC, as in this case, after careful consideration of the patient's condition.

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  • An international genome-wide meta-analysis of primary biliary cholangitis: Novel risk loci and candidate drugs. Reviewed International coauthorship International journal

    Cordell HJ, Fryett JJ, Ueno K, Darlay R, Aiba Y, Hitomi Y, Kawashima M, Nishida N, Khor SS, Gervais O, Kawai Y, Nagasaki M, Tokunaga K, Tang R, Shi Y, Li Z, Juran BD, Atkinson EJ, Gerussi A, Carbone M, Asselta R, Cheung A, de Andrade M, Baras A, Horowitz J, Ferreira MAR, Sun D, Jones DE, Flack S, Spicer A, Mulcahy VL, Byan J, Han Y, Sandford RN, Lazaridis KN, Amos CI, Hirschfield GM, Seldin MF, Invernizzi P, Siminovitch KA, Ma X, Nakamura M, Mells GF; PBC Consortia; Canadian PBC Consortium; Chinese PBC Consortium; Italian PBC Study Group; Japan-PBC-GWAS Consortium; US PBC Consortium; UK-PBC Consortium.

    Journal of Hepatology   75 ( 3 )   572 - 581   2021.9

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    BACKGROUNDS & AIMS: Primary biliary cholangitis (PBC) is a chronic liver disease in which autoimmune destruction of the small intrahepatic bile ducts eventually leads to cirrhosis. Many patients have inadequate response to licensed medications, motivating the search for novel therapies. Previous genome-wide association studies (GWAS) and meta-analyses (GWMA) of PBC have identified numerous risk loci for this condition, providing insight into its aetiology. We undertook the largest GWMA of PBC to date, aiming to identify additional risk loci and prioritise candidate genes for in silico drug efficacy screening. METHODS: We combined new and existing genotype data for 10,516 cases and 20,772 controls from 5 European and 2 East Asian cohorts. RESULTS: We identified 56 genome-wide significant loci (20 novel) including 46 in European, 13 in Asian, and 41 in combined cohorts; and a 57th genome-wide significant locus (also novel) in conditional analysis of the European cohorts. Candidate genes at newly identified loci include FCRL3, INAVA, PRDM1, IRF7, CCR6, CD226, and IL12RB1, which each play key roles in immunity. Pathway analysis reiterated the likely importance of pattern recognition receptor and TNF signalling, JAK-STAT signalling, and differentiation of T helper (TH)1 and TH17 cells in the pathogenesis of this disease. Drug efficacy screening identified several medications predicted to be therapeutic in PBC, some of which are well-established in the treatment of other autoimmune disorders. CONCLUSIONS: This study has identified additional risk loci for PBC, provided a hierarchy of agents that could be trialled in this condition, and emphasised the value of genetic and genomic approaches to drug discovery in complex disorders. LAY SUMMARY: Primary biliary cholangitis (PBC) is a chronic liver disease that eventually leads to cirrhosis. In this study, we analysed genetic information from 10,516 people with PBC and 20,772 healthy individuals recruited in Canada, China, Italy, Japan, the UK, or the USA. We identified several genetic regions associated with PBC. Each of these regions contains several genes. For each region, we used diverse sources of evidence to help us choose the gene most likely to be involved in causing PBC. We used these 'candidate genes' to help us identify medications that are currently used for treatment of other conditions, which might also be useful for treatment of PBC.

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  • 肝細胞癌に対するマイクロ波焼灼療法術後にたこつぼ型心筋症を発症した1例 Reviewed

    岩永 光巨, 千葉 哲博, 黒杉 茜, 宇野澤 秀美, 佐久間 崇文, 藤田 尚人, 金山 健剛, 神崎 洋彰, 興梠 慧輔, 小林 和史, 清野 宗一郎, 中川 良, 叶川 直哉, 中村 昌人, 近藤 孝行, 齊藤 朋子, 日下部 裕子, 小笠原 定久, 鈴木 英一郎, 中本 晋吾, 太和田 暁之, 室山 良介, 加藤 順, 神田 達郎, 丸山 紀史, 加藤 直也

    肝臓   62 ( 9 )   548 - 554   2021.9

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    症例は78歳女性.C型肝硬変を背景とする腫瘍径35mmと16mmの2個の肝細胞癌(HCC)の結節に対して,Emprintアブレーションシステムにて出力100W,計29分間のマイクロ波焼灼療法(MWA)を施行した.翌日のCTでは,腫瘍を含む広い焼灼範囲が得られていた.術後2日目,胸部症状の訴えがあり,十二誘導心電図においてV1-4でのT波の陰転化をみとめた.冠動脈造影検査では冠動脈に有意狭窄はなく,たこつぼ型心筋症と診断された.心不全に対してフロセミドによる心負荷軽減を行い,術後10日目に退院となった.たこつぼ型心筋症は,外科的手術など過剰な身体的ストレスも発症の一因となることが知られている.MWAは広い焼灼範囲が得られる優れたHCCの局所治療であるが,症例によっては身体的ストレスも大きいものと考えられ,たこつぼ型心筋症も合併症の一つとして念頭に置く必要がある.(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00263&link_issn=&doc_id=20210909130003&doc_link_id=10.2957%2Fkanzo.62.548&url=https%3A%2F%2Fdoi.org%2F10.2957%2Fkanzo.62.548&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • Follow-up of patients who achieved sustained virologic response after interferon-free treatment against hepatitis C virus: focus on older patients. Reviewed International coauthorship International journal

    Nirei K, Kanda T, Masuzaki R, Mizutani T, Moriyama M

    Medicina (Kaunas)   57 ( 8 )   761   2021.7

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    Background and Objectives: Direct-acting antiviral agents (DAAs) have improved sustained virologic response (SVR) rates in patients with chronic hepatitis C virus (HCV) infection. Our aim was to elucidate the occurrence of hepatocellular carcinoma (HCC) and to compare the outcomes of patients aged 75 years or older (older group) with those of patients younger than 75 years (younger group) after SVR. Materials and Methods: Among 441 patients treated with interferon-free DAA combinations, a total of 409 SVR patients were analyzed. We compared the two age groups in terms of HCC incidence and mortality rates. Results: Older and younger groups consisted of 68 and 341 patients, respectively. Occurrence of HCC after SVR did not differ between the two groups of patients with a history of HCC. Occurrence of HCC after SVR was observed more in younger patients without a history of HCC (p < 0.01). Although older patients without a history of HCC had a higher mortality rate (p < 0.01), their causes of death were not associated with liver diseases. Among younger patients without a history of HCC, none died. Conclusions: After SVR, liver disease may not be a prognostic factor in older HCV patients without a history of HCC.

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  • Knockdown of Mitogen-Activated Protein Kinase Kinase 3 Negatively Regulates Hepatitis A Virus Replication Reviewed International journal

    Tatsuo Kanda, Reina Sasaki-Tanaka, Ryota Masuzaki, Naoki Matsumoto, Hiroaki Okamoto, Mitsuhiko Moriyama

    International Journal of Molecular Sciences   22 ( 14 )   7420 - 7420   2021.7

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    Zinc chloride is known to be effective in combatting hepatitis A virus (HAV) infection, and zinc ions seem to be especially involved in Toll-like receptor (TLR) signaling pathways. In the present study, we examined this involvement in human hepatoma cell lines using a human TLR signaling target RT-PCR array. We also observed that zinc chloride inhibited mitogen-activated protein kinase kinase 3 (MAP2K3) expression, which could downregulate HAV replication in human hepatocytes. It is possible that zinc chloride may inhibit HAV replication in association with its inhibition of MAP2K3. In that regard, this study set out to determine whether MAP2K3 could be considered a modulating factor in the development of the HAV pathogen-associated molecular pattern (PAMP) and its triggering of interferon-β production. Because MAP2K3 seems to play a role in antiviral immunity against HAV infection, it is a promising target for drug development. The inhibition of MAP2K3 may also prevent HAV patients from developing a severe hepatitis A infection.

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  • No additive effects of peginterferon on the short-term improvement of liver histology by entecavir monotherapy in chronic hepatitis B patients Invited Reviewed

    Tatsuo Kanda

    Hepatology International   15 ( 3 )   579 - 581   2021.6

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    DOI: 10.1007/s12072-021-10191-w

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  • Ultrasonographic grayscale findings related to fibrosis in patients with non-alcoholic fatty liver disease: comparison with transient elastography and Fib-4 index. Reviewed

    Matsumoto N, Kumagawa M, Ogawa M, Kaneko M, Watanabe Y, Nakagawara H, Masuzaki R, Kanda T, Moriyama M, Sugitani M.

    J Med Ultrason (2001).   2021.6

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    <h4>Purpose</h4>Fibrosis is a predictor of mortality in patients with non-alcoholic fatty liver disease (NAFLD). In our institution, abdominal ultrasonography has been performed based on a unified method consisting of 25 images. We investigated ultrasonographic grayscale findings related to fibrosis in patients with NAFLD.<h4>Methods</h4>This retrospective study comprised 41 cases of pathologically proven fatty liver between January 2015 and September 2020. A total of 26 ultrasonographic findings were subjectively evaluated. These findings, transient elastography (TE) with M probe, and FIB-4 index were compared with fibrosis stage.<h4>Results</h4>The frequency of roughness of the dorsal side of the surface (p < 0.001), heterogenicity of the parenchyma (p = 0.003), narrowing of the hepatic vein (p = 0.004), and splenomegaly (p < 0.001) were strongly correlated with the fibrosis stage. Logistic regression analysis for stage ≥ 3 showed narrowing of the hepatic vein (odds ratio [OR] 5.860, p = 0.031) and splenomegaly (OR 6.290, p = 0.028). Logistic regression analysis for stage 4 showed roughness of the ventral side of the surface (OR 42.0, p = 0.019). The AUROC for stage 3 and stage 4 with the number of positive ultrasonographic findings was 0.856, and 0.940, respectively. The AUROC for F3 and F4 with TE was 0.831 and 0.861, respectively. The AUROC for stage 3 and stage 4 with FIB-4 index was 0.815 and 0.806, respectively.<h4>Conclusions</h4>Narrowing of the hepatic vein, roughness of the dorsal side of the surface, heterogenicity of the parenchyma, and splenomegaly and their combination could predict fibrosis in patients with NAFLD.

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  • Occurrence of hepatitis in an elderly woman during the treatment of pembrolizumab for right advanced renal pelvis, ureteral cancer, and bladder cancer. Reviewed International journal

    Asatani S, Kanda T, Honda M, Ishii T, Yamana Y, Kaneko T, Mizutani T, Takahashi H, Kumagawa M, Sasaki R, Masuzaki R, Kanezawa S, Matsumoto N, Nirei K, Yamagami H, Moriyama M.

    JGH Open   5 ( 6 )   722 - 726   2021.5

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    Recently, the use of immune checkpoint inhibitors (ICIs) with or without chemotherapeutic agents has been increasing in the treatment for advanced cancer. Here, we report the occurrence of liver failure after the use of pembrolizumab in an 82-year-old woman with metastatic liver disease derived from right advanced renal pelvis, ureteral cancer, and bladder cancer. She was successfully treated with 0.6 mg/kg daily prednisolone. In patients treated with ICIs, ICI-induced hepatitis is occasionally observed. Even if patients are older, it appears important to diagnose and treat ICI-induced hepatitis earlier by multidisciplinary therapies including steroid treatment. This is a first report of pembrolizumab-induced liver failure in elder patient with age over 80 years. Even if patients are older, it appears important to diagnose and treat ICI-induced hepatitis earlier by multidisciplinary therapies including steroid treatment.

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  • Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma. Reviewed International journal

    Koroki K, Kanogawa N, Maruta S, Ogasawara S, Iino Y, Obu M, Okubo T, Itokawa N, Maeda T, Inoue M, Haga Y, Seki A, Okabe S, Koma Y, Azemoto R, Atsukawa M, Itobayashi E, Ito K, Sugiura N, Mizumoto H, Unozawa H, Iwanaga T, Sakuma T, Fujita N, Kanzaki H, Kobayashi K, Kiyono S, Nakamura M, Saito T, Kondo T, Suzuki E, Ooka Y, Nakamoto S, Tawada A, Chiba T, Arai M, Kanda T, Maruyama H, Kato J, Kato N.

    Liver Cancer   10 ( 5 )   473 - 485   2021.4

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    BACKGROUND: There is no standard posttreatment for patients with advanced hepatocellular carcinoma (HCC) in whom lenvatinib therapy has failed. This study aimed to investigate rates of migration to posttreatment after lenvatinib and to explore candidates for second-line agents in the patients with failed lenvatinib therapy. METHODS: We retrospectively collected data on patients with advanced HCC who received lenvatinib as the first-line agent in 7 institutions. RESULTS: Overall survival and progression-free survival (PFS) of 178 patients who received lenvatinib as the first-line agent were 13.3 months (95% confidence interval [CI], 11.5-15.2) and 6.7 months (95% CI, 5.6-7.8), respectively. Sixty-nine of 151 patients (45.7%) who discontinued lenvatinib moved on to posttreatment. The migration rates from lenvatinib to the second-line agent and from the second-line agent to the third-line agent were 41.7 and 44.4%, respectively. Based on multivariate analysis, response to lenvatinib (complete or partial response according to modified RECIST) and discontinuation of lenvatinib due to radiological progression, as well as male were associated with a significantly higher probability of migration to posttreatment after lenvatinib. On the other hand, alpha-fetoprotein levels of 400 ng/mL or higher was correlated with a significantly lower probability of migration to posttreatment after lenvatinib. Of 63 patients who received second-line systemic therapy, 53 (84.2%) were administered sorafenib. PFS, objective response rate (ORR), and disease control rate (DCR) for sorafenib treatment were 1.8 months (95% CI, 0.6-3.0), 1.8%, and 20.8%, respectively. According to the Cox regression hazard model, Child-Pugh class B significantly contributed to shorter PFS. PFS, ORR, and DCR of 22 patients who received regorafenib after lenvatinib in any lines were 3.2 months (range, 1.5-4.9 months), 13.6%, and 36.3%, respectively. Similarly, PFS, ORR, and DCR of 17 patients who received regorafenib after lenvatinib in the third-line (after sorafenib) were 3.8 months (range, 1.1-6.5 months), 17.6%, and 41.2%, respectively. CONCLUSION: Sorafenib may not be a candidate for use as a posttreatment agent after lenvatinib, according to the results of the present study. Regorafenib has the potential to become an appropriate posttreatment agent after lenvatinib.

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  • Large-volume cell-free and concentrated ascites reinfusion therapy improves venous flow in patients with liver cirrhosis. Reviewed International journal

    Matsumoto N, Ogawa M, Kanda T, Matsuoka S, Moriyama M, Matsusaki K.

    J Med Ultrason (2001).   2021.4

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    <h4>Purpose</h4>Hemodynamic change after total paracentesis was investigated because it might lead to various complications. Although cell-free and concentrated ascites reinfusion therapy (CART) is safer and more effective than total paracentesis in theory, hemodynamic change after CART has been never reported. And previous studies did not mention hemodynamics of the venous system.<h4>Methods</h4>We investigated the hemodynamic change, including that of the venous system, before and after CART using color Doppler ultrasonography and fast Fourier transform analysis. Twenty-eight patients with tensive cirrhotic ascites underwent ultrasonography the day before and after total volume CART. The diameter and velocity of the main, right, and left portal vein; inferior vena cava (IVC); and right renal vein were measured using ultrasonography.<h4>Results</h4>A total of 11.8 ± 4.4 L of ascites (range 3.6-20.9 L) was filtered and concentrated to 0.85 ± 0.40 L (range 0.36-1.50 L). The diameter of the IVC increased from median 13.5 ± 5.4 mm (range 4-25 mm) to 18.5 ± 4.1 mm (range 7-29 mm) (p = 0.007). The diameter of the right segmental renal vein significantly increased after KM-CART [from 5.0 ± 1.0 (4-8) mm to 7.0 ± 2.0 (3-10) mm] (p = 0.011). Hemodynamic change of the portal venous system was not significant. The time to the next CART in patients with an IVC diameter ≥ 20 mm and < 20 mm was 86 days and 20.5 days (p = 0.035), respectively.<h4>Conclusion</h4>Tensive ascites results in venous congestion in patients with cirrhotic ascites. CART improved venous flow, but it did not change the hemodynamics of the portal venous system.

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  • Magnetic resonance elastography-based prediction of hepatocellular carcinoma recurrence after curative resection. Reviewed International journal

    Abe H, Midorikawa Y, Higaki T, Yamazaki S, Aramaki O, Nakayama H, Moriguchi M, Kanda T, Moriyama M, Okada M, Nishimaki H, Sugitani M, Tsuji S, Takayama T.

    Surgery   170 ( 1 )   167 - 172   2021.3

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    BACKGROUND: Liver stiffness measurement using magnetic resonance elastography can assess the severity of liver fibrosis, which is significantly associated with recurrence after curative resection for hepatocellular carcinoma. The aim of this prospective study was to investigate whether preoperative liver stiffness measurement by magnetic resonance elastograhy can predict recurrence after curative resection for hepatocellular carcinoma. METHODS: Patients who underwent preoperative liver stiffness measurement and curative resection for hepatocellular carcinoma were enrolled in this study. Potential associations between liver stiffness measurement, along with other clinical and pathologic variables, and intrahepatic hepatocellular carcinoma recurrence were analyzed. RESULTS: In total, 156 patients were included in this study. During a median follow-up period of 25.1 months (range, 6.0-60.5 months), 72 (46.1%) patients with hepatocellular carcinoma had an intrahepatic recurrence. The median disease-free period after resection was 17.9 months (range, 1.0-60.5 months). In the multivariate analysis, liver stiffness measurement (hazard ratio, 1.27; 95% confidence interval, 1.11-1.43; P <.001) and vascular invasion (hazard ratio, 1.96; 95% confidence interval, 1.15-3.25; P = .013) were identified as independent predictors of recurrence. When the optimal cutoff point was set at 4.53 kPa using the minimal P value approach, the disease-free period after curative resection in 71 patients with a liver stiffness measurement value ≥4.53 kPa (11.3 months [range, 2.0-60.5 months]) was significantly shorter than that of 85 patients with a liver stiffness measurement value <4.53 kPa (22.5 months [range, 1.1-60.5 months]; P <.001). CONCLUSION: Liver stiffness measurement using magnetic resonance elastography is a useful preoperative predictor of intrahepatic recurrence after curative resection for hepatocellular carcinoma.

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  • Serum Angiopoietin 2 acts as a diagnostic and prognostic biomarker in hepatocellular carcinoma. Reviewed International journal

    Ao J, Chiba T, Kanzaki H, Kanayama K, Shibata S, Kurosugi A, Iwanaga T, Kan M, Sakuma T, Qiang N, Ma Y, Kojima R, Kusakabe Y, Nakamura M, Kobayashi K, Kiyono S, Kanogawa N, Saito T, Nakagawa R, Kondo T, Ogasawara S, Suzuki E, Nakamoto S, Muroyama R, Tawada A, Kato J, Kanda T, Maruyama H, Kato N.

    J Cancer   12 ( 9 )   2694 - 2701   2021.3

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    Wyoming, N.S.W. : Ivyspring International Publisher, 2010-

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  • The impact of FGF19/FGFR4 signaling inhibition in antitumor activity of multi-kinase inhibitors in hepatocellular carcinoma. Reviewed International journal

    Kanzaki H, Chiba T, Ao J, Koroki K, Kanayama K, Maruta S, Maeda T, Kusakabe Y, Kobayashi K, Kanogawa N, Kiyono S, Nakamura M, Kondo T, Saito T, Nakagawa R, Ogasawara S, Suzuki E, Ooka Y, Muroyama R, Nakamoto S, Yasui S, Tawada A, Arai M, Kanda T, Maruyama H, Mimura N, Kato J, Zen Y, Ohtsuka M, Iwama A, Kato N.

    Scientific Reports   11 ( 1 )   5303 - 5303   2021.3

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    FGF19/FGFR4 autocrine signaling is one of the main targets for multi-kinase inhibitors (MKIs). However, the molecular mechanisms underlying FGF19/FGFR4 signaling in the antitumor effects to MKIs in hepatocellular carcinoma (HCC) remain unclear. In this study, the impact of FGFR4/ERK signaling inhibition on HCC following MKI treatment was analyzed in vitro and in vivo assays. Serum FGF19 in HCC patients treated using MKIs, such as sorafenib (n = 173) and lenvatinib (n = 40), was measured by enzyme-linked immunosorbent assay. Lenvatinib strongly inhibited the phosphorylation of FRS2 and ERK, the downstream signaling molecules of FGFR4, compared with sorafenib and regorafenib. Additional use of a selective FGFR4 inhibitor with sorafenib further suppressed FGFR4/ERK signaling and synergistically inhibited HCC cell growth in culture and xenograft subcutaneous tumors. Although serum FGF19high (n = 68) patients treated using sorafenib exhibited a significantly shorter progression-free survival and overall survival than FGF19low (n = 105) patients, there were no significant differences between FGF19high (n = 21) and FGF19low (n = 19) patients treated using lenvatinib. In conclusion, robust inhibition of FGF19/FGFR4 is of importance for the exertion of antitumor effects of MKIs. Serum FGF19 levels may function as a predictive marker for drug response and survival in HCC patients treated using sorafenib.

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  • X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis. Reviewed International coauthorship International journal

    Asselta R, Paraboschi EM, Gerussi A, Cordell HJ, Mells GF, Sandford RN, Jones DE, Nakamura M, Ueno K, Hitomi Y, Kawashima M, Nishida N, Tokunaga K, Nagasaki M, Tanaka A, Tang R, Li Z, Shi Y, Liu X, Xiong M, Hirschfield G, Siminovitch KA; Canadian-US PBC Consortium; Italian PBC Genetics Study Group; UK-PBC Consortium; Japan PBC-GWAS Consortium, Carbone M, Cardamone G, Duga S, Gershwin ME, Seldin MF, Invernizzi P.

    Gastroenterology   160 ( 7 )   2483 - 2495   2021.3

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    BACKGROUND & AIMS: Genome-wide association studies in primary biliary cholangitis (PBC) have failed to find X chromosome (chrX) variants associated with the disease. Here, we specifically explore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease. METHODS: We performed a chrX-wide association study, including genotype data from 5 genome-wide association studies (from Italy, United Kingdom, Canada, China, and Japan; 5244 case patients and 11,875 control individuals). RESULTS: Single-marker association analyses found approximately 100 loci displaying P < 5 × 10-4, with the most significant being a signal within the OTUD5 gene (rs3027490; P = 4.80 × 10-6; odds ratio [OR], 1.39; 95% confidence interval [CI], 1.028-1.88; Japanese cohort). Although the transethnic meta-analysis evidenced only a suggestive signal (rs2239452, mapping within the PIM2 gene; OR, 1.17; 95% CI, 1.09-1.26; P = 9.93 × 10-8), the population-specific meta-analysis showed a genome-wide significant locus in East Asian individuals pointing to the same region (rs7059064, mapping within the GRIPAP1 gene; P = 6.2 × 10-9; OR, 1.33; 95% CI, 1.21-1.46). Indeed, rs7059064 tags a unique linkage disequilibrium block including 7 genes: TIMM17B, PQBP1, PIM2, SLC35A2, OTUD5, KCND1, and GRIPAP1, as well as a superenhancer (GH0XJ048933 within OTUD5) targeting all these genes. GH0XJ048933 is also predicted to target FOXP3, the main T-regulatory cell lineage specification factor. Consistently, OTUD5 and FOXP3 RNA levels were up-regulated in PBC case patients (1.75- and 1.64-fold, respectively). CONCLUSIONS: This work represents the first comprehensive study, to our knowledge, of the chrX contribution to the genetics of an autoimmune liver disease and shows a novel PBC-related genome-wide significant locus.

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  • Acquisition of mesenchymal-like phenotypes and overproduction of angiogenic factors in lenvatinib-resistant hepatocellular carcinoma cells. Reviewed International journal

    Ao J, Chiba T, Shibata S, Kurosugi A, Qiang N, Ma Y, Kan M, Iwanaga T, Sakuma T, Kanzaki H, Kanayama K, Kojima R, Kusakabe Y, Nakamura M, Saito T, Nakagawa R, Kondo T, Ogasawara S, Suzuki E, Muroyama R, Kato J, Mimura N, Kanda T, Maruyama H, Kato N.

    Biochemical and Biophysical Research Communications   549   171 - 178   2021.3

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    Lenvatinib is one of the first-line drugs for patients with advanced hepatocellular carcinoma (HCC) and widely used around the world. However, the mechanisms underlying resistance to lenvatinib remain unclear. In this study, we conducted characteristic analyses of lenvatinib-resistant HCC cells. Lenvatinib-resistant HCC cell lines were established by exposure to serially escalated doses of lenvatinib over 2 months. The biological characteristics of these cells were examined by in vitro assays. To investigate the cytokine profile of lenvatinib-resistant HCC cells, the supernatant derived from lenvatinib-resistant Huh7 cells was subjected to nitrocellulose membrane-based sandwich immunoassay. Both activation of the MAPK/MEK/ERK signaling pathway and upregulation of epithelial mesenchymal transition markers were observed in lenvatinib-resistant cells. Concordant with these findings, proliferation and invasion abilities were enhanced in these cells compared with control cells. Screening of a cytokine array spotted with 105 different antibodies to human cytokines enabled us to identify 16 upregulated cytokines in lenvatinib-resistant cells. Among them, 3 angiogenic cytokines: vascular endothelial growth factor (VEGF), platelet-derived growth factor-AA (PDGF-AA), and angiogenin, were increased significantly. Conditioned medium from lenvatinib-resistant cells accelerated tube formation of human umbilical vein cells. In conclusion, lenvatinib-resistant HCC cells were characterized by enhanced proliferation and invasion abilities. These findings might contribute to the establishment of new combination therapies with lenvatinib.

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  • Importance of HBsAg recognition by HLA molecules as revealed by responsiveness to different hepatitis B vaccines. Reviewed International journal

    Nishida N, Sugiyama M, Ohashi J, Kawai Y, Khor SS, Nishina S, Yamasaki K, Yazaki H, Okudera K, Tamori A, Eguchi Y, Sakai A, Kakisaka K, Sawai H, Tsuchiura T, Ishikawa M, Hino K, Sumazaki R, Takikawa Y, Kanda T, Yokosuka O, Yatsuhashi H, Tokunaga K, Mizokami M.

    Scientific Reports   11 ( 1 )   3703 - 3703   2021.3

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    Hepatitis B (HB) vaccines (Heptavax-II and Bimmugen) designed based on HBV genotypes A and C are mainly used for vaccination against HB in Japan. To determine whether there are differences in the genetic background associated with vaccine responsiveness, genome-wide association studies were performed on 555 Heptavax-II and 1193 Bimmugen recipients. Further HLA imputation and detailed analysis of the association with HLA genes showed that two haplotypes, DRB1*13:02-DQB1*06:04 and DRB1*04:05-DQB1*04:01, were significantly associated in comparison with high-responders (HBsAb > 100 mIU/mL) for the two HB vaccines. In particular, HLA-DRB1*13:02-DQB1*06:04 haplotype is of great interest in the sense that it could only be detected by direct analysis of the high-responders in vaccination with Heptavax-II or Bimmugen. Compared with healthy controls, DRB1*13:02-DQB1*06:04 was significantly less frequent in high-responders when vaccinated with Heptavax-II, indicating that high antibody titers were less likely to be obtained with Heptavax-II. As Bimmugen and Heptavax-II tended to have high and low vaccine responses to DRB1*13:02, 15 residues were found in the Heptavax-II-derived antigenic peptide predicted to have the most unstable HLA-peptide binding. Further functional analysis of selected hepatitis B patients with HLA haplotypes identified in this study is expected to lead to an understanding of the mechanisms underlying liver disease.

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  • HCV GT1b-patient with alanine aminotransferase elevation and sustained virologic response achieved by grazoprevir/elbasvir discontinuation Reviewed International journal

    Hiroshi Takahashi, Tatsuo Kanda, Naoki Matsumoto, Taku Mizutani, Tomohiro Kaneko, Masayuki Honda, Yoichiro Yamana, Tomotaka Ishii, Mariko Kumagawa, Reina Sasaki, Ryota Masuzaki, Kazushige Nirei, Hiroaki Yamagami, Masahiro Ogawa, Shunichi Matsuoka, Mitsuhiko Moriyama

    Future Virology   16 ( 3 )   161 - 165   2021.3

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    London, UK : Future Medicine Ltd.

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  • Artificial intelligence and machine learning could support drug development for hepatitis A virus internal ribosomal entry sites. Invited Reviewed International journal

    Kanda T, Sasaki R, Masuzaki R, Moriyama M.

    Artif Intell Gastroenterol.   2 ( 1 )   1 - 9   2021.2

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    Pleasanton, CA : Baishideng Publishing Group

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  • Japanese man with HCV genotype 4 infection and cirrhosis who was successfully treated by the combination of glecaprevir and pibrentasvir. Reviewed

    Totsuka M, Honda M, Kanda T, Ishii T, Matsumoto N, Yamana Y, Kaneko T, Mizutani T, Takahashi H, Kumagawa M, Sasaki R, Masuzaki R, Kanezawa S, Nirei K, Yamagami H, Matsuoka S, Ohnishi H, Okamoto H, Moriyama M.

    Intern Medicine   2021.2

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    Tokyo, Japan : Japanese Society of Internal Medicine

    DOI: 10.2169/internalmedicine.6728-20.

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  • Male-dominant hepatitis A outbreak observed among non-HIV-infected persons in the northern part of Tokyo, Japan. Reviewed International journal

    Honda M, Asakura H, Kanda T, Somura Y, Ishii T, Yamana Y, Kaneko T, Mizutani T, Takahashi H, Kumagawa M, Sasaki R, Masuzaki R, Kanezawa S, Nirei K, Yamagami H, Matsumoto N, Nagashima M, Chiba T, Moriyama M.

    Viruses   13 ( 2 )   207   2021.1

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    Basel, Switzerland : MDPI

    DOI: 10.3390/v13020207

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  • Clinical-Radiomic Analysis for Pretreatment Prediction of Objective Response to First Transarterial Chemoembolization in Hepatocellular Carcinoma. Reviewed International coauthorship International journal

    Chen M, Cao J, Hu J, Topatana W, Li S, Juengpanich S, Lin J, Tong C, Shen J, Zhang B, Wu J, Pocha C, Kudo M, Amedei A, Trevisani F, Sung P.S, Zaydfudim V.M, Kanda T, Cai X, AME Hepatocellular Carcinoma Collaborative Group.

    Liver Cancer   10 ( 1 )   38 - 51   2021.1

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    Basel : S. Karger

    DOI: 10.1159/000512028

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  • 根治的アブレーション治療後に異時性に孤立性肺転移および骨転移を来した肝細胞癌の1例 Reviewed

    佐久間 崇文, 千葉 哲博, 鈴木 英一郎, 大岡 美彦, 神崎 洋彰, 金山 健剛, 丸田 享, 興梠 慧輔, 叶川 直哉, 小林 和史, 清野 宗一郎, 中村 昌人, 近藤 孝行, 齊藤 明子, 日下部 裕子, 小笠原 定久, 中本 晋吾, 太和田 暁之, 加藤 順, 神田 達郎, 丸山 紀史, 吉野 一郎, 岸本 充, 加藤 直也

    肝臓   62 ( 1 )   25 - 32   2021.1

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    症例は87歳男性。X年に肝S5の約20mm大の単発の肝細胞癌(Hepatocellular carcinoma:以下HCC)に対してラジオ波焼灼療法を施行した。術後6ヵ月の時点で再発がないことを確認し、インターフェロンフリー治療を行い、C型肝炎ウイルスを駆除した。X+2年に腫瘍マーカーの上昇を伴って右肺下葉に結節影が見つかった。肝内病変の再発はなかったことから、肺部分切除を行った結果HCCの肺転移の診断に至った。X+5年に、肺転移巣切除後に正常化していた腫瘍マーカーが再上昇し、第6胸椎に転移性骨腫瘍が見つかった。速やかに放射線照射を行うとともに経口マルチキナーゼ阻害剤による全身化学療法を開始した。昨今の抗ウイルス療法やHCCの治療法の進歩に伴い、しばしば肝内病変を伴わない遠隔転移のみの再発症例に遭遇することがある。治療経過や患者の病態を考慮した上で、適切な治療選択を行うことが予後延長に重要であると考えられた。(著者抄録)

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    Other Link: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00263&link_issn=&doc_id=20210119050004&doc_link_id=10.2957%2Fkanzo.62.25&url=https%3A%2F%2Fdoi.org%2F10.2957%2Fkanzo.62.25&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • The delay of tolvaptan-induced liver injury in an autosomal dominant polycystic kidney disease (ADPKD) patient: A case report

    Reina Sasaki, Tatsuo Kanda, Masayuki Honda, Hiroshi Takahashi, Tomohiro Kaneko, Yoichiro Yamana, Mariko Kumagawa, Tomotaka Ishii, Taku Mizutani, Ryota Masuzaki, Kazushige Nirei, Hiroaki Yamagami, Naoki Matsumoto, Mitsuhiko Moriyama

    Acta Hepatologica Japonica   62 ( 2 )   72 - 79   2021

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    Case presentation: Tolvaptan has been administrated in a 61-year-old man with autosomal dominant polycystic kidney disease (ADPKD) for 11 weeks before the detection of liver dysfunction. At four weeks after the discontinuation of tolvaptan therapy, his liver dysfunction temporarily worsened. Abdominal imaging showed no sign of liver cirrhosis and biliary tract diseases. He received ursodeoxycholic acid (UDCA) with the discontinuation of the previous medication. His transaminase levels improved to levels within the normal range four months after the discontinuation of tolvaptan therapy. He was diagnosed with drug-induced liver injury associated with tolvaptan, based on the liver biopsy findings. Our case suggests that it is highly important to carefully monitor liver function in order to recognize early hepatic side effects in ADPKD patients under tolvaptan therapy. We also need to recognize the long-term effect of tolvaptan-induced liver disease after the discontinuation of tolvaptan therapy.

    DOI: 10.2957/kanzo.62.72

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  • A case of takotsubo cardiomyopathy after microwave ablation therapy for hepatocellular carcinoma

    Terunao Iwanaga, Tetsuhiro Chiba, Akane Kurosugi, Hidemi Unozawa, Takafumi Sakuma, Naoto Fujita, Kengo Kanayama, Hiroaki Kanzaki, Keisuke Koroki, Kazufumi Kobayashi, Soichiro Kiyono, Ryo Nakagawa, Naoya Kanogawa, Masato Nakamura, Takayuki Kondo, Tomoko Saito, Yuko Kusakabe, Sadahisa Ogasawara, Eiichiro Suzuki, Shingo Nakamoto, Akinobu Tawada, Ryosuke Muroyama, Jun Kato, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato

    Acta Hepatologica Japonica   62 ( 9 )   548 - 554   2021

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    A 78-year-old female patient underwent microwave ablation (MWA) for recurrent hepatocellular carcinoma (HCC) on segment 7 of the liver. On the day after treatment, contrast-enhanced computed tomography demonstrated a sufficient ablative area. On the second postoperative day, the patient complained of chest discomfort and shortness of breath on exertion, accompanied by a negative T wave in V1-4 on electrocardiography and an increase in serum myocardial troponin I. Coronary angiography and left ventriculography suggested Takotsubo cardiomyopathy, but not acute coronary syndrome. The patient’s symptoms gradually resolved in response to medication, and the patient was discharged 10 days after MWA. Although the pathogenesis of Takotsubo cardiomyopathy is unclear, excessive physical stress, such as surgical procedures, is associated with its development. Takotsubo cardiomyopathy should be considered a complication related to MWA for relatively large HCCs.

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  • トルバプタン投与により遷延する肝機能障害をきたした1例 Reviewed

    佐々木玲奈, 神田達郎, 本田真之, 高橋央, 金子朋弘, 山名陽一郎, 熊川まり子, 石井大雄, 水谷卓, 増崎亮太, 楡井和重, 山上裕晃, 松本直樹, 森山光彦

    肝臓   62 ( 2 )   72 - 79   2021

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  • Evolution of Survival Impact of Molecular Target Agents in Patients with Advanced Hepatocellular Carcinoma. Reviewed International journal

    Kobayashi K, Ogasawara S, Takahashi A, Seko Y, Unozawa H, Sato R, Watanabe S, Moriguchi M, Norimoto N, Tsuchiya S, Iwai K, Inoue M, Ogawa K, Ishino T, Iwanaga T, Sakuma T, Fujita N, Kanzaki H, Koroki K, Nakamura M, Kanogawa N, Kiyono S, Kondo T, Saito T, Nakagawa R, Suzuki E, Ooka Y, Nakamoto S, Tawada A, Chiba T, Arai M, Kanda T, Maruyama H, Nagashima K, Kato J, Isoda N, Aramaki T, Itoh Y, Kato N.

    Liver Cancer   11 ( 1 )   48 - 60   2021

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    &lt;b&gt;&lt;i&gt;Background and Aims:&lt;/i&gt;&lt;/b&gt; The prognosis of patients with advanced hepatocellular carcinoma (HCC) is expected to improve as multiple molecular target agents (MTAs) are now available. However, the impact of the availability of sequential MTAs has not been fully verified yet. &lt;b&gt;&lt;i&gt;Approach and Results:&lt;/i&gt;&lt;/b&gt; We retrospectively collected the data on the whole clinical course of 877 patients who received any MTAs as first-line systemic therapy for advanced HCC between June 2009 and March 2019. The study population was divided into 3 groups according to the date of first-line MTA administration (period 1: 2009–2012, &lt;i&gt;n&lt;/i&gt; = 267; period 2: 2013–2016, &lt;i&gt;n&lt;/i&gt; = 352; period 3: 2017–2019, &lt;i&gt;n&lt;/i&gt; = 258). Then, we compared the number of MTAs used, overall survival (OS), and MTA treatment duration among the 3 groups. Analysis was also performed separately for advanced-stage and nonadvanced-stage HCC. The proportion of patients who received multiple MTAs was remarkably increased over time (1.1%, 10.2%, and 42.6% in periods 1, 2, and 3, respectively, &lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.001). The median OS times were prolonged to 10.4, 11.3, and 15.2 months in periods 1, 2, and 3, respectively (&lt;i&gt;p&lt;/i&gt; = 0.016). Similarly, the MTA treatment durations were extended (2.7, 3.2, and 6.6 months in periods 1, 2, and 3, respectively; &lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.001). We confirmed that the correlation between OS and MTA treatment duration was strengthened (period 1: 0.395, period 2: 0.505, and period 3: 0.667). All these trends were pronounced in the patients with advanced-stage HCC but limited in the patients with nonadvanced-stage HCC. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; The availability of multiple MTAs had steadily improved the prognosis of patients with advanced HCC patients, particularly advanced-stage HCC patients.

    DOI: 10.1159/000519868

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  • 血行異常. Budd-Chiari症候群. Invited

    神田達郎, 増﨑亮太, 佐々木玲奈, 楡井和重, 森山光彦.

    別冊日本臨床 領域別症候群シリーズ No.13 肝・胆道系症候群 (第3版) I 肝臓編(上)   270 - 271   2021

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  • Propofol versus midazolam for sedation during radiofrequency ablation in patients with hepatocellular carcinoma. Reviewed International journal

    Kanogawa N, Ogasawara S, Ooka Y, Inoue M, Wakamatsu T, Yokoyama M, Maruta S, Unozawa H, Iwanaga T, Sakuma T, Fujita N, Koroki K, Kanzaki H, Maeda T, Kobayashi K, Kiyono S, Nakamura M, Kondo T, Saito T, Motoyama T, Suzuki E, Nakamoto S, Tawada A, Chiba T, Arai M, Kanda T, Maruyama H, Kato J, Takemura R, Nozaki-Taguchi N, Shiroh I, Yokosuka O, Kato N.

    JGH Open.   5 ( 2 )   273 - 279   2020.12

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    [Richmond, Victoria, Australia] : John Wiley & Sons Australia, Ltd.

    DOI: 10.1002/jgh3.12483

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  • Additive Effects of Zinc Chloride on the Suppression of Hepatitis A Virus Replication by Interferon in Human Hepatoma Huh7 Cells. Reviewed International journal

    Kanda T, Sasaki R, Masuzaki R, Takahashi H, Fujisawa M, Matsumoto N, Okamoto H, Moriyama M.

    In Vivo.   34 ( 6 )   3301 - 3308   2020.11

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    Athens : Dr. J.G. Delinassios

    DOI: 10.21873/invivo.12168

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  • Association of Genetic Polymorphisms With Hepatitis C Virus-related Liver Cirrhosis in Japan. Reviewed International journal

    Kamimura S, Tamura A, Ishii T, Kanda T, Moriyama M.

    In Vivo.   34 ( 6 )   3309 - 3313   2020.11

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    Athens : Dr. J.G. Delinassios

    DOI: 10.21873/invivo.12169

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  • Quantitative Ultrasound Image Analysis Helps in the Differentiation of Hepatocellular Carcinoma (HCC) From Borderline Lesions and Predicting the Histologic Grade of HCC and Microvascular Invasion. Reviewed

    Naoki Matsumoto, Ogawa M, Kaneko M, Kumagawa M, Yukinobu Watanabe, Hirayama M, Nakagawara H, Masuzaki R, Kanda T, Moriyama M, Takayama T, Sugitani M

    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine   2020.8

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    OBJECTIVES:Quantitative image analysis is one of the methods to overcome the lack of objectivity of ultrasound (US). The aim of this study was to clarify the correlation between the features from a US image analysis and the histologic grade and microvascular invasion (MVI) of hepatocellular carcinoma (HCC) and differentiation of HCC smaller than 2 cm from borderline lesions. METHODS:We retrospectively analyzed grayscale US images with histopathologic evidence of HCC or a precancerous lesion using ImageJ version 1.47 software (National Institutes of Health, Bethesda, MD). RESULTS:A total of 148 nodules were included (borderline lesion, n = 31; early HCC [eHCC], n = 3; well-differentiated HCC [wHCC], n = 16; moderately differentiated HCC [mHCC], n = 79; and poorly differentiated HCC [pHCC], n = 19). A multivariate analysis selected lower minimum gray values (odds ratio [OR], 0.431; P = .003) and a higher standard deviation (OR, 1.880; P = .019) as predictors of HCC smaller than 2 cm. Median (range) minimum gray values of borderline lesions, eHCC, wHCC, mHCC, and pHCC were 29 (0-103), 7 (0-47), 6 (0-60), 10 (0-53), and 2 (0-38), respectively, and gradually decreased from borderline lesions to pHCC (P < 0.001). The multivariate analysis showed a higher aspect ratio (OR, 2.170; P = .001) and lower minimum gray value (OR, 0.475; P = .043) as predictors of MVI. An anechoic area diagnosed by a subjective evaluation was correlated with the minimum gray value (P < .0001). The proportion of the anechoic area gradually increased from eHCC to pHCC (P = .031). CONCLUSIONS:In a US image analysis, HCC smaller than 2 cm had features of greater heterogeneity and a lower minimum gray value than borderline lesions. Moderately differentiated HCC was smoother than borderline lesions, and the anechoic area correlated with histologic grading. Microvascular invasion was correlated with a slender shape and a lower minimum gray value.

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  • Involvement of the Interferon Signaling Pathways in Pancreatic Cancer Cells. Reviewed International journal

    Fujisawa M, Kanda T, Shidata T, Sasaki R, Masuzaki R, Matsumoto N, Nirei K, Imazu H, Kuroda K, Sugitani M, Takayama T, Moriyama M.

    Anticancer Res.   40 ( 8 )   4445 - 4455   2020.8

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    Attiki, Greece : International Institute of Anticancer Research

    DOI: 10.21873/anticanres.14449

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  • Application of artificial intelligence in hepatology: Minireview Invited Reviewed International journal

    Tatsuo Kanda

    Artificial Intelligence in Gastroenterology   1 ( 1 )   5 - 11   2020.7

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Pleasanton, CA : Baishideng Publishing Group  

    Pleasanton, CA : Baishideng Publishing Group

    DOI: 10.35712/aig.v1.i1.5

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  • High platelet count as a poor prognostic factor for liver cancer patients without cirrhosis. Reviewed

    Midorikawa Y, Takayama T, Higaki T, Aramaki O, Teramoto K, Yoshida N, Tsuji S, Kanda T, Moriyama M

    Bioscience trends   2020.7

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Tokyo : International Research and Cooperation Association for Bio & Socio-Sciences Advancement  

    Tokyo : International Research and Cooperation Association for Bio & Socio-Sciences Advancement

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  • Analyses of Intermediate-Stage Hepatocellular Carcinoma Patients Receiving Transarterial Chemoembolization prior to Designing Clinical Trials Reviewed International journal

    Koroki K, Ogasawara S, Ooka Y, Kanzaki H, Kanayama K, Maruta S, Maeda T, Yokoyama M, Wakamatsu T, Inoue M, Kobayashi K, Kiyono S, Nakamura M, Kanogawa N, Saito T, Kondo T, Suzuki E, Nakamoto S, Yasui S, Tawada A, Chiba T, Arai M, Kanda T, Maruyama H, Kato J, Kuboki S, Ohtsuka M, Miyazaki M, Yokosuka O, Kato N.

    Liver Cancer   9 ( 5 )   596 - 612   2020.7

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    Basel : S. Karger

    DOI: 10.1159/000508809.

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  • Pilot study of tenofovir disoproxil fumarate and pegylated interferon-alpha 2a add-on therapy in Japanese patients with chronic hepatitis B. Reviewed

    Akihiro Matsumoto, Shuhei Nishiguchi, Hirayuki Enomoto, Yasuhito Tanaka, Noboru Shinkai, Chiaki Okuse, Jong-Hon Kang, Takeshi Matsui, Shiho Miyase, Hiroshi Yatsuhashi, Shinya Nagaoka, Tatsuo Kanda, Masaru Enomoto, Ryoko Yamada, Naoki Hiramatsu, Satoru Saito, Koichi Takaguchi, Kiyoaki Ito, Tsutomu Masaki, Daisuke Morihara, Masataka Tsuge, Kazuaki Chayama, Fusao Ikeda, Tatehiro Kagawa, Yasuteru Kondo, Kazumoto Murata, Eiji Tanaka

    Journal of gastroenterology   55 ( 10 )   977 - 989   2020.7

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    BACKGROUND: A prospective pilot study of tenofovir disoproxil fumarate (TDF) and pegylated interferon alpha 2a (P-IFN) add-on therapy was conducted to evaluate its efficacy in reducing viral antigen levels in Japanese patients with chronic hepatitis B (UMIN 000020179). METHODS: Patients with chronic hepatitis B receiving maintenance TDF therapy and exhibiting hepatitis B surface antigen (HBsAg) level > 800 IU/ml were divided into two arms. P-IFN was added for 48 weeks in the add-on arm (n = 32), while TDF monotherapy was maintained in the control arm (n = 51). Both groups were followed for 96 weeks after baseline measurements. RESULTS: Almost all patients in the control arm displayed a slow and constant reduction in HBsAg during follow-up. In contrast, roughly half of the add-on arm exhibited a sharp decline in HBsAg during P-IFN administration, which disappeared after halting P-IFN. At 96 weeks after baseline, 41% (13/32) of patients in the add-on arm had shown a rapid decrease in HBsAg, versus 2% (1/51) in the control arm (p < 0.001). Add-on therapy and increased cytotoxic T-cell response were significant factors associated with a rapid decrease in HBsAg according to multivariate analysis. In addition, higher HB core-related antigen (HBcrAg) level at baseline (p = 0.001) and add-on therapy (p = 0.036) were significant factors associated with a rapid reduction in HBcrAg. CONCLUSIONS: TDF and P-IFN add-on therapy in Japanese patients with chronic hepatitis B facilitated rapid decreases in HBsAg and HBcrAg. Further studies are needed to improve early HBsAg clearance rate.

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  • Noninvasive Assessment of Liver Fibrosis: Current and Future Clinical and Molecular Perspectives. Reviewed International coauthorship International journal

    Masuzaki R, Kanda T, Sasaki R, Matsumoto N, Ogawa M, Matsuoka S, Karp SJ, Moriyama M.

    Int J Mol Sci.   21 ( 14 )   E4906   2020.7

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    Basel, Switzerland : MDPI

    DOI: 10.3390/ijms21144906

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  • Analysis of full-length hepatitis B virus genome from chronic hepatitis B-patients with higher alanine aminotransferase elevation Reviewed International journal

    Hiroshi Takahashi, Tatsuo Kanda, Naoki Matsumoto, Toshikatsu Shibata, Kazushige Nirei, Akinori Tamura, Shunichi Matsuoka, Kazumichi Kuroda, Mitsuhiko Moriyama

    Future Virology   15 ( 7 )   429 - 439   2020.7

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Future Medicine Ltd  

    London, UK : Future Medicine Ltd.

    DOI: 10.2217/fvl-2020-0104

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  • Analysis of HBV Genomes Integrated into the Genomes of Human Hepatoma PLC/PRF/5 Cells by HBV Sequence Capture-Based Next-Generation Sequencing. Reviewed International journal

    Tomotaka Ishii, Akinori Tamura, Toshikatsu Shibata, Kazumichi Kuroda, Tatsuo Kanda, Masaya Sugiyama, Masashi Mizokami, Mitsuhiko Moriyama

    Genes   11 ( 6 )   2020.6

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    Hepatitis B virus (HBV) infection is a leading cause of hepatocellular carcinoma (HCC) worldwide. The integration of HBV genomic DNA into the host genome occurs randomly, early after infection, and is associated with hepatocarcinogenesis in HBV-infected patients. Therefore, it is important to analyze HBV genome integration. We analyzed HBV genome integration in human hepatoma PLC/PRF/5 cells by HBV sequence capture-based next-generation sequencing (NGS) methods. We confirmed the results by using Sanger sequencing methods. We observed that HBV genotype A is integrated into the genome of PLC/PRF/5 cells. HBV sequence capture-based NGS is useful for the analysis of HBV genome integrants and their locations in the human genome. Among the HBV genome integrants, we performed functional analysis and demonstrated the automatic expression of some HBV proteins encoded by HBV integrants from chromosomes 3 and 11 in Huh7 cells transfected with these DNA sequences. HBV sequence capture-based NGS may be a useful tool for the assessment of HBV genome integration into the human genome in clinical samples and suggests new strategies for hepatocarcinogenesis in HBV infection.

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  • Clinical practice guidance for hepatology and liver transplant providers during the COVID-19 pandemic: APASL expert panel consensus recommendations. Invited Reviewed International coauthorship International journal

    Tatsuo Kanda

    Hepatology International   14 ( 4 )   415 - 428   2020.5

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    BACKGROUND:Confronting a once-in-a-century pandemic with COVID-19, tremendous stress has been placed in all walks of life worldwide. AIMS:In order to enhance scientific information interflow in the arena of liver diseases in Asia-Pacific region during this difficult time, Asian-Pacific Association for the Study of the Liver (APASL) has taken the initiative to form the APASL COVID-19 Taskforce to formulate a clinical practice guidance in Hepatology, liver-related oncology, transplantation and conduct of clinical trials. METHODS:A taskforce with 22 key opinion leaders in Hepatology from 16 countries or administration regions in Asia-Pacific regions was formed and through intense interaction via webinar, this guidance was formulated. Based on scientific data and experiences, recommendations were made in the management of liver injury, liver transplantation, autoimmune diseases, chronic liver diseases, delivery of elective and emergency services and conduct of clinical trials. CONCLUSIONS:This is the first consensus clinical guidance synthesized by APASL for our hepatologist and their allied medical personal.

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  • Cell Culture Systems and Drug Targets for Hepatitis A Virus Infection. Reviewed

    Kanda T, Sasaki R, Masuzaki R, Matsumoto N, Ogawa M, Moriyama M.

    Viruses   12 ( 5 )   E533   2020.5

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Basel, Switzerland : MDPI  

    Basel, Switzerland : MDPI

    DOI: 10.3390/v12050533

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  • Different Mechanisms of Action of Regorafenib and Lenvatinib on Toll-Like Receptor-Signaling Pathways in Human Hepatoma Cell Lines. Reviewed International journal

    Sasaki R, Kanda T, Fujisawa M, Matsumoto N, Masuzaki R, Ogawa M, Matsuoka S, Kuroda K, Moriyama M.

    International Journal of Molecular Sciences   21 ( 9 )   3349   2020.5

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    Basel, Switzerland : MDPI

    DOI: 10.3390/ijms21093349

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  • Molecular Mechanisms: Connections between Nonalcoholic Fatty Liver Disease, Steatohepatitis and Hepatocellular Carcinoma. Reviewed International journal

    Tatsuo Kanda, Taichiro Goto, Yosuke Hirotsu, Ryota Masuzaki, Mitsuhiko Moriyama, Masao Omata

    International journal of molecular sciences   21 ( 4 )   2020.2

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    Nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH), causes hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The patatin-like phospholipase-3 (PNPLA3) I148M sequence variant is one of the strongest genetic determinants of NAFLD/NASH. PNPLA3 is an independent risk factor for HCC among patients with NASH. The obesity epidemic is closely associated with the rising prevalence and severity of NAFLD/NASH. Furthermore, metabolic syndrome exacerbates the course of NAFLD/NASH. These factors are able to induce apoptosis and activate immune and inflammatory pathways, resulting in the development of hepatic fibrosis and NASH, leading to progression toward HCC. Small intestinal bacterial overgrowth (SIBO), destruction of the intestinal mucosa barrier function and a high-fat diet all seem to exacerbate the development of hepatic fibrosis and NASH, leading to HCC in patients with NAFLD/NASH. Thus, the intestinal microbiota may play a role in the development of NAFLD/NASH. In this review, we describe recent advances in our knowledge of the molecular mechanisms contributing to the development of hepatic fibrosis and HCC in patients with NAFLD/NASH.

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  • Hy’s Lawとは. 肝疾患 vs. 薬物療法. 第6章 緊急性の高い肝障害 Invited

    神田達郎, 森山光彦

    月刊薬事   62 ( 2 )   220 - 222   2020.1

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  • Successful Invasive Treatments by Repeated Administration of Lusutrombopag for Hepatocellular Carcinoma Patients with Severe Thrombocytopenia A Report of Two Cases

    Miyuki Iwasaki, Eiichiro Suzuki, Tetsuhiro Chiba, Yoshihiko Ooka, Sadahisa Ogasawara, Takayuki Kondo, Masato Nakamura, Naoya Kanogawa, Susumu Maruta, Keisuke Koroki, Kazufumi Kobayashi, Souichiro Kiyono, Kengo Kanayama, Hiroaki Kanzaki, Tomoko Saito, Akinobu Tawada, Makoto Arai, Hitoshi Maruyama, Tatsuo Kanda, Jun Kato, Naoya Kato

    Therapeutic Research   41 ( 1 )   49 - 53   2020

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    Lusutrombopag has been covered by national health insurance in Japan, and now has been widely available for severe thrombocytopenia in the chronic liver disease patients. We experienced two cases of repeated treatment using lusutrombopag. Both of two patients had hepatocellular carcinoma with severe thrombocytopenia, and received repeated invasive treatments such as radiofrequency ablation and transcatheter arterial chemoembolization successfully, without severe bleeding, thrombosis or any serious adverse events. Repetitive administration of lusutrombopag was efficient and safe.

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  • Long-term administration of Tolvaptan to patients with decompensated cirrhosis. Reviewed International journal

    Kengo Kanayama, Tetsuhiro Chiba, Kazufumi Kobayashi, Keisuke Koroki, Susumu Maruta, Hiroaki Kanzaki, Yuko Kusakabe, Tomoko Saito, Soichiro Kiyono, Masato Nakamura, Sadahisa Ogasawara, Eiichiro Suzuki, Yoshihiko Ooka, Shingo Nakamoto, Shin Yasui, Tatsuo Kanda, Hitoshi Maruyama, Jun Kato, Naoya Kato

    International journal of medical sciences   17 ( 7 )   874 - 880   2020

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    Aim: Tolvaptan, an oral vasopressin-2 antagonist, sometimes improves hepatic edema including ascites in patients with decompensated cirrhosis. In this study, we examined the effectiveness and survival advantage in patients with the long-term administration of tolvaptan. Methods: A total of 115 patients with refractory ascites who were treated with tolvaptan were retrospectively analyzed based on their clinical records. Patients with a decrease in body weight of ≥1.5 kg from the baseline on day 7 were determined as responders. Re-exacerbation was defined as a return to the baseline BW, dose escalation of conventional diuretics, or abdominal drainage. Results: Of the 115 patients, 84 were included in this analysis. Response to tolvaptan treatment was observed in 55 out of the 84 patients (65.5%), with a mean weight reduction of 2.52 kg. Multivariate analyses demonstrated that body mass index (≥24) and urinary specific gravity (≥1.018) were significant predictors of the response to tolvaptan. However, cumulative re-exacerbation rates in responders at 6 and 12 months were 42.4 and 60.1%, respectively. Child-Pugh (classification C), HCC complication, and serum sodium levels (≥133 mEq/L) were determined as independent prognostic factors impacting overall survival (OS). Although there were no significant differences in OS between tolvaptan responders and non-responders, the responders without re-exacerbation within 3 months showed significantly longer OS than those with re-exacerbation within 3 months. Conclusion: A persistent therapeutic response, but not early response to tolvaptan, was associated with favorable survival of decompensated cirrhotic patients.

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  • 3. ワクチン各論. 17) A型肝炎. Invited

    神田達郎

    小児科臨床   73 ( 12 )   1806 - 1810   2020

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  • A型肝炎. Invited

    神田達郎, 本田真之, 森山光彦.

    診断と治療   108 ( 2 )   243 - 245   2020

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  • Co-Occurrence of Hepatitis A Infection and Chronic Liver Disease. Reviewed International journal

    Kanda T, Sasaki R, Masuzaki R, Takahashi H, Mizutani T, Matsumoto N, Nirei K, Moriyama M.

    Int J Mol Sci.   21 ( 17 )   E6384   2020

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    Hepatitis A virus (HAV) infection occasionally leads to a critical condition in patients with or without chronic liver diseases. Acute-on-chronic liver disease includes acute-on-chronic liver failure (ACLF) and non-ACLF. In this review, we searched the literature concerning the association between HAV infection and chronic liver diseases in PubMed. Chronic liver diseases, such as metabolic associated fatty liver disease and alcoholic liver disease, coinfection with other viruses, and host genetic factors may be associated with severe hepatitis A. It is important to understand these conditions and mechanisms. There may be no etiological correlation between liver failure and HAV infection, but there is an association between the level of chronic liver damage and the severity of acute-on-chronic liver disease. While the application of an HAV vaccination is important for preventing HAV infection, the development of antivirals against HAV may be important for preventing the development of ACLF with HAV infection as an acute insult. The latter is all the more urgent given that the lives of patients with HAV infection and a chronic liver disease of another etiology may be at immediate risk.

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  • Potential of Lenvatinib for an Expanded Indication from the REFLECT Trial in Patients with Advanced Hepatocellular Carcinoma. Reviewed International journal

    Maruta S, Ogasawara S, Ooka Y, Obu M, Inoue M, Itokawa N, Haga Y, Seki A, Okabe S, Azemoto R, Itobayashi E, Atsukawa M, Sugiura N, Mizumoto H, Koroki K, Kanayama K, Kanzaki H, Kobayashi K, Kiyono S, Nakamura M, Kanogawa N, Saito T, Kondo T, Suzuki E, Nakamoto S, Tawada A, Chiba T, Arai M, Kanda T, Maruyama H, Kato N.

    Liver Cancer   9 ( 8 )   382 - 396   2020

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    Basel : S. Karger

    DOI: 10.1159/000507022

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  • ニボルマブ投与後に急性増悪したC 型慢性肝炎の1 例 Reviewed

    高橋幸治, 神田達郎, 中村昌人, 安井伸, 新井誠人, 加藤直也

    肝臓   60 ( 12 )   459 - 465   2019.12

  • Serum fibroblast growth factor 19 serves as a potential novel biomarker for hepatocellular carcinoma. Reviewed International journal

    Maeda T, Kanzaki H, Chiba T, Ao J, Kanayama K, Maruta S, Kusakabe Y, Saito T, Kobayashi K, Kiyono S, Nakamura M, Ogasawara S, Suzuki E, Ooka Y, Nakamoto S, Nakagawa R, Muroyama R, Kanda T, Maruyama H, Kato N.

    BMC Cancer.   19 ( 1 )   1088 - 1088   2019.11

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    BACKGROUND: Abnormal autocrine fibroblast growth factor 19 (FGF19) production has been observed in several types of cancers, including hepatocellular carcinoma (HCC). In this study, we investigated the potential of serum FGF19 as a novel tumor marker of HCC based on a sandwich enzyme-linked immunosorbent assay (ELISA). METHODS: The serum FGF19 levels of 304 patients with HCC was measured by ELISA. The serum levels of existing markers, including alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) were determined by chemiluminescence enzyme immunoassay. Both diagnostic value of FGF19 and its changes after curative ablation therapy was further examined. RESULTS: The median FGF19 levels in controls, chronic liver disease patients, and primary HCC patients, were 78.8 pg/mL, 100.1 pg/mL, and 214.5 pg/mL, respectively. The subsequent receiver operating characteristic curves (ROC) successfully determined an optimal cut-off value of 200.0 pg/mL. The area under the ROC curve (AUC) of FGF19 for HCC detection was comparable to those of AFP and DCP. Of importance, FGF19 showed higher sensitivity for the detection of small HCC (solitary cancer with diameter < 20 mm) than those of existing markers. In addition, 43 out of 79 cases (54.4%) with normal AFP and DCP (so-called "double negative HCC") exhibited serum FGF19 level ≥ 200 pg/mL. In 45 HCC patients treated with curative ablation therapy, serum FGF19 levels changed from 257.4 pg/mL to 112.0 pg/mL after the treatment. CONCLUSION: Our findings reveal that FGF19 can be a potential novel biomarker for HCC. Although FGF19 is not necessarily a substitute for existing markers, it may help improve the prognosis in HCC patients owing to its resourceful use in various aspects of HCC management and treatment.

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  • APASL HCV guidelines of virus-eradicated patients by DAA on how to monitor HCC occurrence and HBV reactivation Reviewed International coauthorship International journal

    Kanda T, Lau GKK, Wei L, Moriyama M, Ming-Lung Yu, Chuang WL, Ibrahim A, Lesmana CRA, Sollano J, Kumar M, Jindal A, Sharma BC, Hamid SS, Kadir Dokmeci A, Mamun-Al-Mahtab, GEOFFREY MCCAUGHAN, Wasim J, Darrell Crawford, JIA-HORNG KAO, Ooka Y, Yokosuka O, Sarin SK, Omata M

    Hepatology International   2019.11

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    New York, NY : Springer

    DOI: 10.1007/s12072-019-09988-7

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  • Long-term follow-up of a Japanese patient with hepatitis B virus genotype H and human immunodeficiency virus coinfection

    Masahiro Ogawa, Shinya Kamimura, Tatsuo Kanda, Hiroshi Takahashi, Taku Mizutani, Naoki Matsumoto, Toshiki Yamamoto, Kazushige Nirei, Shunichi Matsuoka, Masami Takei, Mitsuhiko Moriyama

    Future Virology   14 ( 10 )   633 - 639   2019.10

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  • Successful Management of a Patient with Multiple Nucleos(t)ide Analogue-Resistant Hepatitis B Virus and Diffuse Large B Cell Lymphoma Using Tenofovir Disoproxil Fumarate: A Case Report Reviewed

    Tatsuo Kanda

    Journal of Nihon University Medical Association   78 ( 5 )   295 - 300   2019.10

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  • Long-term follow-up of a Japanese patient with hepatitis B virus genotype H and human immunodeficiency virus coinfection

    Masahiro Ogawa, Shinya Kamimura, Given Names Deactivated Family Name Deactivated, Hiroshi Takahashi, Taku Mizutani, Naoki Matsumoto, Toshiki Yamamoto, Kazushige Nirei, Shunichi Matsuoka, Masami Takei, Mitsuhiko Moriyama

    Future Virology   2019.10

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    <jats:p> Hepatitis B virus (HBV) genotypes affect the pathogenesis of disease progression during the course of HBV infection. In Japan, HBV genotype H is one of the rare HBV genotypes. We recovered HBV genotype H from a blood sample from a Japanese HIV-infected patient with acute exacerbation of chronic HBV infection. Due to the development of drugs for treating HBV and HIV, HBV genotype H and HIV coinfection has been well controlled by nucleos(t)ide analogs and highly active antiretroviral therapy, respectively, from 2002 to 2019. Further study is needed with regard to HBV genotype H and its pathogenesis. </jats:p>

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  • Prognostic four-gene signature for overall survival in patients with hepatocellular carcinoma Invited Reviewed International journal

    Tatsuo Kanda, Osamu Yokosuka, Mitsuhiko Moriyama

    Hepatology International   13 ( 5 )   519 - 520   2019.9

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    New York, NY : Springer

    DOI: 10.1007/s12072-019-09976-x

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  • Prior hepatitis B virus infection as a co-factor of chronic hepatitis C patient survival after resection of hepatocellular carcinoma. Reviewed International journal

    Midorikawa Y, Takayama T, Nakayama H, Higaki T, Moriguchi M, Moriya K, Kanda T, Matsuoka S, Moriyama M

    BMC gastroenterology   19 ( 1 )   147   2019.8

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    London : BioMed Central

    DOI: 10.1186/s12876-019-1069-y

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  • Are direct-acting antivirals against hepatitis C virus infection not associated with the recurrence of hepatocellular carcinoma? Invited Reviewed International journal

    Ogawa M, Kanda T, Moriyama M

    Hepatobiliary surgery and nutrition   8 ( 4 )   423 - 425   2019.8

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    Hong Kong : AME Publishing Company

    DOI: 10.21037/hbsn.2019.03.19

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  • Follow-up Results of HCV GT2 Patients after Sofosbuvir/Ribavirin Therapy: Careful Attention to Occurrence of HCC. Reviewed International journal

    Kaneko T, Kanda T, Nirei K, Matsumoto N, Yamazaki M, Shibata T, Tamura A, Ogawa M, Nakajima N, Matsuoka S, Kuroda K, Komoriya T, Yamamoto T, Takayama T, Moriyama M.

    Anticancer Res.   39 ( 7 )   3855 - 3862   2019.7

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    Athens, Greece : Hellenic Anticancer Institute

    DOI: 10.21873/anticanres.13535

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  • Antiviral activity of zinc sulfate against hepatitis A virus replication Reviewed International journal

    Masahiro Ogawa, Tatsuo Kanda, Akiko Suganami, Shingo Nakamoto, Nan Nwe Win, Yutaka Tamura, Masato Nakamura, Shunichi Matsuoka, Osamu Yokosuka, Naoya Kato, Osamu Ohara, Hiroaki Okamoto, Mitsuhiko Moriyama, Hiroshi Shirasawa

    Future Virology   14 ( 6 )   399 - 406   2019.6

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    London, UK : Future Medicine Ltd.

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  • Sequential therapy with sorafenib and regorafenib for advanced hepatocellular carcinoma: a multicenter retrospective study in Japan. Reviewed International journal

    Ogasawara S, Ooka Y, Itokawa N, Inoue M, Okabe S, Seki A, Haga Y, Obu M, Atsukawa M, Itobayashi E, Mizumoto H, Sugiura N, Azemoto R, Kanayama K, Kanzaki H, Maruta S, Maeda T, Kusakabe Y, Yokoyama M, Kobayashi K, Kiyono S, Nakamura M, Saito T, Suzuki E, Nakamoto S, Yasui S, Tawada A, Chiba T, Arai M, Kanda T, Maruyama H, Kato N.

    Invest New Drugs.   38 ( 1 )   172 - 180   2019.6

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    New York : Springer

    DOI: 10.1007/s10637-019-00801-8

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  • Possible association of arrestin domain-containing protein 3 and progression of non-alcoholic fatty liver disease. Reviewed International journal

    Ogawa M, Kanda T, Higuchi T, Takahashi H, Kaneko T, Matsumoto N, Nirei K, Yamagami H, Matsuoka S, Kuroda K, Moriyama M.

    Int J Med Sci.   16 ( 7 )   909 - 921   2019.6

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    [Australia] : Ivyspring International Publisher

    DOI: 10.7150/ijms.34245.

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  • Exosomes and Hepatocellular Carcinoma: From Bench to Bedside. Invited Reviewed International journal

    Sasaki R, Kanda T, Yokosuka O, Kato N, Matsuoka S, Moriyama M.

    Int J Mol Sci.   20 ( 6 )   2019.3

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    Basel, Switzerland : MDPI

    DOI: 10.3390/ijms20061406

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  • Molecular Mechanisms Driving Progression of Liver Cirrhosis towards Hepatocellular Carcinoma in Chronic Hepatitis B and C Infections: A Review. Invited Reviewed International journal

    Tatsuo Kanda, Taichiro Goto, Yosuke Hirotsu, Mitsuhiko Moriyama, Masao Omata

    International journal of molecular sciences   20 ( 6 )   2019.3

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    Almost all patients with hepatocellular carcinoma (HCC), a major type of primary liver cancer, also have liver cirrhosis, the severity of which hampers effective treatment for HCC despite recent progress in the efficacy of anticancer drugs for advanced stages of HCC. Here, we review recent knowledge concerning the molecular mechanisms of liver cirrhosis and its progression to HCC from genetic and epigenomic points of view. Because ~70% of patients with HCC have hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection, we focused on HBV- and HCV-associated HCC. The literature suggests that genetic and epigenetic factors, such as microRNAs, play a role in liver cirrhosis and its progression to HCC, and that HBV- and HCV-encoded proteins appear to be involved in hepatocarcinogenesis. Further studies are needed to elucidate the mechanisms, including immune checkpoints and molecular targets of kinase inhibitors, associated with liver cirrhosis and its progression to HCC.

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  • Rapid hepatitis C virus clearance by antivirals correlates with immune status of infected patients Reviewed International coauthorship International journal

    Reina Sasaki, Keith Meyer, Mitsuhiko Moriyama, Naoya Kato, Osamu Yokosuka, Ratna B. Ray, Rajeev Aurora, Ranjit Ray, Tatsuo Kanda

    Journal of Medical Virology   91 ( 3 )   411 - 418   2019.3

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    Wiley

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  • POGLUT1, the putative effector gene driven by rs2293370 in primary biliary cholangitis susceptibility locus chromosome 3q13.33. Reviewed International journal

    Hitomi Y, Ueno K, Kawai Y, Nishida N, Kojima K, Kawashima M, Aiba Y, Nakamura H, Kouno H, Kouno H, Ohta H, Sugi K, Nikami T, Yamashita T, Katsushima S, Komeda T, Ario K, Naganuma A, Shimada M, Hirashima N, Yoshizawa K, Makita F, Furuta K, Kikuchi M, Naeshiro N, Takahashi H, Mano Y, Yamashita H, Matsushita K, Tsunematsu S, Yabuuchi I, Nishimura H, Shimada Y, Yamauchi K, Komatsu T, Sugimoto R, Sakai H, Mita E, Koda M, Nakamura Y, Kamitsukasa H, Sato T, Nakamuta M, Masaki N, Takikawa H, Tanaka A, Ohira H, Zeniya M, Abe M, Kaneko S, Honda M, Arai K, Arinaga-Hino T, Hashimoto E, Taniai M, Umemura T, Joshita S, Nakao K, Ichikawa T, Shibata H, Takaki A, Yamagiwa S, Seike M, Sakisaka S, Takeyama Y, Harada M, Senju M, Yokosuka O, Kanda T, Ueno Y, Ebinuma H, Himoto T, Murata K, Shimoda S, Nagaoka S, Abiru S, Komori A, Migita K, Ito M, Yatsuhashi H, Maehara Y, Uemoto S, Kokudo N, Nagasaki M, Tokunaga K, Nakamura M.

    Sci Rep.   9 ( 1 )   102   2019.1

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  • Efficacy and safety of sofosbuvir-velpatasvir with or without ribavirin in HCV-infected Japanese patients with decompensated cirrhosis: an open-label phase 3 trial. Reviewed

    Takehara T, Sakamoto N, Nishiguchi S, Ikeda F, Tatsumi T, Ueno Y, Yatsuhashi H, Takikawa Y, Kanda T, Sakamoto M, Tamori A, Mita E, Chayama K, Zhang G, De-Oertel S, Dvory-Sobol H, Matsuda T, Stamm LM, Brainard DM, Tanaka Y, Kurosaki M.

    J Gastroenterol.   54 ( 1 )   87 - 95   2019.1

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  • Acutely exacerbated chronic hepatitis C after administration of nivolumab: A case report

    Koji Takahashi, Tatsuo Kanda, Masato Nakamura, Shin Yasui, Makoto Arai, Naoya Kato

    Acta Hepatologica Japonica   60 ( 12 )   459 - 465   2019

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    A 48-year-old man was referred to our hospital for nivolumab administration for the treatment of unre- sectable squamous cell carcinoma of the lung. He had hepatitis C virus infection with virus genotype type 2a and was not treated with antiviral therapy with interferon or direct-acting antivirals. Nivolumab was administered three times every 2 weeks. The serum transaminase levels increased 2 weeks after the third administration. At first, drug-induced liver injury due to nivolumab was suspected
    however, liver biopsy revealed acute exac¬erbation of chronic hepatitis C (new Inuyama classification, F1/A2). A 12-week combination therapy of sofosbu-vir and ribavirin was initiated. The serum transaminase levels improved, and a sustained virological response was obtained 24 weeks after the completion of antiviral therapy. No subsequent transaminase elevation has been observed.

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  • Superinfection of hepatitis A virus in hepatocytes infected with hepatitis B virus. Reviewed International journal

    Win NN, Kanda T, Ogawa M, Nakamoto S, Haga Y, Sasaki R, Nakamura M, Wu S, Matsumoto N, Matsuoka S, Kato N, Shirasawa H, Yokosuka O, Okamoto H, Moriyama M.

    Int J Med Sci.   16 ( 10 )   1366 - 1370   2019

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    [Australia] : Ivyspring International Publisher

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  • Hepatitis C virus-associated hepatocellular carcinoma after sustained virologic response. Invited Reviewed International journal

    Sasaki R, Kanda T, Kato N, Yokosuka O, Moriyama M.

    World J Hepatol.   10 ( 12 )   898 - 906   2018.12

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    The introduction of a direct-acting antiviral (DAA) for patients with hepatitis C virus (HCV) infection, could lead to higher sustained virologic response (SVR) rates with fewer adverse events, and it could shorten the treatment duration relative to the interferon era. Although most recent clinical studies have demonstrated that the occurrence rates of hepatocellular carcinoma (HCC) are decreased by SVR with both interferon-based and interferon-free-regimens, there are several reports about the unexpected observation of high rates of early tumor occurrence and recurrence in patients with HCV-related HCC undergoing interferon-free therapy despite SVR. Several mechanisms of HCC occurrence and rapid immunological changes, including cytokines and chemokines during and after DAA treatment, have also been reported. We focused on the possibilities that HCC occurs or recurs during and after DAA treatment, based on the reported clinical and basic studies. Further studies and observations will be needed to determine the short-term and long-term effects on hepatocarcinogenesis caused by the eradication of HCV with DAAs. New serum biomarkers and a follow-up system for HCV-patients with SVR should be established.

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  • APASL clinical practice recommendation: how to treat HCV-infected patients with renal impairment? Reviewed International coauthorship International journal

    Kanda T, Lau GKK, Wei L, Moriyama M, Ming-Lung Yu, Chuang WL, Ibrahim A, Lesmana CRA, Sollano J, Kumar M, Jindal A, Sharma BC, Hamid SS, Abdulkadir Dökmeci, Mamun-Al-Mahtab, GEOFFREY MCCAUGHAN, Wasim J, Darrell Crawford, JIA-HORNG KAO, Yokosuka O, Sarin SK, Omata M

    Hepatology International   13 ( 2 )   103 - 109   2018.12

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    Chronic hepatitis C virus (HCV) infection is common among patients with chronic kidney disease (CKD) and those on hemodialysis due to nosocomial infections and past blood transfusions. While a majority of HCV-infected patients with end-stage renal disease are asymptomatic, some may ultimately experience decompensated liver diseases and hepatocellular carcinoma. Administration of a combination of elbasvir/grazoprevir for 12 weeks leads to high sustained virologic response (SVR) rates in patients with HCV genotypes (GTs) 1a, 1b or 4 and stage 4 or 5 CKD. Furthermore, a combination of glecaprevir/pibrentasvir for 8-16 weeks also results in high SVR rates in patients with all HCV GTs and stage 4 or 5 CKD. However, these regimens are contraindicated in the presence of advanced decompensated cirrhosis. Although sofosbuvir and/or ribavirin are not generally recommended for HCV-infected patients with severe renal impairment, sofosbuvir-based regimens may be appropriate for those with mild renal impairment. To eliminate HCV worldwide, HCV-infected patients with renal impairment should be treated with interferon-free therapies.

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  • Prediction of the very early occurrence of HCC right after DAA therapy for HCV infection. Reviewed International journal

    Ooka Y, Miho K, Shuntaro O, Nakamura M, Ogasawara S, Suzuki E, Yasui S, Chiba T, Arai M, Kanda T, Maruyama H, Yokosuka O, Kato N, Mochizuki H, Omata M.

    Hepatol Int.   12 ( 6 )   523 - 530   2018.11

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  • Determination of serum carbohydrate-deficient transferrin by a nephelometric immunoassay for differential diagnosis of alcoholic and non-alcoholic liver diseases. Reviewed International journal

    Fumio Nomura, Tatsuo Kanda, Masanori Seimiya, Mamoru Satoh, Youko Kageyama, Takeshi Yamashita, Osamu Yokosuka, Naoya Kato, Katsuya Maruyama

    Clinica chimica acta; international journal of clinical chemistry   485   181 - 186   2018.10

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    BACKGROUND: Carbohydrate-deficient transferrin is a biological marker of excessive drinking. The aim of this study was to evaluate the diagnostic value of a direct nephelometric immunoassay for the differential diagnosis of alcoholic and non-alcoholic liver diseases in comparison with gamma glutamyl transferase. METHODS: Serum samples were obtained from 305 subjects, including 122 patients with alcoholic and 102 cases with non-alcoholic liver diseases. Serum levels of carbohydrate-deficient transferrin were expressed as a percentage of total transferrin. RESULTS: Serum % carbohydrate-deficient transferrin levels were significantly higher in patients with alcoholic than with non-alcoholic liver diseases. Carbohydrate-deficient transferrin had better specificity than gamma glutamyl transferase to differentiate between alcoholic and non-alcoholic liver diseases.There were 8 alcoholic liver disease patients with normal gamma glutamyl transferase levels, and carbohydrate-deficient transferrin was significantly elevated in 6 of them. On the other hand, there were 25 non-alcoholic liver disease patients with elevated gamma glutamyl transferase levels; their carbohydrate-deficient transferrin levels were within the reference intervals in all cases. CONCLUSION: This simple carbohydrate-deficient transferrin immunoassay is useful to detect so-called gamma glutamyl transferase non-responding drinkers and also to exclude the possible role of excessive drinking in apparently non-alcoholic liver diseases. A large-scale prospective study is needed to further confirm the diagnostic utility of carbohydrate-deficient transferrin.

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  • Prediction of the very early occurrence of HCC right after DAA therapy for HCV infection.

    yoshihiko ooka, Miho K, Shuntaro O, Nakamura M, Ogasawara S, Suzuki E, Yasui S, Chiba T, Arai M, Kanda T, Maruyama H, Yokosuka O, Kato N, Mochizuki H, Omata M

    Hepatology international   2018.9

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    BACKGROUND:Although direct-acting antiviral (DAA) developments make most of hepatitis C virus (HCV) infection curable, some HCV patients develop hepatocellular carcinoma (HCC) after curative treatment of HCV. There is much dispute whether the rapid clearance of the virus enhances the HCC development. In advance of the dispute, we should make clear the characteristics of the patients with very early occurrence and recurrence of HCC after DAA therapy because it was still unclear. METHODS:We prospectively followed consecutive patients with HCV who had received sofosbuvir (SOF)-based treatment at two hospitals. The baseline characteristics, laboratory data, and liver imaging findings were acquired. We evaluated the rate of HCC occurrence and recurrence within 1-year after DAA therapy and analyzed the associated factors of very early HCC occurrence and recurrence right after SOF therapy. RESULTS:Between July 2013 and October 2016, we studied two cohorts with HCV infection that received SOF therapy. 402 and 462 patients in Yamanashi Central Hospital and Chiba University Hospital were included in this analysis, respectively. The SVR12 rates of genotypes 1 and 2 were 98.9% (561/567) and 96.0% (285/297), respectively. 41 patients developed HCC within 1 year after SOF therapy. The cumulative HCC occurrence and recurrence rate after SOF therapy was 5.0%. The common associated factor of 1-year HCC occurrence and recurrence in all cohorts was the existence of imaging "dysplastic nodule". CONCLUSIONS:SOF regimens for HCV also have very high rates of SVR 12 in the post-market distribution. The appearance of imaging "dysplastic nodule" was an associated factor of 1-year HCC occurrence and recurrence. To investigate existence of "dysplastic nodule" by imaging surveillance before DAA treatment is useful to detect high-risk patients of very early HCC occurrence and recurrence and it should be performed.

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  • Key HLA-DRB1-DQB1 haplotypes and role of the BTNL2 gene for response to a hepatitis B vaccine. Reviewed International journal

    Nao Nishida, Masaya Sugiyama, Hiromi Sawai, Sohji Nishina, Aiko Sakai, Jun Ohashi, Seik-Soon Khor, Keisuke Kakisaka, Takayo Tsuchiura, Keisuke Hino, Ryo Sumazaki, Yasuhiro Takikawa, Kazumoto Murata, Tatsuo Kanda, Osamu Yokosuka, Katsushi Tokunaga, Masashi Mizokami

    Hepatology (Baltimore, Md.)   68 ( 3 )   848 - 858   2018.9

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    Approximately 5-10% of individuals who are vaccinated with a hepatitis B (HB) vaccine designed based on the hepatitis B virus (HBV) genotype C fail to acquire protective levels of antibodies. Here, host genetic factors behind low immune response to this HB vaccine were investigated by a genome-wide association study (GWAS) and Human Leukocyte Antigen (HLA) association tests. The GWAS and HLA association tests were carried out using a total of 1,193 Japanese individuals including 107 low responders, 351 intermediate responders, and 735 high responders. Classical HLA class II alleles were statistically imputed using the genome-wide SNP typing data. The GWAS identified independent associations of HLA-DRB1-DQB1, HLA-DPB1 and BTNL2 genes with immune response to a HB vaccine designed based on the HBV genotype C. Five HLA-DRB1-DQB1 haplotypes and two DPB1 alleles showed significant associations with response to the HB vaccine in a comparison of three groups of 1,193 HB vaccinated individuals. When frequencies of DRB1-DQB1 haplotypes and DPB1 alleles were compared between low immune responders and HBV patients, significant associations were identified for three DRB1-DQB1 haplotypes, and no association was identified for any of the DPB1 alleles. In contrast, no association was identified for DRB1-DQB1 haplotypes and DPB1 alleles in a comparison between high immune responders and healthy individuals. Conclusion: The findings in this study clearly show the importance of HLA-DR-DQ (i.e., recognition of a vaccine related HB surface antigen (HBsAg) by specific DR-DQ haplotypes) and BTNL2 molecules (i.e., high immune response to HB vaccine) for response to a HB vaccine designed based on the HBV genotype C. (Hepatology 2018).

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  • Hepatitis C virus genotype 4-infection and interferon-free treatment in Egypt Invited Reviewed International journal

    Tatsuo Kanda

    Hepatology International   2018.7

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    DOI: 10.1007/s12072-018-9883-9

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  • Apoptosis and non-alcoholic fatty liver diseases. Invited Reviewed International journal

    Kanda T, Matsuoka S, Yamazaki M, Shibata T, Nirei K, Takahashi H, Kaneko T, Fujisawa M, Higuchi T, Nakamura H, Matsumoto N, Yamagami H, Ogawa M, Imazu H, Kuroda K, Moriyama M

    World journal of gastroenterology   2018.7

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    The number of patients with nonalcoholic fatty liver diseases (NAFLD) including nonalcoholic steatohepatitis (NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma (HCC) and is one of the most serious health problems in the world. The mechanism through which NASH progresses is still largely unknown. Activation of caspases, Bcl-2 family proteins, and c-Jun N-terminal kinase-induced hepatocyte apoptosis plays a role in the activation of NAFLD/NASH. Apoptotic hepatocytes stimulate immune cells and hepatic stellate cells toward the progression of fibrosis in the liver through the production of inflammasomes and cytokines. Abnormalities in glucose and lipid metabolism as well as microbiota accelerate these processes. The production of reactive oxygen species, oxidative stress, and endoplasmic reticulum stress is also involved. Cell death, including apoptosis, seems very important in the progression of NAFLD and NASH. Recently, inhibitors of apoptosis have been developed as drugs for the treatment of NASH and may prevent cirrhosis and HCC. Increased hepatocyte apoptosis may distinguish NASH from NAFLD, and the improvement of apoptosis could play a role in controlling the development of NASH. In this review, the association between apoptosis and NAFLD/NASH are discussed. This review could provide their knowledge, which plays a role in seeing the patients with NAFLD/NASH in daily clinical practice.

    DOI: 10.3748/wjg.v24.i25.2661

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  • Genome-wide association study identified new susceptible genetic variants in HLA class I region for hepatitis B virus-related hepatocellular carcinoma. Reviewed International journal

    Hiromi Sawai, Nao Nishida, Seik-Soon Khor, Masao Honda, Masaya Sugiyama, Natsumi Baba, Kayoko Yamada, Norie Sawada, Shoichiro Tsugane, Kazuhiko Koike, Yuji Kondo, Hiroshi Yatsuhashi, Shinya Nagaoka, Akinobu Taketomi, Moto Fukai, Masayuki Kurosaki, Namiki Izumi, Jong-Hon Kang, Kazumoto Murata, Keisuke Hino, Sohji Nishina, Akihiro Matsumoto, Eiji Tanaka, Naoya Sakamoto, Koji Ogawa, Kazuhide Yamamoto, Akihiro Tamori, Osamu Yokosuka, Tatsuo Kanda, Isao Sakaida, Yoshito Itoh, Yuichiro Eguchi, Satoshi Oeda, Satoshi Mochida, Man-Fung Yuen, Wai-Kay Seto, Yong Poovorawan, Nawarat Posuwan, Masashi Mizokami, Katsushi Tokunaga

    Scientific reports   8 ( 1 )   7958 - 7958   2018.5

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    We have performed a genome-wide association study (GWAS) including 473 Japanese HBV (hepatitis B virus)-positive HCC (hepatocellular carcinoma) patients and 516 HBV carriers including chronic hepatitis and asymptomatic carrier individuals to identify new host genetic factors associated with HBV-derived HCC in Japanese and other East Asian populations. We identified 65 SNPs with P values < 10-4 located within the HLA class I region and three SNPs were genotyped in three independent population-based replication sets. Meta-analysis confirmed the association of the three SNPs (rs2523961: OR = 1.73, P = 7.50 × 10-12; rs1110446: OR = 1.79, P = 1.66 × 10-13; and rs3094137: OR = 1.73, P = 7.09 × 10-9). We then performed two-field HLA genotype imputation for six HLA loci using genotyping data to investigate the association between HLA alleles and HCC. HLA allele association testing revealed that HLA-A * 33:03 (OR = 1.97, P = 4.58 × 10-4) was significantly associated with disease progression to HCC. Conditioning analysis of each of the three SNPs on the HLA class I region abolished the association of HLA-A*33:03 with disease progression to HCC. However, conditioning the HLA allele could not eliminate the association of the three SNPs, suggesting that additional genetic factors may exist in the HLA class I region.

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  • Case of lipoatrophic diabetes induced by juvenile dermatomyositis Reviewed

    Yusuke Baba, Hiyori Kaneko, Minoru Takemoto, Kana Ide, Yuki Haga, Tatsuo Kanda, Shinsuke Akita, Yoshitaka Kubota, Masayuki Kuroda, Yutaka Kitagawa, Koutaro Yokote

    Journal of Diabetes Investigation   9 ( 3 )   632 - 635   2018.5

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    Lipodystrophy is a rare condition that is often accompanied by one or more metabolic diseases. Here, we report a case of lipoatrophic diabetes induced by juvenile dermatomyositis. Although pioglitazone was not effective for lowering blood glucose levels, our observation suggested that it improved liver function slightly. The effectiveness of metreleptin for lowering blood glucose levels could not be determined, as we administered it in a short period. Liver biopsy showed burned-out non-alcoholic steatohepatitis. The present results show that the successful treatment of lipoatrophic diabetes induced by juvenile dermatomyositis requires an early diagnosis and therapeutic intervention.

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  • Transarterial chemoembolization as a substitute to radiofrequency ablation for treating Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma Reviewed

    Kentaro Ishikawa, Tetsuhiro Chiba, Yoshihiko Ooka, Eiichiro Suzuki, Sadahisa Ogasawara, Takahiro Maeda, Masayuki Yokoyama, Masanori Inoue, Toru Wakamatsu, Yuko Kusakabe, Tomoko Saito, Akinobu Tawada, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Fumio Imazeki, Naoya Kato

    Oncotarget   9 ( 30 )   21560 - 21568   2018.4

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    Background and Aim: Transarterial chemoembolization (TACE) is the standard procedure for treating Barcelona clinic liver cancer (BCLC) stage B hepatocellular carcinoma (HCC). However, it is often carried out in the treatment of BCLC stage 0/A HCC for various reasons. This study aimed to elucidate the prognosis for BCLC stage 0/A HCC patients treated with TACE or with radiofrequency ablation (RFA). Materials and Methods: The prognosis of 242 BCLC stage 0/A HCC patients within Milan criteria who underwent initially TACE or RFA were retrospectively analyzed using propensity score matching analysis. Results: The analyses of baseline patient characteristics revealed that the maximum tumor size and the proportion of BCLC stage A patients were significantly higher in patients treated with TACE than in those treated with RFA (P &lt
    0.001 and 0.047, respectively). After adjusting these factors using propensity score matching (1:3 matching), patients treated with TACE (n=32) and those treated with RFA (n=96) were further analyzed. The local recurrence rate was significantly higher in the TACE group than in the RFA group (P &lt
    0.001). However, the overall survival (OS) in HCC patients treated with TACE was comparable to that in HCC patients treated with RFA (1 year, 93.5 vs. 95.8%
    3 years, 75.4 vs. 85.8%
    5 years, 61.8 vs. 70.7%
    P=0.196). Multivariate analyses followed by univariate analyses revealed that serum bilirubin level (P=0.032), serum albumin level (P=0.008), HBV-DNA (P=0.013), and tumor number (P=0.021) were independent predictors of OS. Conclusion: TACE can substitute RFA at least in some patients with BCLC 0/A HCC.

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  • Characteristics of patients with sorafenib-treated advanced hepatocellular carcinoma eligible for second-line treatment Reviewed

    Sadahisa Ogasawara, Tetsuhiro Chiba, Yoshihiko Ooka, Eiichiro Suzuki, Takahiro Maeda, Masayuki Yokoyama, Toru Wakamatsu, Masanori Inoue, Tomoko Saito, Kazufumi Kobayashi, Soichiro Kiyono, Masato Nakamura, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Osamu Yokosuka, Naoya Kato

    Investigational New Drugs   36 ( 2 )   332 - 339   2018.4

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    Background Regorafenib has been investigated for its efficacy and safety as a second-line treatment in patients with advanced hepatocellular carcinoma (HCC). We assessed the characteristics of patients with HCC treated with sorafenib who might be eligible for second-line treatment in general and regorafenib in particular. Methods Patients with HCC treated with sorafenib were retrospectively analyzed. We defined second-line candidate patients as maintaining Child–Pugh A and ECOG-PS ≤1 at the time of sorafenib failure. We also defined regorafenib candidate patients as follows: 1) continuing sorafenib at the time of radiological progression, 2) maintaining Child–Pugh A and ECOG-PS ≤ 1 at the time of sorafenib failure, and 3) continuing sorafenib 400 mg or more without intolerable adverse events at least 20 days of the last 28 days of treatment. Results Of 185 patients, 130 (70%) and 69 (37%) were candidates for second-line treatment and regorafenib. Child-Pugh score 6 and ECOG-PS 1 at the time of starting sorafenib were significantly lower in both second-line treatment and regorafenib candidate patients. Moreover, hand–foot skin reaction and liver failure during sorafenib treatment were associated with significantly low and high probabilities, respectively, of both Child–Pugh score &gt
    6 and ECOG-PS &gt
    1 at the time of sorafenib failure. Conclusion Regorafenib candidate patients after sorafenib failure are limited, and generally fewer than those who are candidates for second-line treatment. A lower Child–Pugh score and a better ECOG-PS were predictors of eligibility for second-line therapy and regorafenib treatment in sorafenib-treated patients with advanced HCC patients.

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  • Interferon-Free Treatment for Chronic Hepatitis C in Japan

    Tatsuo Kanda

    Journal of Nihon University Medical Association   2018.4

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    DOI: 10.4264/numa.77.2_123

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  • 静脈管開存合併I型先天性門脈欠損症を呈した原発性胆汁性胆管炎の一成人例 Reviewed

    清野 宗一郎, 丸山 紀史, 小林 和史, 嶋田 太郎, 高橋 正憲, 中村 昌人, 中本 晋吾, 安井 伸, 神田 達郎, 齊藤 朋子, 日下部 裕子, 小笠原 定久, 鈴木 英一郎, 大岡 美彦, 太和田 暁之, 千葉 哲博, 加藤 直也

    肝臓   59 ( 4 )   217 - 223   2018.4

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    症例は40歳、男性。慢性腎不全による腎移植後のため、近医で通院加療を受けていた。高アンモニア血症と意識消失発作を認め、同院のCT検査で腹部血行異常を疑われたため精査目的に紹介となった。超音波では、門脈から下大静脈へ連続する管腔構造が認められ、門脈側から下大静脈へ向かう血流が観察されたことから静脈管開存が疑われた。血管造影検査では下大静脈から短絡路部へバルンカテーテルが挿入され、静脈管開存の存在が確認された。バルンカテーテルによる短絡路の閉塞試験では、門脈ならびに脾静脈血流は停滞し肝内門脈血流も観察されなかった。以上より、先天性門脈欠損症I型と診断され、外科的な短絡路結紮切離による改善は期待できないと考えられた。なお肝生検組織から、原発性胆汁性胆管炎(Scheuer分類Stage 2、中沼分類Stage 3)と診断された。今後、肝移植の適応を含めた診療の展開が求められる。(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00263&link_issn=&doc_id=20180508070002&doc_link_id=10.2957%2Fkanzo.59.217&url=https%3A%2F%2Fdoi.org%2F10.2957%2Fkanzo.59.217&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • Early occurrence and recurrence of hepatocellular carcinoma in hepatitis C virus-infected patients after sustained virological response Invited Reviewed

    Tatsuo Kanda, Shunichi Matsuoka, Mitsuhiko Moriyama

    Hepatology International   12 ( 2 )   90 - 93   2018.3

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  • Interferon-free treatment for patients with chronic hepatitis C and autoimmune liver disease: Higher SVR rates with special precautions for deterioration of autoimmune hepatitis Reviewed

    Tatsuo Kanda, Shin Yasui, Masato Nakamura, Shingo Nakamoto, Koji Takahashi, Shuang Wu, Reina Sasaki, Yuki Haga, Sadahisa Ogasawara, Tomoko Saito, Kazufumi Kobayashi, Soichiro Kiyono, Yoshihiko Ooka, Eiichiro Suzuki, Tetsuhiro Chiba, Hitoshi Maruyama, Fumio Imazeki, Mitsuhiko Moriyama, Naoya Kato

    Oncotarget   9 ( 14 )   11631 - 11637   2018.2

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    Background: Interferon-free treatment can achieve higher sustained virological response (SVR) rates, even in patients in whom hepatitis C virus (HCV) could not be eradicated in the interferon treatment era. Immune restoration in the liver is occasionally associated with HCV infection. We examined the safety and effects of interferon-free regimens on HCV patients with autoimmune liver diseases. Results: All 7 HCV patients with autoimmune hepatitis (AIH) completed treatment and achieved SVR. Three patients took prednisolone (PSL) at baseline, and 3 did not take PSL during interferon-free treatment. In one HCV patient with AIH and cirrhosis, PSL were not administered at baseline, but she needed to take 40 mg/day PSL at week 8 for liver dysfunction. She also complained back pain and was diagnosed with vasospastic angina by coronary angiography at week 11. However, she completed interferon-free treatment. All 5 HCV patients with primary biliary cholangitis (PBC) completed treatment and achieved SVR. Three of these HCV patients with PBC were treated with UDCA during interferon-free treatment. Conclusions: Interferon-free regimens could result in higher SVR rates in HCV patients with autoimmune liver diseases. As interferon-free treatment for HCV may have an effect on hepatic immunity and activity of the autoimmune liver diseases, careful attention should be paid to unexpected adverse events in their treatments. Methods: Total 12 patients with HCV and autoimmune liver diseases [7 AIH and PBC], who were treated with interferon-free regimens, were retrospectively analyzed.

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  • Combinational use of hepatitis B viral antigens predicts responses to nucleos(t)ide analogue/peg-interferon sequential therapy. Reviewed

    Akihiro Matsumoto, Shuhei Nishiguchi, Hirayuki Enomoto, Jong-Hon Kang, Yasuhito Tanaka, Noboru Shinkai, Masayuki Kurosaki, Masaru Enomoto, Tatsuo Kanda, Osamu Yokosuka, Hiroshi Yatsuhashi, Shinya Nagaoka, Chiaki Okuse, Tatehiro Kagawa, Tetsuya Mine, Koichi Takaguchi, Satoru Saito, Keisuke Hino, Fusao Ikeda, Shotaro Sakisaka, Daisuke Morihara, Shiho Miyase, Masataka Tsuge, Kazuaki Chayama, Naoki Hiramatsu, Yoshiyuki Suzuki, Kazumoto Murata, Eiji Tanaka

    Journal of gastroenterology   53 ( 2 )   247 - 257   2018.2

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    BACKGROUND: This prospective cohort study searched for factors associated with a response to nucleos(t)ide analogue/peg-interferon (NUC/peg-IFN) sequential therapy. METHODS: A total of 95 patients with chronic hepatitis B being treated with NUCs were enrolled. Immediately following NUC cessation, peg-IFN was administered at 180 µg/dose weekly for 48 weeks. RESULTS: Twenty-six patients (27%) were judged to be responders at 48 weeks after the completion of peg-IFN. Analysis of baseline factors revealed that hepatitis B surface antigen (HBsAg) <3.1 log IU/ml and HB core-related antigen (HBcrAg) <3.9 log U/ml were significant indicators of a treatment response. The levels of the markers decreased in both responders and non-responders during peg-IFN therapy but continued falling in responders only after halting peg-IFN. Lower HBsAg (<2.0 log IU/ml) and HBcrAg (<3.8 log U/ml) levels at the time of response judgment were also significantly associated with a favorable response. While lower HBcrAg at baseline was the sole predictor of decreased HBcrAg levels at judgment, lower HBsAg, lower HBcrAg, and the use of adefovir dipivoxil at baseline predicted decreased HBsAg levels at the study endpoint. The use of adefovir dipivoxil was also associated with higher serum IFN-λ3, which might have contributed to the reduction in patient HBsAg levels. CONCLUSIONS: The combinational use of HBsAg and HBcrAg levels at baseline and their changes throughout sequential therapy may be useful for predicting a response to NUC/peg-IFN sequential therapy.

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  • Early Combination Therapy with Corticosteroid and Nucleoside Analogue Induces Rapid Resolution of Inflammation in Acute Liver Failure Due to Transient Hepatitis B Virus Infection. Reviewed International journal

    Fujiwara K, Yasui S, Haga Y, Nakamura M, Yonemitsu Y, Arai M, Kanda T, Oda S, Yokosuka O, Kato N.

    Intern Med.   57 ( 11 )   1543 - 1552   2018.1

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    Objective Patients with acute hepatitis B sometimes develop acute liver failure (ALF), which has a poor prognosis. The efficacy of nucleoside analogue (NA) monotherapy for ALF due to transient hepatitis B virus infection (HBV-ALF) remains controversial. Further investigations are necessary in nations with a shortage of donor livers for liver transplantation. In the present study, we aimed to clarify the efficacy of combination therapy with corticosteroid (CS) and NA in the treatment HBV-ALF. Patients We examined the clinical and biochemical features of 19 patients with HBV-ALF who were treated in the early stage of the disease between 2000 and 2015. Results Fourteen patients received CS and NA (CS + NA group) and 5 received NA monotherapy (NA group). Eleven patients (58%) survived and 8 (42%) died. The survival rates in the CS + NA and NA groups were 64% and 40%, respectively (p=0.60). The mean alanine aminotransferase (ALT) levels declined significantly at week 2 in both groups. The mean PT activities improved significantly at weeks 1 and 2 in the CS + NA group (p&lt
    0.05) but not in the NA group. None of the surviving patients developed persistent infection. Conclusion Combination therapy with CS and NA induces the rapid resolution of inflammation leading to a rapid recovery of the liver function. When it is administered at a sufficiently early stage, it would have a survival benefit and prevent persistent infection in HBV-ALF.

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  • 自己免疫性肝炎とステロイド薬投与 Invited

    神田達郎, 森山光彦

    内科総合誌 Medical Practice M.P.   35 ( 3 )   482   2018

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  • C型慢性肝炎の最新治療~肝硬変・肝がん撲滅を目指して~ Invited Reviewed

    神田達郎

    日大医誌   77 ( 2 )   123 - 125   2018

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  • A型肝炎の最近の動向. Invited

    神田達郎, 松本直樹, 中村仁美, 山名陽一郎, 水谷卓, 高橋央, 金子朋弘, 有間修平, 金澤芯依, 上村慎也, 樋口晃久, 楡井和重, 山上裕晃, 松岡俊一, 石井孝司, 森山光彦.

    消化器・肝臓内科   4 ( 2 )   135 - 140   2018

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    科学評論社

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  • Successful retreatment with sofosbuvir plus ledipasvir for cirrhotic patients with hepatitis C virus genotype 1b who discontinued the prior treatment with asunaprevir plus daclatasvir: A case series and review of the literature Reviewed

    Yuki Haga, Tatsuo Kanda, Shin Yasui, Masato Nakamura, Yoshihiko Ooka, Koji Takahashi, Shuang Wu, Shingo Nakamoto, Makoto Arai, Tetsuhiro Chiba, Hitoshi Maruyama, Osamu Yokosuka, Nobuo Takada, Mitsuhiko Moriyama, Fumio Imazeki, Naoya Kato

    Oncotarget   9 ( 4 )   5509 - 5513   2018

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    Background: Interferon-free treatment results in higher sustained virologic response (SVR) rates, with no serious adverse events in hepatitis C virus (HCV)- infected patients. However, in some patients with treatment-failure in HCV NS5A inhibitor-including interferon-free regimens, the treatment-emergent HCV NS5A resistance-associated variants (RAVs), which are resistant to interferon-free retreatment including HCV NS5A inhibitors, are observed. In HCV-infected Japanese patients with daclatasvir and asunaprevir treatment failure, retreatment with sofosbuvir and ledipasvir could lead to only ~70% SVR rates. Case summary: Three HCV genotype (GT)-1b-infected cirrhotic patients who discontinued the combination of daclatasvir and asunaprevir due to adverse drug reactions within 4 weeks
    retreatment with sofosbuvir and ledipasvir combination could result in SVR in these patients without RAVs. One HCV GT-1b-infected cirrhotic patient who discontinued the combination of daclatasvir and asunaprevir due to viral breakthrough at week 10
    retreatment with sofosbuvir and ledipasvir combination for this patient with the treatment-emergent HCV NS5A RAV-Y93H resulted in viral relapse at week 4 after the end of the treatment. Conclusion: Retreatment with sofosbuvir and ledipasvir is effective for HCV GT- 1b patients who discontinue the combination of daclatasvir and asunaprevir within 4 weeks. The treatment response should be related to the existence of treatmentemergent HCV NS5A RAVs, but may not be related to the short duration of treatment.

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  • Persistent Hepatic Inflammation Plays a Role in Hepatocellular Carcinoma After Sustained Virological Response in Patients with HCV Infection. Reviewed International journal

    Nirei K, Kanda T, Nakamura H, Matsuoka S, Takayama T, Sugitani M, Moriyama M.

    Int J Med Sci   15 ( 5 )   466 - 474   2018

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    Objective: Hepatitis C virus (HCV) infection has long been treated with interferon therapy (IFN). Currently, more than 90% of IFN-treated patients show a sustained virological response (SVR) when also treated with ribavirin and/or a protease inhibitor. Histological inflammation and fibrosis improve in IFN-treated patients, which indicates HCV clearance. IFN also reduces the incidence of hepatocellular carcinoma (HCC). However, a small proportion of patients with SVR develop HCC. To investigate the causes of hepatic carcinogenesis after SVR, we compared the liver histological findings before IFN to those after the development of HCC. Patients and methods: In total, 602 patients infected with type C chronic hepatitis or with liver cirrhosis who received IFN therapy during the period from 1992 through 2015 were included in this study. We assessed 14 of the 287 patients who achieved an SVR. Results: HCC was diagnosed by computed tomography, angiography or liver biopsy. The longest time from the SVR until HCC detection was 16.5 years, and the mean was 7.2±4.6 years. Nine of the 14 patients underwent surgery and one radiofrequency ablation. The histological findings of 10 patients were available for comparison. The comparison of the histological findings before treatment with those after the HCC diagnosis revealed an amelioration of liver fibrosis and other inflammatory changes. All ten patients showed improvements in fibrosis and steatosis. However, we observed that mild inflammatory change persisted from 1.8 years to 16.5 years after the confirmation of SVR in all cases. Conclusion: We suspect that persistent histological inflammation is one of the factors contributing to hepatocarcinogenesis (i.e., HCC development) even after successful treatment.

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  • Successful retreatment with grazoprevir and elbasvir for patients infected with hepatitis C virus genotype 1b, who discontinued prior treatment with NS5A inhibitor-including regimens due to adverse events. Reviewed International journal

    Kanda T, Yasui S, Nakamura M, Nakamoto S, Takahashi K, Wu S, Sasaki R, Haga Y, Ogasawara S, Saito T, Kobayashi K, Kiyono S, Ooka Y, Suzuki E, Chiba T, Maruyama H, Imazeki F, Moriyama M, Kato N.

    Oncotarget   9 ( 22 )   16263 - 16270   2018

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    Background: Sustained virologic response (SVR) by interferon and interferon-free treatment can results in the reduction of advanced liver fibrosis and the occurrence of hepatocellular carcinoma in patients infected with hepatitis C virus (HCV). Recent interferon-free treatment for HCV shortens the duration of treatment and leads to higher SVR rates, without any serious adverse events. However, it is important to retreat patients who have had treatment-failure with HCV non-structural protein 5A (NS5A) inhibitor-including regimens. Combination of sofosbuvir and ledipasvir only leads to approximately 100% SVR rates in HCV genotype (GT1b), NS5A inhibitornaïve patients in Japan. This combination is not an indication for severe renal disease or heart disease, and these patients should be treated or retreated with a different regimen. Case summary: Retreatment with HCV non-structural protein 3/4A inhibitor, grazoprevir, and HCV NS5A inhibitor, elbasvir, successfully eradicated HCV RNA in three patients with HCV genotype 1b infection who discontinued prior interferon-free treatments including HCV NS5A inhibitors due to adverse events within 2 weeks. Conclusion: Retreatment with the 12-week combination regimen of grazoprevir and elbasvir is effective for HCV GT1b patients who discontinue the HCV NS5A inhibitor-including regimens within 2 weeks. The treatment response may be related to the short duration of initial treatment, which did not produce treatment-emergent RASs.

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  • Case of Portal-Systemic Encephalopathy due to Complicated Spleno-renal Shunt Successfully Treated with Balloon-occluded Retrograde Transvenous Obliteration Using a Double Coaxial Balloon Catheter System and Shape-memory Coils. Reviewed

    Matsuoka S, Yamana Y, Ishii T, Kumagawa M, Mizutani T, Kamimura S, Matsumoto N, Nakamura H, Nirei K, Tatsuo K, Moriyama M.

    Intern Med   2018

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    A 70-year-old woman with hepatitis C cirrhosis underwent balloon-occluded retrograde transvenous obliteration for hepatic encephalopathy due to spleno-renal shunt. Because the shunt was thick, long, and winding, we used a coaxial and double interruption system, which enables the effective occlusion of the drainage route, and shape-memory coils, which are more physically stable than conventional metallic coils because they form three-dimensional loops. The patient was successfully treated with the combined usage of these devices, resulting in a normal serum ammonia level. Thereafter, the patient was treated with direct-acting antivirals, and a sustained virological response was achieved.

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  • Association of mRNA expression of iron metabolism-associated genes and progression of non-alcoholic steatohepatitis in rats Reviewed

    Teruhisa Higuchi, Mitsuhiko Moriyama, Akiko Fukushima, Hiroshi Matsumura, Shunichi Matsuoka, Tatsuo Kanda, Masahiko Sugitani, Akiko Tsunemi, Takahiro Ueno, Noboru Fukuda

    Oncotarget   9 ( 40 )   26183 - 26194   2018

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    Background: Excess iron is associated with non-alcoholic steatohepatitis (NASH). Results: mRNA expression of duodenal cytochrome b, divalent metal transporter 1, ferroportin 1, hepcidin, hephaestin and transferrin receptor 1 in liver were higher in high fat, high cholesterol-containing diet (HFCD) group than in normal diet (ND) group. mRNA levels of divalent metal transporter 1 and transferrin receptor 1, which stimulate iron absorption and excretion, were enhanced in small intestine. Epithelial mucosa of small intestine in HFCD group was characterized by plasma cell and eosinophil infiltration and increased vacuoles. Iron absorption was enhanced in this NASH model in the context of chronic inflammation of small intestinal epithelial cells, consequences of intestinal epithelial cell impairment caused by HFCD. Iron is transported to hepatocytes via portal blood, and abnormalities in iron absorption and excretion occur in small intestine from changes in iron transporter expression, which also occurs in NASH liver. Knockdown of hepcidin antimicrobial peptide led to enhanced heavy chain of ferritin expression in human hepatocytes, indicating association between hepcidin production and iron storage in hepatocytes. Conclusions: Iron-related transporters in liver and lower/upper portions of small intestine play critical roles in NASH development. Methods: Expression of iron metabolism-related genes in liver and small intestine was analyzed in stroke-prone spontaneously hypertensive rats (SHR-SP), which develop NASH. Five-week-old SHR-SP fed ND or HFCD were examined. mRNA and protein levels of iron metabolism-related genes in liver and small intestine from 12- and 19-week-old rats were evaluated by real-time RT-PCR and immunohistochemistry or Western blot.

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  • Inhibitory effect of Japanese rice-koji miso extracts on hepatitis A virus replication in association with the elevation of glucose-regulated protein 78 expression. Reviewed International journal

    Nan Nwe Win, Tatsuo Kanda, Shingo Nakamoto, Mitsuhiko Moriyama, Xia Jiang, Akiko Suganami, Yutaka Tamura, Hiroaki Okamoto, Hiroshi Shirasawa

    International journal of medical sciences   15 ( 11 )   1153 - 1159   2018

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    Hepatitis A virus (HAV) infection is one of the major causes of acute hepatitis and acute liver failure in developing and developed countries. Although effective vaccines for HAV infection are available, outbreaks of HAV infection still cause deaths, even in developed countries. One approach to control HAV infection is prevention through diet, which can inhibit HAV propagation and replication. Glucose-regulated protein 78 (GRP78) is a member of the heat shock protein 70 family of molecular chaperone required for endoplasmic reticulum stress and stress-induced autophagy. We previously showed that the elevation of GRP78 expression inhibits HAV replication. It has been reported that Japanese miso extracts, which was made from rice-koji, enhance GRP78 expression. In the present study, we used human hepatoma Huh7 cells and human hepatocyte PXB cells to examine the efficacy of Japanese miso extracts as antiviral agents against HAV. Japanese miso extracts enhanced GRP78 expression and inhibited HAV replication in human hepatocytes. Together, these results demonstrate that Japanese miso extracts may partly modulate GRP78 expression and additively or synergistically work as antivirals against HAV infection. Japanese miso extracts can be used as effective dietary supplements for severe hepatitis A.

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  • Hepatitis B Virus Genotype C is Predominant in Myanmar Reviewed International journal

    Nan Nwe Win, Shingo Nakamoto, Myint Myint Sein, Mitsuhiko Moriyama, Tatsuo Kanda, Hiroshi Shirasawa

    Diseases   6 ( 1 )   3 - 3   2017.12

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    Myanmar is adjacent to India, Bangladesh, Thailand, Laos and China. In Myanmar, the prevalence of hepatitis B virus (HBV) infections is 6.5% and accounts for 60% of hepatocellular carcinoma. HBV has nine genotypes that have been identified by molecular genetic analysis. HBV genotypes are associated with several clinical features. We reviewed the prevalence of HBV genotypes in Myanmar and neighboring countries. We also reviewed HBV genotypes in refugees from Myanmar. HBV subgenotype C1 is predominant in Myanmar. As HBV genotype C is associated with hepatocellular carcinoma (HCC), it is important to screen for cirrhosis and HCC and to prevent their development in HBV-infected individuals of Myanmar.

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  • Retreatment of patients with treatment failure of direct-acting antivirals: Focus on hepatitis C virus genotype 1b Invited Reviewed

    Tatsuo Kanda, Kazushige Nirei, Naoki Matsumoto, Teruhisa Higuchi, Hitomi Nakamura, Hiroaki Yamagami, Shunichi Matsuoka, Mitsuhiko Moriyama

    WORLD JOURNAL OF GASTROENTEROLOGY   23 ( 46 )   8120 - 8127   2017.12

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    The recent development of direct-acting antiviral agents (DAAs) against hepatitis C virus (HCV) infection could lead to higher sustained virological response (SVR) rates, with shorter treatment durations and fewer adverse events compared with regimens that include interferon. However, a relatively small proportion of patients cannot achieve SVR in the first treatment, including DAAs with or without peginterferon and/or ribavirin. Although retreatment with a combination of DAAs should be conducted for these patients, it is more difficult to achieve SVR when retreating these patients because of resistance-associated substitutions (RASs) or treatment-emergent substitutions. In Japan, HCV genotype 1b (GT1b) is founded in 70% of HCV-infected individuals. In this minireview, we summarize the retreatment regimens and their SVR rates for HCV GT1b. It is important to avoid drugs that target the regions targeted by initial drugs, but next-generation combinations of DAAs, such as sofosbuvir/velpatasvir/voxilaprevir for 12 wk or glecaprevir/pibrentasvir for 12 wk, are proposed to be potential solution for the HCV GT1b-infected patients with treatment failure, mainly on a basis of targeting distinctive regions. Clinicians should follow the new information and resources for DAAs and select the proper combination of DAAs for the retreatment of HCV GT1b-infected patients with treatment failure.

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  • Anemia during Direct-Acting Antiviral Regimens in Kidney Transplant Recipients with Hepatitis C. Reviewed International journal

    Tatsuo Kanda, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan, Shunich Matsuoka, Mitsuhiko Moriyama, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan

    OBM Hepatology and Gastroenterology.   2017.10

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  • Odalasvir Nonstructural protein 5A (NS5A) inhibitor Treatment of hepatitis C virus (HCV) Invited Reviewed

    T. Kanda, M. Moriyama

    DRUGS OF THE FUTURE   42 ( 9 )   549 - 553   2017.9

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    Hepatitis C virus (HCV) is a major cause of advanced liver diseases and hepatocellular carcinoma in the U.S. and Japan. In the era of direct-acting antiviral agents (DAAs) against HCV, interferon-free DAA combinations could achieve higher sustained virologic response rates in DAA-naive patients compared to interferon-including regimens. However, HCV nonstructural protein 5A (NS5A) resistance-associated variants (RAVs) could occur in treatment-failure patients treated with interferon-free regimens including first-generation HCV NS5A inhibitors. Odalasvir (ACH-3102), a second-generation HCV NS5A inhibitor, has improved potency against HCV genotype (GT)-1 (GT-1a/GT-1b), GT-2b and RAVs in vitro compared with first-generation HCV NS5A inhibitors. A phase IIa study showed that AL-335, odalasvir and simeprevir for 6 or 8 weeks were well tolerated and highly effective in HCV GT-1 patients. Odalasvir is a new HCV NS5A inhibitor with higher genetic barrier and picomolar potency than first-generation HCV NS5A inhibitors. Therefore, this agent may be useful for retreatment of DAA-failure patients treated with first-generation HCV NS5A inhibitors.

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  • Direct-acting antiviral agents against hepatitis C virus and lipid metabolism Invited Reviewed

    Tatsuo Kanda, Mitsuhiko Moriyama

    WORLD JOURNAL OF GASTROENTEROLOGY   23 ( 31 )   5645 - 5649   2017.8

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    Hepatitis C virus (HCV) infection induces steatosis and is accompanied by multiple metabolic alterations including hyperuricemia, reversible hypocholesterolemia and insulin resistance. Total cholesterol, low-density lipoprotein-cholesterol and triglyceride levels are increased by peginterferon and ribavirin combination therapy when a sustained virologic response (SVR) is achieved in patients with HCV. Steatosis is significantly more common in patients with HCV genotype 3 but interferon-free regimens are not always effective for treating HCV genotype 3 infections. HCV infection increases fatty acid synthase levels, resulting in the accumulation of fatty acids in hepatocytes. Of note, low-density lipoprotein receptor, scavenger receptor class B type. and Niemann-Pick C1-like 1 proteins are candidate receptors that may be involved in HCV. They are also required for the uptake of cholesterol from the external environment of hepatocytes. Among HCV-infected patients with or without human immunodeficiency virus infection, changes in serum lipid profiles are observed during interferon-free treatment and after the achievement of an SVR. It is evident that HCV affects cholesterol metabolism during interferon-free regimens. Although higher SVR rates were achieved with interferon-free treatment of HCV, special attention must also be paid to unexpected adverse events based on host metabolic changes including hyperlipidemia.

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  • Successful Treatment with Tenofovir Disoproxil Fumarate for A Pregnant Woman with Chronic Active Hepatitis B. Reviewed International journal

    Koji Takahashi, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Masato Nakamura, Shuang Wu, Shingo Nakamoto, Shin Yasui, Hidehiro Kamezaki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan

    OBM Hepatology and Gastroenterology.   2017.7

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    <jats:p>(1) Background: Infection with hepatitis B virus (HBV) infection during pregnancy occasionally raises concerns, including acute exacerbation and the potential for mother-to-child transmission.(2) Case Report: Here, we present a case of a female patient with a chronic HBV infection who was treated with tenofovir disoproxil fumarate (TDF) and had a normal pregnancy and delivery. Furthermore, the use of TDF, HBV vaccination and passive immunization of her child with hyperimmune hepatitis B immunoglobulin successfully prevented vertical transmission of HBV to her child.(3) Conclusions: Women with chronic active HBV infections who become pregnant may receive additional care and consideration such as the administration of TDF.</jats:p>

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  • Treatment of real-world HCV genotype 2-infected Japanese patients with sofosbuvir plus ribavirin Invited Reviewed

    Tatsuo Kanda, Masato Nakamura, Shin Yasui, Yuki Haga, Akinobu Tawada, Eiichiro Suzuki, Yoshihiko Ooka, Koji Takahashi, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Makoto Arai, Fumio Imazeki, Osamu Yokosuka

    Biology   6 ( 2 )   2017.6

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    The aim of this study was to characterize the treatment response and tolerability of sofosbuvir plus ribavirin therapies in Japanese patients infected with hepatitis C virus (HCV) genotype (GT)-2. This retrospective study analyzed 114 Japanese HCV GT-2 patients treated for 12 weeks with 400 mg of sofosbuvir plus weight-based ribavirin daily. This treatment led to higher sustained virologic response at 12-weeks post-treatment (SVR12) rates in both treatment-naïve and treatment-experienced patients. The efficacy of this treatment in compensated cirrhotics was the same as that in patients with chronic hepatitis. HCV GT-2a infection and lower estimated glomerular filtration rates (eGFR) tended to be associated with SVR12. Of 114 patients, 113 completed the combination of sofosbuvir plus ribavirin for 12 weeks. Seven patients without SVR12 did not have HCV NS5B-S282 mutations. The overall SVR12 rate was 90.4% (103 of 114). More effective therapeutic options with less adverse events are desired to achieve higher SVR rates in HCV GT-2 Japanese patients.

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  • Glucose-regulated protein 78 is an antiviral against hepatitis A virus replication Reviewed

    Xia Jiang, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Masato Nakamura, Shuang Wu, Shingo Nakamoto, Hiroshi Shirasawa, Hiroaki Okamoto, Osamu Yokosuka

    EXPERIMENTAL AND THERAPEUTIC MEDICINE   13 ( 6 )   3305 - 3308   2017.6

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    Infection with hepatitis A virus (HAV) is a major cause of acute hepatitis globally and it is important to identify the mechanisms of HAV replication. Glucose-regulated protein 78 (GRP78) is an endoplasmic reticulum (ER) chaperone and serves a role in unfolded protein response pathways. Previous studies have demonstrated that GRP78 functions as an endogenous antiviral factor. In the present study, two loss-of-function studies using GRP78 were completed to elucidate the role of GRP78 in HAV infection. HAV replication was observed to be enhanced by deficient GRP78 although GRP78-deficiency also led to lower expression of ER stress molecules downstream of GRP78. Therefore, GRP78 appears to be a potential novel defensive molecule against HAV in hepatocytes.

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  • Overexpression of the androgen receptor in human hepatoma cells and its effect on fatty acid metabolism Reviewed

    Tatsuo Kanda, Xia Jiang, Masato Nakamura, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Fumio Imazeki, Osamu Yokosuka

    ONCOLOGY LETTERS   13 ( 6 )   4481 - 4486   2017.6

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    Hepatocellular carcinoma (HCC) is a predominantly male disease in which the androgen receptor (AR) serves an important pathogenic role in hepatocarcinogenesis. Fatty acid metabolism also contributes to hepatocarcinogenesis and is associated with the prognosis of cancer. The present study aimed to investigate the effects of the AR on fatty acid metabolism-associated gene expression in human hepatoma cell lines. AR-expression plasmids or control plasmids were transiently transfected into the human HCC cell lines Huh7 and HepG2. After 48 h, cellular protein and RNA were extracted and the expression of AR was confirmed by western blotting. Complementary DNA was synthesized and subjected to a quantitative polymerase chain reaction-based array to examine the expression of 84 fatty acid metabolism-associated genes. Overexpression of AR significantly downregulated the expression of 11 fatty acid metabolism-associated genes in Huh7 cells and 35 in HepG2 cells. The overexpression of AR also resulted in the upregulation of 6 fatty acid metabolism genes in HepG2 cells; however, it had no effect in Huh7 cells. Acyl-coenzyme A (CoA) thioesterase 7 and acyl-CoA oxidase 3 were downregulated in both cell lines. In conclusion, upregulation of AR via overexpression led to the disturbance of fatty acid metabolism-associated gene expression in human HCC cells. Therefore, the AR may serve a role in hepatocarcinogenesis via the regulation of hepatocellular fatty acid metabolism.

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  • Serum microRNA-122 and Wisteria floribunda agglutinin-positive Mac-2 binding protein are useful tools for liquid biopsy of the patients with hepatitis B virus and advanced liver fibrosis Reviewed

    Masato Nakamura, Tatsuo Kanda, Xia Jiang, Yuki Haga, Koji Takahashi, Shuang Wu, Shin Yasui, Shingo Nakamoto, Osamu Yokosuka

    PLOS ONE   12 ( 5 )   e0177302   2017.5

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    Background
    Noninvasive methods to accurately and conveniently evaluate liver fibrosis are desirable. MicroRNA (miR) is one of the candidates. MiRs are small RNAs consisting of 19-25 nucleotides that negatively regulate many target genes at transcriptional levels. Recently, many researchers have focused on circulating miRs in the blood stream as biomarkers. Hepatic miR-122 has been reported to have an association with viral replication and hepatic fibrosis in chronic hepatitis B virus (HBV) and hepatic C virus (HCV) infection.
    Methods
    We measured serum miR-122 levels in HBV- and HCV-infected patients confirmed with liver biopsy. We also investigated a novel liver fibrosis marker Wisteria floribunda agglutinin-positive Mac-2 binding protein [WFA(+)-M2BP]. We evaluated the diagnostic usefulness of these markers in hepatic fibrosis and inflammation of patients with chronic viral infection.
    Results
    The serum miR-122 levels of HBV-infected patients were higher than those of the control subjects. In HBV-infected patients, the serum miR-122 levels of patients with advanced liver fibrosis were significantly lower. Serum WFA(+)-M2BP was significantly higher dependent on both the staging of fibrosis and the grading of inflammatory activity in patients with both HBV and HCV infection. We also observed that higher serum WFA(+)-M2BP levels augmented the prediction of advanced liver fibrosis among HBV-infected patients with lower serum miR-122 levels.
    Conclusions
    A lower serum miR-122 level is a useful predictor of advanced liver fibrosis in HBV-infected patients. Serum WFA(+)-M2BP could predict liver fibrosis in both HBV and HCV infection. The combination of these markers may result in the more accurate evaluation of liver fibrosis in HBV infection.

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  • Androgen Receptor Could Be a Potential Therapeutic Target in Patients with Advanced Hepatocellular Carcinoma Reviewed

    Tatsuo Kanda, Koji Takahashi, Masato Nakamura, Shingo Nakamoto, Shuang Wu, Yuki Haga, Reina Sasaki, Xia Jiang, Osamu Yokosuka

    CANCERS   9 ( 5 )   2017.5

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    Hepatocellular carcinoma (HCC) is a male-dominant disease with poor prognosis. Sorafenib is the only approved systemic chemotherapeutic drug for patients with advanced HCC. Previous studies have shown that androgen and androgen receptor (AR) are involved in human hepatocarcinogenesis and the development of HCC. Here, we discuss the recent data on AR and HCC, and the combination of sorafenib and inhibitors of AR for advanced-HCC patients. Androgen-dependent and androgen-independent AR activation exist in human hepatocarcinogenesis. AR could directly control hepatocarcinogenesis and regulate the innate immune system to influence HCC progression. Combination of sorafenib with AR inhibitors might represent a potential treatment for patients with advanced HCC.

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  • Real-World Experiences with the Combination Treatment of Ledipasvir plus Sofosbuvir for 12 Weeks in HCV Genotype 1-Infected Japanese Patients: Achievement of a Sustained Virological Response in Previous Users of Peginterferon plus Ribavirin with HCV NS3/4A Inhibitors Reviewed

    Tatsuo Kanda, Shin Yasui, Masato Nakamura, Eiichiro Suzuki, Makoto Arai, Yoshihiko Ooka, Sadahisa Ogasawara, Tetsuhiro Chiba, Tomoko Saito, Yuki Haga, Koji Takahashi, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Akinobu Tawada, Hitoshi Maruyama, Fumio Imazeki, Naoya Kato, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES   18 ( 5 )   2017.5

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    The aim of this study was to characterize the treatment response and serious adverse events of ledipasvir plus sofosbuvir therapies in Japanese patients infected with hepatitis C virus (HCV) genotype 1 (GT1). This retrospective study analyzed 240 Japanese HCV GT1 patients treated for 12 weeks with 90 mg of ledipasvir plus 400 mg of sofosbuvir daily. Sustained virological response at 12 weeks post-treatment (SVR12) was achieved in 236 of 240 (98.3%) patients. Among treatment-naive patients, SVR12 was achieved in 136 of 138 (98.6%) patients, and among treatment-experienced patients, SVR12 was achieved in 100 of 102 (98.0%) patients. In patients previously treated with peginterferon plus ribavirin with various HCV NS3/4A inhibitors, 100% SVR rates (25/25) were achieved. Two relapsers had HCV NS5A resistance-associated variants (RAVs), but no HCV NS5B-S282 was observed after they relapsed. We experienced two patients with cardiac events during treatment. In conclusion, combination of ledipasvir plus sofosbuvir for 12 weeks is a potential therapy for HCV GT1 patients. Caution is needed for HCV NS5A RAVs, which were selected by HCV NS5A inhibitors and cardiac adverse events.

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  • Interferon induces interleukin 8 and bone marrow stromal cell antigen 2 expression, inhibiting the production of hepatitis B virus surface antigen from human hepatocytes Reviewed

    Yuki Haga, Tatsuo Kanda, Shingo Nakamoto, Masato Nakamura, Reina Sasaki, Shuang Wu, Osamu Yokosuka

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   486 ( 3 )   858 - 863   2017.5

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    Hepatitis B virus (HBV) surface antigen (HBsAg) loss is one of the treatment goals of chronic HBV infection. Bone marrow stromal cell antigen 2 (BST2) is one of the interferon (IFN)-stimulated genes (ISGs) and inhibits the release of various enveloped viruses. Here we examined the effects of antiviral treatment on HBsAg levels and its intracellular mechanism in HBsAg-producing hepatocytes. In PLC/PRF/ 5 and Huhl, IFNoc-2a treatment decreased HBsAg levels in their conditioned media. Upregulation of interleukin 8 (IL8), toll-like receptor 2 (TLR2) and interferon gamma -induced protein 10 (IP10) mRNAs was associated with the reduction of HBsAg in both PLC/PRF/5 and Huhl. The HBsAg level was upregulated by knockdown of IL8, TLR2 or IP10. Exogenous addition of IL8 enhanced BST2 promoter activity and BST2 mRNA expression. Additionally, knockdown of IL8 could lead to the downregulation of BST2 mRNA. Transfection of poly(I-C) enhanced IL8 and BST2 mRNA expression and inhibited HBsAg secretion from PLC/PRF/5 cells. In conclusion, IL8 might play an important role in the enhancement of BST2 and be involved in HBsAg eradication. (C) 2017 Elsevier Inc. All rights reserved.

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  • Overexpression of c-Jun contributes to sorafenib resistance in human hepatoma cell lines Reviewed

    Yuki Haga, Tatsuo Kanda, Masato Nakamura, Shingo Nakamoto, Reina Sasaki, Koji Takahashi, Shuang Wu, Osamu Yokosuka

    PLOS ONE   12 ( 3 )   e0174153   2017.3

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    Background Despite recent advances in treatment strategies, it is still difficult to cure patients with hepatocellular carcinoma (HCC). Sorafenib is the only approved multiple kinase inhibitor for systemic chemotherapy in patients with advanced HCC. The majority of advanced HCC patients are resistant to sorafenib. The mechanisms of sorafenib resistance are still unknown.
    Methods The expression of molecules involved in the mitogen-activated protein kinase (MAPK) signaling pathway in human hepatoma cell lines was examined in the presence or absence of sorafenib. Apoptosis of human hepatoma cells treated with sorafenib was investigated, and the expression of Jun proto-oncogene (c-Jun) was measured.
    Results The expression and phosphorylation of c-Jun were enhanced in human hepatoma cell lines after treatment with sorafenib. Inhibiting c-Jun enhanced sorafenib-induced apoptosis. The overexpression of c-Jun impaired sorafenib-induced apoptosis. The expression of osteopontin, one of the established AP-1 target genes, was enhanced after treatment with sorafenib in human hepatoma cell lines.
    Conclusions The protein c-Jun plays a role in sorafenib resistance in human hepatoma cell lines. The modulation and phosphorylation of c-Jun could be a new therapeutic option for enhancing responsiveness to sorafenib. Modulating c-Jun may be useful for certain HCC patients with sorafenib resistance.

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  • Hepatitis A virus genotype IA-infected patient with marked elevation of aspartate aminotransferase levels Reviewed

    Yoshifumi Miura, Tatsuo Kanda, Shin Yasui, Koji Takahashi, Yuki Haga, Reina Sasaki, Masato Nakamura, Shuang Wu, Shingo Nakamoto, Makoto Arai, Tsutomu Nishizawa, Hiroaki Okamoto, Osamu Yokosuka

    Clinical Journal of Gastroenterology   10 ( 1 )   52 - 56   2017.2

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    We describe a case of acute liver failure (ALF) without hepatic encephalopathy with marked elevation of aminotransferase due to hepatitis A, according to the revised Japanese criteria of ALF. This liver biopsy of the patient showed compatible to acute viral hepatitis and she immediately recovered without intensive care. She had no comorbid disorders. Of interest, phylogenetic tree analysis using almost complete genomes of hepatitis A virus (HAV) demonstrated that the HAV isolate from her belonged to the HAV subgenotype IA strain and was similar to the HAJFF-Kan12 strain (99% nucleotide identity) or FH1 strain (98% nucleotide identity), which is associated with severe or fulminant hepatitis A. Careful interpretation of the association between HAV genome variations and severity of hepatitis A is needed and the mechanism of the severe hepatitis should be explored.

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  • Genome-wide association studies identify PRKCB as a novel genetic susceptibility locus for primary biliary cholangitis in the Japanese population Reviewed

    Minae Kawashima, Yuki Hitomi, Yoshihiro Aiba, Nao Nishida, Kaname Kojima, Yosuke Kawai, Hitomi Nakamura, Atsushi Tanaka, Mikio Zeniya, Etsuko Hashimoto, Hiromasa Ohira, Kazuhide Yamamoto, Masanori Abe, Kazuhiko Nakao, Satoshi Yamagiwa, Shuichi Kaneko, Masao Honda, Takeji Umemura, Takafumi Ichida, Masataka Seike, Shotaro Sakisaka, Masaru Harada, Osamu Yokosuka, Yoshiyuki Ueno, Michio Senju, Tatsuo Kanda, Hidetaka Shibata, Takashi Himoto, Kazumoto Murata, Yasuhiro Miyake, Hirotoshi Ebinuma, Makiko Taniai, Satoru Joshita, Toshiki Nikami, Hajime Ota, Hiroshi Kouno, Hirotaka Kouno, Makoto Nakamuta, Nobuyoshi Fukushima, Motoyuki Kohjima, Tatsuji Komatsu, Toshiki Komeda, Yukio Ohara, Toyokichi Muro, Tsutomu Yamashita, Kaname Yoshizawa, Yoko Nakamura, Masaaki Shimada, Noboru Hirashima, Kazuhiro Sugi, Keisuke Ario, Eiichi Takesaki, Atsushi Naganuma, Hiroshi Mano, Haruhiro Yamashita, Kouki Matsushita, Kazuhiko Yamauchi, Fujio Makita, Hideo Nishimura, Kiyoshi Furuta, Naohiro Takahashi, Masahiro Kikuchi, Naohiko Masaki, Tomohiro Tanaka, Sumito Tamura, Akira Mori, Shintaro Yagi, Ken Shirabe, Atsumasa Komori, Kiyoshi Migita, Masahiro Ito, Shinya Nagaoka, Seigo Abiru, Hiroshi Yatsuhashi, Michio Yasunami, Shinji Shimoda, Kenichi Harada, Hiroto Egawa, Yoshihiko Maehara, Shinji Uemoto, Norihiro Kokudo, Hajime Takikawa, Hiromi Ishibashi, Kazuaki Chayama, Masashi Mizokami, Masao Nagasaki, Katsushi Tokunaga, Minoru Nakamura

    HUMAN MOLECULAR GENETICS   26 ( 3 )   650 - 659   2017.2

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    A previous genome- wide association study (GWAS) performed in 963 Japanese individuals (487 primary biliary cholangitis [PBC] cases and 476 healthy controls) identified TNFSF15 (rs4979462) and POU2AF1 (rs4938534) as strong susceptibility loci for PBC. In this study, we performed GWAS in additional 1,923 Japanese individuals (894 PBC cases and 1,029 healthy controls),and combined the results with the previous data. This GWAS, together with a subsequent replication study in an independent set of 7,024 Japanese individuals (512 PBC cases and 6,512 healthy controls), identified PRKCB (rs7404928) as a novel susceptibility locus for PBC ( odds ratio [OR] = 1.26, P = 4.13 x 10(-9)). Furthermore, a primary functional variant of PRKCB (rs35015313) was identified by genotype imputation using a phased panel of 1,070 Japanese individuals from a prospective, general population cohort study and subsequent in vitro functional analyses. These results may lead to improved understanding of the disease pathways involved in PBC, forming a basis for prevention of PBC and development of novel therapeutics.

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  • Response-Guided Treatment with an Ultrarapid Virological Response Creates the Future of Interferon-Free Treatment against Hepatitis C Invited Reviewed International journal

    Tatsuo Kanda, Osamu Yokosuka

    OBM Hepatology and Gastroenterology.   2017.1

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  • Pneumocystis jirovecii pneumonia Suspected Due to Low-Dosage Prednisolone Treatment for Acute Autoimmune Hepatitis: Case Report and Literature Review Reviewed International journal

    Hidehiro Kamezaki, Department of Gastroenterology, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane City, Chiba Pref., 283-8686, Japan, Tatsuo Kanda, Osamu Yokosuka, Masanori Tsukahara, Yasunori Kasahara, Takayuki Sakurai, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba Pref., 260-8670, Japan, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba Pref., 260-8670, Japan, Department of Respiratory Medicine, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane City, Chiba Pref., 283-8686, Japan, Department of Respiratory Medicine, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane City, Chiba Pref., 283-8686, Japan, Department of Infectious Diseases, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba Pref., 260-8670, Japan

    OBM Hepatology and Gastroenterology.   2017.1

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    <jats:p>(1) Background: Preventative treatment for Pneumocystis jirovecii pneumonia (PCP) has been recommended for patients receiving ≥20 mg/day prednisolone. We describe a patient who developed PCP while receiving a dose of 15 mg/day prednisolone, and consider criteria for the initiation of preventative therapy for PCP in patients with autoimmune hepatitis (AIH) treated with prednisolone.(2) Case Report: A 71-year-old woman initially possessed dark-colored urine, white stool, and decreased appetite, which indicated hepatic dysfunction. Further comprehensive investigation suggested a diagnosis of acute hepatitis with probable autoimmune etiology. Treatment was initiated at 60 mg/day prednisolone. Following a positive response by the patient, the dose was gradually reduced to 15 mg/day. Seventy days after the start of prednisolone treatment, respiratory symptoms appeared, and PCP was diagnosed following examination of bronchoalveolar lavage samples. The patient responded positively to treatment with sulfamethoxazole/trimethoprim combination therapy.(3) Conclusions: Preventative therapy for PCP may be indicated for AIH patients treated with steroids with (1) a dose of prednisolone of 12–15 mg/day or more, (2) a CD4+ lymphocyte count of 200–250/mm3 or less, or (3) a total lymphocyte count of 600/mm3 or less.</jats:p>

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  • The prognosis of hepatitis B inactive carriers in Japan: a multicenter prospective study Reviewed

    Takashi Taida, Makoto Arai, Tatsuo Kanda, Shuhei Hige, Yoshiyuki Ueno, Fumio Imazeki, Namiki Izumi, Eiji Tanaka, Noboru Shinkai, Kentaro Yoshioka, Yasunari Nakamoto, Shuhei Nishiguchi, Masataka Tsuge, Masanori Abe, Michio Sata, Hiroshi Yatsuhashi, Akio Ido, Kazuhiko Kita, Ryousaku Azemoto, Yoshio Kitsukawa, Nobuaki Goto, Osamu Yokosuka

    Journal of Gastroenterology   52 ( 1 )   113 - 122   2017.1

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    Background: Hepatitis B e antigen (HBeAg)-negative inactive carriers, the majority of hepatitis B virus (HBV) carriers, are considered to have a good prognosis. The definition of the inactive HBV carrier state has been based on HBV DNA and alanine aminotransferase (ALT) levels. Here we conducted a prospective study involving 18 hospitals to clarify the prognosis of HBeAg-negative inactive carriers. Methods: Three hundred eighty-eight HBeAg-negative inactive carriers at the baseline were observed prospectively from January 2011 to November 2015. We evaluated the primary end point, defined as the development of cirrhosis, hepatocellular carcinoma (HCC), or liver-related death. Also, we analyzed the factors associated with inactive carrier dropout and markedly increased levels of ALT or HBV DNA or both during the follow-up period. Results: At the baseline, the mean age was 57.5 ± 13.1 years and 42 % of patients were male. No individual developed cirrhosis, HCC, or liver-related death during the follow-up period (1035 ± 252 days). Loss of inactive carrier status was seen in 75 patients (19.3 %). Factors associated with failure to meet the inactive carrier criteria in the multivariate analysis were the levels of ALT (hazard ratio 1.13, 95 % confidence interval 1.07–1.19, p &lt
     0.001), HBV DNA (hazard ratio 2.70, 95 % confidence interval 1.63–4.49, p &lt
     0.001), and γ-glutamyl transpeptidase (hazard ratio 1.01, 95 % confidence interval 1.00–1.02, p = 0.003) at the baseline. Conclusions: Most inactive carriers in Japan had a good prognosis. However, despite the short observation period, some patients had loss of IC status. The long-term prognosis of inactive carriers remains unclear
    therefore, careful follow-up of inactive carriers is needed.

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  • Free fatty acids or high-concentration glucose enhances hepatitis A virus replication in association with a reduction in glucose-regulated protein 78 expression Reviewed

    Nan Nwe Win, Tatsuo Kanda, Masato Nakamura, Shingo Nakamoto, Hiroaki Okamoto, Osamu Yokosuka, Hiroshi Shirasawa

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   483 ( 1 )   694 - 699   2017.1

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    Although the interaction between host and hepatitis A virus (HAV) factors could lead to severe hepatitis A, the exact mechanism of acute liver failure caused by HAV infection is not yet fully understood. The effects of metabolic diseases such as dyslipidemia or diabetes mellitus on HAV replication are still unknown. Here, we examined the effects of free fatty acids or high-concentration glucose on HAV replication and the effects on mitogen-activated protein kinase signaling pathway-related genes in human hepatocytes. We discovered a novel effect of free fatty acids or high-concentration glucose on HAV replication in association with a reduction in the expression of glucose-regulated protein 78 (GRP78). We also observed that thapsigargin induced GRP78 expression and inhibited HAV replication. These findings may provide a new interpretation of the relationship between metabolic diseases and severity of hepatitis A and suggest a new understanding of the mechanism of severe HAV infection. (C)16 Elsevier Inc. All rights reserved.

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  • Interferon-free treatment for HCV-infected patients with decompensated cirrhosis Reviewed

    Tatsuo Kanda

    HEPATOLOGY INTERNATIONAL   11 ( 1 )   38 - 44   2017.1

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    Progress in interferon-free treatment against hepatitis C virus (HCV) has remained a challenge in patients with decompensated cirrhosis due to a paucity of information on efficacy and safety profiles. This review illustrates that interferon-free treatment could result in greater than 85 % sustained virological response (SVR) rates in patients with HCV genotype 1 and decompensated cirrhosis. The combination of pangenotypic HCV NS5A inhibitor velpatasvir and HCV NS5B inhibitor sofosbuvir has demonstrated high SVR rates in patients with HCV genotypes 1, 2, 3, 4 or 6 and decompensated cirrhosis. Certain patients discontinued treatment due to adverse events, death or having liver transplantation. Taken together, interferon-free treatment could produce higher SVR rates in decompensated hepatic cirrhosis. However, as adverse events were occasionally observed, liver transplantation should always be considered as well. Further improvements in treatment are called for in patients with decompensated cirrhosis.

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  • Discrepancy between Hepatitis C Virus Genotypes and NS4-Based Serotypes: Association with Their Subgenomic Sequences Reviewed

    Nan Nwe Win, Shingo Nakamoto, Tatsuo Kanda, Hiroki Takahashi, Azusa Takahashi-Nakaguchi, Shin Yasui, Masato Nakamura, Shuang Wu, Fumio Imazeki, Shigeru Mikami, Osamu Yokosuka, Tohru Gonoi, Hiroshi Shirasawa

    INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES   18 ( 1 )   2017.1

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    Determination of hepatitis C virus (HCV) genotypes plays an important role in the direct-acting agent era. Discrepancies between HCV genotyping and serotyping assays are occasionally observed. Eighteen samples with discrepant results between genotyping and serotyping methods were analyzed. HCV serotyping and genotyping were based on the HCV nonstructural 4 (NS4) region and 5'-untranslated region (5'-UTR), respectively. HCV core and NS4 regions were chosen to be sequenced and were compared with the genotyping and serotyping results. Deep sequencing was also performed for the corresponding HCV NS4 regions. Seventeen out of 18 discrepant samples could be sequenced by the Sanger method. Both HCV core and NS4 sequences were concordant with that of genotyping in the 5'-UTR in all 17 samples. In cloning analysis of the HCV NS4 region, there were several amino acid variations, but each sequence was much closer to the peptide with the same genotype. Deep sequencing revealed that minor clones with different subgenotypes existed in two of the 17 samples. Genotyping by genome amplification showed high consistency, while several false reactions were detected by serotyping. The deep sequencing method also provides accurate genotyping results and may be useful for analyzing discrepant cases. HCV genotyping should be correctly determined before antiviral treatment.

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  • Association of IFNL3 Genotype with Hepatic Steatosis in Chronic Hepatitis C Patients Treated with Peginterferon and Ribavirin Combination Therapy Reviewed

    Shingo Nakamoto, Fumio Imazeki, Tatsuo Kanda, Shuang Wu, Masato Nakamura, Shin Yasui, Akinobu Tawada, Rintaro Mikata, Tetsuhiro Chiba, Makoto Arai, Osamu Yokosuka, Hiroshi Shirasawa

    INTERNATIONAL JOURNAL OF MEDICAL SCIENCES   14 ( 11 )   1088 - 1093   2017

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    Background: Genetic variation near the interferon lambda 3 (IFNL3) is known to be associated with response to pegylated interferon (pegIFN) and ribavirin combination therapy in patients with chronic hepatitis C virus (HCV) infection which is often accompanied by hepatic steatosis.
    Aims: We examined whether this genetic variation is associated with host lipids and treatment response.
    Methods: A total of 101 Japanese patients who had underwent liver biopsy before treatment with pegIFN and ribavirin for HCV genotype 1b infection were retrospectively analyzed for association between IFNL3 genotypes (rs8099917) and clinical factors including histopathological features of the liver. The presence of &gt;5% steatosis in the liver specimen was defined as hepatic steatosis.
    Results: Forty patients (40%) had liver steatosis before therapy. Patients with IFNL3 minor genotype (non-TT) showed lower low-density lipoprotein cholesterol level (p=0.0045), higher.-glutamyl transpeptidase level (p=0.0003) and higher prevalence of hepatic steatosis (p=0.0002). Advanced fibrosis [odds ratio (OR) 4.63, p=0.03] and IFNL3 major genotype (OR 0.13, p= 0.001) were 2 independent factors for determining the presence of hepatic steatosis. Among the factors associated with sustained virological response, IFNL3 genotype was the most significant predictor, as per multivariate analysis.
    Conclusions: Our results confirmed that IFNL3 genotype is associated with hepatic steatosis as well as IFN response.

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  • A型肝炎の現状とトピックス Invited

    神田達郎

    Medical Practice   34 ( 5 )   787 - 789   2017

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  • Serum Wisteria Floribunda Agglutinin-Positive Mac-2 Binding Protein Could Not Always Predict Early Cirrhosis in Non-Viral Liver Diseases. Reviewed International journal

    Haga Y, Kanda T, Sasaki R, Nakamura M, Takahashi K, Wu S, Yasui S, Arai M, Nakamoto S, Yokosuka O.

    Diseases.   4 ( 4 )   2016.12

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    BACKGROUND: Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA(+)-M2BP) is a novel non-invasive marker of liver fibrosis. The goal of the study was to investigate whether the novel serum biomarker WFA(+)-M2BP or other non-invasive markers are useful for the prediction of liver fibrosis in patients with nonalcoholic steatohepatitis (NASH), autoimmune hepatitis (AIH), and primary biliary cholangitis (PBC). METHODS: We examined a significant correlation between serum WFA(+)-M2BP levels and histological staging of fibrosis in several chronic liver diseases, such as NASH, AIH, and PBC. RESULTS: WFA(+)-M2BP could not predict hepatic fibrosis in these patients. We also showed that the level of platelet counts is a useful predictor of hepatic fibrosis progression in patients with NASH, AIH, and PBC. There was a significant correlation between staging of fibrosis and grading of activity in the liver in all groups except for AIH patients. CONCLUSION: Platelet counts can predict hepatic fibrosis in patients with NASH, AIH, or PBC. Clinicians should pay attention to the grading of liver activity in the use of WFA(+)-M2BP.

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  • Infectious complications, steroid use and timing for emergency liver transplantation in acute liver failure: analysis in a Japanese center Reviewed

    Shin Yasui, Keiichi Fujiwara, Yuuki Haga, Masato Nakamura, Rintaro Mikata, Makoto Arai, Tatsuo Kanda, Shigeto Oda, Osamu Yokosuka

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   23 ( 12 )   756 - 762   2016.12

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    Background Corticosteroid (CS) has been introduced in most acute liver failure (ALF) patients for the purpose of suppressing pro-inflammatory cytokines in Japan where a shortage of donor livers exists, whereas CS use is evaluated to be no benefit in Western countries. In the present study, we aimed to clarify the association between infectious complications and CS use in ALF, and determine when to evaluate treatment response and consider the timing for switching to liver transplantation (LT).
    Methods Corticosteroid was administered to patients in the early stage prospectively. Clinical and biochemical features of 110 adult patients were analyzed.
    Results Corticosteroids were administered to 78 (71%) patients. The duration between start of CS and onset of infection was 17 +/- 10 days. Multivariate analysis revealed that infection was associated with age 50 years (P = 0.034) and T-BIL &gt; 15 mg/dl (P &lt; 0.001), and not with CS use (P = 0.10). Accumulative incidence of infection was not different between patients with and without CS (P = 0.18).
    Conclusions Corticosteroid use did not significantly increase the incidence of infection. Two weeks after introduction of CS is a critical point for evaluating treatment response, avoiding infectious complications and switching to LT.

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  • Drug-induced liver injury associated with complementary and alternative medicines Reviewed

    Koji Takahashi, Tatsuo Kanda, Shin Yasui, Yuki Haga, Junichiro Kumagai, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Masato Nakamura, Makoto Arai, Osamu Yokosuka

    Case Reports in Gastroenterology   10 ( 3 )   706 - 713   2016.10

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    A 24-year-old man was admitted due to acute hepatitis with unknown etiology. After his condition and laboratory data gradually improved with conservative therapy, he was discharged 1 month later. Two months after his discharge, however, liver dysfunction reappeared. After his mother accidentally revealed that he took complementary and alternative medicine, discontinuation of the therapy caused his condition to improve. Finally, he was diagnosed with a recurrent drug-induced liver injury associated with Japanese complementary and alternative medicine. It is important to take the medical history in detail and consider complementary and alternative medicine as a cause of liver disease.

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  • APASL consensus statements and recommendation on treatment of hepatitis C Reviewed

    Masao Omata, Tatsuo Kanda, Lai Wei, Ming-Lung Yu, Wang-Long Chuang, Alaaeldin Ibrahim, Cosmas Rinaldi Adithya Lesmana, Jose Sollano, Manoj Kumar, Ankur Jindal, Barjesh Chander Sharma, Saeed S. Hamid, A. Kadir Dokmeci, Mamun-Al-Mahtab, Geofferey W. McCaughan, Jafri Wasim, Darrell H. G. Crawford, Jia-Horng Kao, Osamu Yokosuka, George K. K. Lau, Shiv Kumar Sarin

    HEPATOLOGY INTERNATIONAL   10 ( 5 )   702 - 726   2016.9

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    The Asian-Pacific Association for the Study of the Liver (APASL) convened an international working party on the "APASL consensus statements and recommendation on management of hepatitis C" in March, 2015, in order to revise "APASL consensus statements and management algorithms for hepatitis C virus infection (Hepatol Int 6:409-435, 2012)". The working party consisted of expert hepatologists from the Asian-Pacific region gathered at Istanbul Congress Center, Istanbul, Turkey on 13 March 2015. New data were presented, discussed and debated to draft a revision. Participants of the consensus meeting assessed the quality of cited studies. Finalized recommendations on treatment of hepatitis C are presented in this review.

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  • Two-dimensional shear wave elastography with propagation-based reliability assessment for grading hepatic fibrosis and portal hypertension Reviewed

    Hitoshi Maruyama, Kazufumi Kobayashi, Soichiro Kiyono, Tadashi Sekimoto, Tatsuo Kanda, Osamu Yokosuka

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   23 ( 9 )   595 - 602   2016.9

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    BackgroundThe aim of the present study was to examine the diagnostic ability of two-dimensional shear wave elastography (2D-SWE) with propagation-based reliability for grading of hepatic fibrosis and portal hypertension.
    MethodsThis prospective study (UMIN000022838) consisted of 135 subjects. Phase I (n=40) examined the effect of standard deviation (SD)/median as the reliability criterion of 2D-SWE, and phase II (n=95) compared the diagnostic ability of 2D-SWE under the best SD/median value and transient elastography (TE).
    ResultsPhase I reported 0.49 as a best cut-off SD/median value. In phase II, the elasticity showed a correlation between the 2D-SWE and TE (r=0.88, P &lt;0.001). The area under the receiver operating characteristic curve (AUROC) was comparable between the 2D-SWE and TE (0.936 and 0.948 for chronic hepatitis, P=0.34; 0.939 and 0.956 for cirrhosis, P=0.25). The hepatic venous pressure gradient showed a positive correlation with the 2D-SWE (r=0.435, P=0.043) and TE (r=0.378, P=0.083) in 22 patients. The AUROC was comparable between the 2D-SWE (0.844 for 10mmHg, 0.838 for 12mmHg) and TE (0.781 for 10mmHg, P=0.484; 0.800 for 12mmHg, P=0.589).
    Conclusions2D-SWE is promising for the assessment of the grade of hepatic fibrosis and portal hypertension, with the SD/median value as a reliability criterion.

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  • APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing Reviewed

    Masao Omata, Tatsuo Kanda, Lai Wei, Ming-Lung Yu, Wang-Long Chuang, Alaaeldin Ibrahim, Cosmas Rinaldi Adithya Lesmana, Jose Sollano, Manoj Kumar, Ankur Jindal, Barjesh Chander Sharma, Saeed S. Hamid, A. Kadir Dokmeci, Mamun Al-Mahtab, Geofferey W. McCaughan, Jafri Wasim, Darrell H. G. Crawford, Jia-Horng Kao, Osamu Yokosuka, George K. K. Lau, Shiv Kumar Sarin

    HEPATOLOGY INTERNATIONAL   10 ( 5 )   681 - 701   2016.9

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    The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on "APASL consensus statements and recommendations for management of hepatitis C" in March 2015 to revise the "APASL consensus statements and management algorithms for hepatitis C virus infection" (Hepatol Int 6:409-435, 2012). The working party consisted of expert hepatologists from the Asian-Pacific region gathered at the Istanbul Congress Center, Istanbul, Turkey on 13 March 2015. New data were presented, discussed, and debated during the course of drafting a revision. Participants of the consensus meeting assessed the quality of the cited studies. The finalized recommendations for hepatitis C prevention, epidemiology, and laboratory testing are presented in this review.

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  • Cooperative effects of hepatitis B virus and TNF may play important roles in the activation of metabolic pathways through the activation of NF-B Reviewed

    Shuang Wu, Tatsuo Kanda, Shingo Nakamoto, Xia Jiang, Masato Nakamura, Reina Sasaki, Yuki Haga, Hiroshi Shirasawa, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE   38 ( 2 )   475 - 481   2016.8

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    Elevated levels of inflammatory cytokines such as tumor necrosis factor- (TNF-) and interleukin (IL)-1 are often observed in the sera of hepatitis B virus (HBV)-infected patients. It is well known that these cytokines activate nuclear factor-B (NF-B)-signaling, and are associated with endoplasmic reticulum (ER) stress. We investigated whether HBV or HBV X protein (HBx) enhanced the activation of NF-B in the presence of TNF and/or IL-1, and their effects on the expression of metabolic pathway-associated genes. We examined whether HBV or HBx enhanced cytokine-induced activation of NF-B in hepatocytes, using a reporter assay, in the presence or absence of TNF and/or IL-1. The expression of insulin-like growth factor binding protein 1 (IGFBP1), one of the NF-B target genes was also examined. The expression of metabolic pathway-associated genes in HepG2 and HepG2.2.15 cells in the presence or absence of TNF was evaluated by RT-qPCR. Human hepatocytes expressed TNF receptors and IL-1 receptors. NF-B was activated by cooperation between HBx and TNF in human hepatocytes. We observed IGFBP1 expression in HBV infection and that a number of metabolic pathway-associated genes were upregulated in HepG2.2.15 cells, compared with HepG2 cells with or without TNF treatment. We observed the cooperative effects of HBV and TNF which enhanced the activation of NF-B as well as upregulated the expression of metabolic pathway-associated genes in hepatocytes. These effects may be important in the development of HBV-associated metabolic syndrome.

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  • Successful sofosbuvir treatment with ribavirin dose reduction for chronic hepatitis C virus genotype 2 infection in a patient with ulcerative colitis: a case report Reviewed

    Yuki Ohta, Tatsuo Kanda, Tatsuro Katsuno, Shin Yasui, Yuki Haga, Reina Sasaki, Masato Nakamura, Shuang Wu, Shingo Nakamoto, Makoto Arai, Osamu Yokosuka

    BMC GASTROENTEROLOGY   16 ( 1 )   66   2016.7

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    Background: Ulcerative colitis is a lifelong, immunologically mediated disease. Direct-acting antivirals (DAAs) are now available for the treatment of chronic hepatitis C virus (HCV) infection. An interferon-free regimen appears useful, safe and effective for many patients for whom interferon-based treatment is contraindicated.
    Case presentation: We studied a 56-year-old treatment-naive Japanese man with chronic HCV genotype 2b infection who had ulcerative colitis. This patient was treated with sofosbuvir and ribavirin for 12 weeks. During treatment, diarrhoea and bloody faeces were frequent. After ribavirin was reduced to 400 mg daily, these symptoms decreased. Finally, the patient achieved a sustained virologic response 12 weeks after the stoppage of the treatment.
    Conclusion: Clinicians should pay careful attention to the ribavirin dose in the treatment of certain HCV patients with inflammatory bowel disease who are receiving sofosbuvir plus ribavirin.

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  • Hepatitis C virus genotypes in Myanmar Invited Reviewed

    Nan Nwe Win, Tatsuo Kanda, Shingo Nakamoto, Osamu Yokosuka, Hiroshi Shirasawa

    WORLD JOURNAL OF GASTROENTEROLOGY   22 ( 27 )   6095 - 6099   2016.7

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    Myanmar is adjacent to India, Bangladesh, Thailand, Laos and China. In Myanmar, the prevalence of hepatitis C virus (HCV) infection is 2%, and HCV infection accounts for 25% of hepatocellular carcinoma. In this study, we reviewed the prevalence of HCV genotypes in Myanmar. HCV genotypes 1, 3 and 6 were observed in volunteer blood donors in and around the Myanmar city of Yangon. Although there are several reports of HCV genotype 6 and its variants in Myanmar, the distribution of the HCV genotypes has not been well documented in areas other than Yangon. Previous studies showed that treatment with peginterferon and a weight-based dose of ribavirin for 24 or 48 wk could lead to an 80%-100% sustained virological response (SVR) rates in Myanmar. Current interferon-free treatments could lead to higher SVR rates (90%-95%) in patients infected with almost all HCV genotypes other than HCV genotype 3. In an era of heavy reliance on direct-acting antivirals against HCV, there is an increasing need to measure HCV genotypes, and this need will also increase specifically in Myanmar. Current available information of HCV genotypes were mostly from Yangon and other countries than Myanmar. The prevalence of HCV genotypes in Myanmar should be determined.

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  • Prevention of hepatitis B virus-associated liver diseases by antiviral therapy Reviewed

    Akinobu Tawada, Tatsuo Kanda, Fumio Imazeki, Osamu Yokosuka

    HEPATOLOGY INTERNATIONAL   10 ( 4 )   574 - 593   2016.7

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    Hepatitis B virus (HBV) is a major cause of acute and chronic hepatitis, cirrhosis and hepatocellular carcinoma, particularly in Asia-Pacific countries. The major complications in HBV carriers are hepatocellular carcinoma (HCC), liver failure and esophageal varices following the progression to cirrhosis, while some develop HCC without cirrhosis. The progression to liver fibrosis and these other complications could be prevented by treatment with nucleos(t)ide analogues (NUCs); however, NUCs must be continuously administered for a long time. Peginterferon could lead to HBV surface antigen loss. It is difficult to use peginterferon in HBV-infected patients with decompensated cirrhosis. Acute liver failure due to HBV infection and acute exacerbation of chronic hepatitis B could be treated by NUCs. Universal vaccination programs against HBV could prevent new HBV infections globally. Here, we review the currently available treatments for HBV infection.

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  • Daclatasvir plus Asunaprevir Treatment for Real-World HCV Genotype 1-Infected Patients in Japan. Reviewed

    Kanda T, Yasui S, Nakamura M, Suzuki E, Arai M, Haga Y, Sasaki R, Wu S, Nakamoto S, Imazeki F, Yokosuka O

    Int J Med Sci.   13 ( 6 )   418 - 423   2016.5

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  • Daclatasvir plus asunaprevir treatment for real-world HCV genotype 1-infected patients in Japan Reviewed

    Tatsuo Kanda, Shin Yasui, Masato Nakamura, Eiichiro Suzuki, Makoto Arai, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Fumio Imazeki, Osamu Yokosuka

    International Journal of Medical Sciences   13 ( 6 )   418 - 423   2016.5

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    Background. All-oral combination of direct-acting antivirals could lead to higher sustained virologic response (SVR) in hepatitis C virus (HCV)-infected patients. In the present study, we examined the efficacy and safety of the dual oral treatment with HCV nonstructural protein (NS) 5A inhibitor daclatasvir (DCV) plus HCV NS3/4A inhibitor asunaprevir (ASV) for 24 weeks in real-world HCV genotype 1-infected Japanese individuals. Methods. After screening for HCV NS5A resistance-associated variants (RAVs) by PCR invader assay, a total of 54 Japanese patients infected with HCV genotype 1 treated with DCV plus ASV were retrospectively analyzed. SVR12 was used for evaluation of the virologic response. Results. Of the total 54 patients, 46 patients (85.2%) were treated with DCV plus ASV for 24 weeks and achieved SVR12. The other 8 patients (14.8%) discontinued this treatment before 24 weeks due to adverse events. Of these 8 patients, 5 and 3 patients did and did not achieve SVR12, respectively. Finally, 51 of 54 (94.4%) patients achieved SVR12. Conclusion. Treatment with DCV and ASV after screening for HCV NS5A RAVs by PCR invader assay is effective and safe in the treatment of real-world HCV genotype 1-infected patients in Japan.

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  • Autoimmune hepatitis following drug-induced liver injury in an elderly patient.

    Kumagai J, Kanda T, Yasui S, Haga Y, Sasaki R, Nakamura M, Wu S, Nakamoto S, Arai M, Iino Y, Yokosuka O

    Clinical journal of gastroenterology   2016.5

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    We describe a case of autoimmune hepatitis (AIH) that may have occurred following drug-induced liver injury with camostat mesilate and/or benzbromarone in an elderly patient. The patient's liver biopsy showed chronic active hepatitis and autoimmune hepatitis. Stopping the use of these drugs did not lead to complete remission, but the use of a low dose of corticosteroids completely cured his liver dysfunction. In the present case, liver dysfunction was caused by an autoimmune mechanism. Special attention should be paid to idiopathic AIH and drug-induced AIH in elderly patients.

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  • Analysis of infectious complications and timing for emergency liver transplantation in autoimmune acute liver failure Reviewed

    Keiichi Fujiwara, Shin Yasui, Yutaka Yonemitsu, Makoto Arai, Tatsuo Kanda, Yoshihiro Fukuda, Masayuki Nakano, Shigeto Oda, Osamu Yokosuka

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   23 ( 4 )   212 - 219   2016.4

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    BackgroundAutoimmune hepatitis (AIH) is one of major etiologies of acute liver failure (ALF), and the survival rate without liver transplantation (LT) of patients with fulminant AIH is especially poor worldwide. We investigated the clinicopathological features of infectious complications in autoimmune ALF retrospectively and tried to determine when to continue corticosteroid (CS) treatment or abandon it for LT.
    MethodsTwenty patients with autoimmune ALF, comprising five severe hepatitis, 13 fulminant hepatitis and two late onset hepatic failure, were analyzed.
    ResultsCorticosteroids were administered to 19 patients. Seventeen infectious complications were observed in 12 patients. The median (range) duration between the introduction of CS and onset of infection was 15 (10-41) days. There were no significant differences in clinicobiochemical features between patients with and without infection. Of 20 patients, eight (40%) recovered without LT, four (20%) received LT and eight (40%) died without LT. Dead or transplanted patients had more advanced liver failure on admission than recovered ones (P&lt;0.01).
    ConclusionsTwo-week after the introduction of CS is a critical point for avoiding infectious complications. Therefore, we should have evaluated efficacy of CS and performed LT by then at the latest in case of failure to improve.

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  • Possible Involvement of Hepatitis B Virus Infection of Hepatocytes in the Attenuation of Apoptosis in Hepatic Stellate Cells Reviewed

    Reina Sasaki, Tatsuo Kanda, Masato Nakamura, Shingo Nakamoto, Yuki Haga, Shuang Wu, Hiroshi Shirasawa, Osamu Yokosuka

    PLOS ONE   11 ( 1 )   e0146314   2016.1

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    Background
    The induction of apoptosis in hepatic stellate cells (HSCs) is a promising therapeutic strategy against hepatitis B virus (HBV)-related hepatic fibrosis. The underlying mechanisms of apoptosis in HSCs, however, are unknown under consideration of HBV infection. In this study, the effects of HBV on apoptosis and endoplasmic reticulum (ER) stress signaling in HSCs were examined.
    Methods
    The effects of conditioned media (CM) from HepG2.2.15 on apoptosis induced by the proteasome inhibitor MG132 in LX-2 and HHSteC were studied in regard to c-Jun. In combination with c-Fos, c-Jun forms the AP-1 early response transcription factor, leading to AP-1 activation, signal transduction, endoplasmic reticulum (ER) stress and apoptosis.
    Results
    In LX-2 cells, MG132 treatment was associated with the phosphorylation of c-Jun, activation of AP-1 and apoptosis. However, in the presence of CM from HepG2.2.15, these phenomena were attenuated. In HHSteC cells, similar results were observed. HBV genomic DNA is not involved in the process of HSC apoptosis. It is possible that HBeAg has an inhibitory effect on MG132-induced apoptosis in LX-2. We also observed the upregulation of several ER stress-associated genes, such as cAMP responsive element binding protein 3-like 3, inhibin-beta A and solute carrier family 17-member 2, in the presence of CM from HepG2.2.15, or CM from PXB cells infected with HBV.
    Conclusions
    HBV inhibits the activation of c-Jun/AP-1 in HSCs, contributing to the attenuation of apoptosis and resulting in hepatic fibrosis. HBV also up-regulated several ER stress genes associated with cell growth and fibrosis. These mechanistic insights might shed new light on a treatment strategy for HBV-associated hepatic fibrosis.

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  • Utility of Prediction Scores for Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Treated with Nucleos(t)ide Analogues Reviewed

    Akinobu Tawada, Tetsuhiro Chiba, Tomoko Saito, Sadahida Ogasawara, Eiichiro Suzuki, Yoshihiko Ooka, Makoto Arai, Tatsuo Kanda, Masami Shinozaki, Nobuaki Goto, Kengo Nagashima, Osamu Yokosuka

    ONCOLOGY   90 ( 4 )   199 - 208   2016

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    Objective: The utility of risk scores to predict the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients treated with nucleos(t)ide analogue (NA) remains to be elucidated. Methods: CU-HCC (The Chinese University of Hong Kong-HCC) and GAG-HCC (Guide with Age, Gender, HBV DNA, Core promoter mutations and Cirrhosis) scores of 225 Japanese patients treated with NAs for at least 2 years were calculated before and 2 years after the NA treatment. According to the cutoff values, the patients were categorized into high-score or low-score groups. Results: Sixteen of 225 patients developed HCC. Patients with a high score before the NA treatment showed a significantly higher HCC incidence than those with a low score using both score models (p &lt; 0.001). Time-dependent receiver operating characteristic analyses based on scores before and 2 years after the NA treatment showed that both models exhibited moderate accuracy in predicting HCC development. The HCC incidence was significantly lower in the patients whose scores decreased below the cutoff values in response to the NA treatment than in those whose scores remained high using both models (p &lt; 0.01). Conclusions: The predictive performance of the CU-HCC and GAG-HCC scores in the CHB patients treated with NAs is comparable to that in the NA-naive patients. The patients with sustained high scores after the NA treatment showed a higher incidence of HCC development. (C) 2016 S. Karger AG, Basel

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  • Sustained Virologic Response at 24 Weeks after the End of Treatment Is a Better Predictor for Treatment Outcome in Real-World HCV-Infected Patients Treated by HCV NS3/4A Protease Inhibitors with Peginterferon plus Ribavirin Reviewed

    Tatsuo Kanda, Shingo Nakamoto, Reina Sasaki, Masato Nakamura, Shin Yasui, Yuki Haga, Sadahisa Ogasawara, Akinobu Tawada, Makoto Arai, Shigeru Mikami, Fumio Imazeki, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MEDICAL SCIENCES   13 ( 4 )   310 - 315   2016

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    Background. Direct-acting antiviral agents against HCV with or without peginterferon plus ribavirin result in higher eradication rates of HCV and shorter treatment duration. We examined which is better for predicting persistent virologic response, the assessment of serum HCV RNA at 12 or 24 weeks after the end of treatment for predicting sustained virologic response (SVR12 or SVR24, respectively) in patients treated by HCV NS3/4A protease inhibitors with peginterferon plus ribavirin.
    Methods. In all, 149 Japanese patients infected with HCV genotype 1b treated by peginterferon plus ribavirin with telaprevir or simeprevir were retrospectively analyzed: 59 and 90 patients were treated with telaprevir- and simeprevir-including regimens, respectively. HCV RNA was measured by TaqMan HCV Test, version 2.0, real-time PCR assay. SVR12 or SVR24, respectively, was defined as HCV RNA negativity at 12 or 24 weeks after ending treatment.
    Results. Total SVR rates were 78.0% and 66.7% in the telaprevir and simeprevir groups, respectively. In the telaprevir group, all 46 patients with SVR12 finally achieved SVR24. In the simeprevir group, 60 (93.8%) of the total 64 patients with SVR12 achieved SVR24, with the other 4 patients all being previous-treatment relapsers.
    Conclusions. SVR12 was suitable for predicting persistent virologic response in almost all cases. In simeprevir-including regimens, SVR12 could not always predict persistent virologic response. Clinicians should use SVR24 for predicting treatment outcome in the use of HCV NS3/4A protease inhibitors with peginterferon plus ribavirin for any group of real-world patients chronically infected with HCV.

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  • Successful Management of Acute Liver Failure Patients Waiting for Liver Transplantation by On-Line Hemodiafiltration with an Arteriovenous Fistula Reviewed

    Yuki Haga, Shin Yasui, Tatsuo Kanda, Noriyuki Hattori, Toru Wakamatsu, Masato Nakamura, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Makoto Arai, Hitoshi Maruyama, Masayuki Ohtsuka, Shigeto Oda, Masaru Miyazaki, Osamu Yokosuka

    Case Reports in Gastroenterology   10 ( 1 )   139 - 145   2016

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    On-line hemodiafiltration (OLHDF) is one of the treatment options in the management of acute liver failure (ALF) in Japan. It is essential to avoid infection in the management of ALF. In fact, infection is one of the prognostic factors in ALF. In this report, we present a middle-aged Japanese man with ALF associated with benzbromarone use. He was successfully managed without infection until liver transplantation by creating an arteriovenous fistula for OLHDF. Utilizing an arteriovenous fistula for OLHDF, rather than inserting a vascular access catheter, is a beneficial option to avoid infectious diseases in the management of ALF.

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  • Successful Eradication of Hepatitis C Virus by Interferon-Free Regimens in Two Patients with Advanced Liver Fibrosis following Kidney Transplantation Reviewed

    Reina Sasaki, Tatsuo Kanda, Shin Yasui, Yuki Haga, Masato Nakamura, Mutsumi Yamato, Shuang Wu, Shingo Nakamoto, Makoto Arai, Shigeru Mikami, Hideaki Miyauchi, Hisahiro Matsubara, Osamu Yokosuka

    Case Reports in Gastroenterology   10 ( 2 )   248 - 256   2016

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    Hepatitis C virus (HCV) infection leads to acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Following kidney transplantation, HCV increases the risk of graft loss and patient mortality compared with uninfected patients. The achievement of a sustained virological response with antiviral therapy improves survival and diminishes the risk of hepatic decompensation in HCV patients after a kidney transplant. It has been reported that direct-acting antivirals (DAAs) are relatively safe and highly effective for the eradication of HCV in patients who are liver transplant recipients. In the present study, we investigated HCV eradication via interferon-free therapies with DAAs in two HCV patients with advanced liver fibrosis following renal transplantation. In both cases, the interferon-free regimens with DAAs were effective in eradicating HCV in the patients after kidney transplantation. No adverse events caused by interferon were identified with the exception of anemia. Interferon-free regimens with DAAs for recurrent HCV in patients following kidney transplantation are relatively safe and effective. However, attention should be focused on anemia during these treatments.

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  • Successful Management of Graft Reinfection of HCV Genotype 2 in Living Donor Liver Transplantation from a Hepatitis B Core Antibody-Positive Donor with Sofosbuvir and Ribavirin Reviewed

    Reina Sasaki, Tatsuo Kanda, Masayuki Ohtsuka, Shin Yasui, Yuki Haga, Masato Nakamura, Masayuki Yokoyama, Shuang Wu, Shingo Nakamoto, Makoto Arai, Hitoshi Maruyama, Masaru Miyazaki, Osamu Yokosuka

    Case Reports in Gastroenterology   10 ( 2 )   366 - 372   2016

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    Direct-acting antivirals (DAAs) are relatively safe and highly effective for the eradication of hepatitis C virus (HCV) in liver transplant recipients. In this case study, we present a female with a graft reinfected with HCV genotype 2 who was treated with a combination of sofosbuvir and ribavirin after living donor liver transplantation (LDLT). Because the graft was from a hepatitis B core antibody-positive donor, passive immunization with hyperimmune hepatitis B immunoglobulin (HBIG) and entecavir were also provided to prevent hepatitis B virus (HBV) reactivation. It became clear that the combination of sofosbuvir and ribavirin promptly led to a sustained virologic response and that this combination was safe to treat graft reinfection with HCV genotype 2 after LDLT. Adverse events caused by DAAs were not observed, except for slight anemia. HBIG and entecavir were useful in the prevention of HBV reactivation. In conclusion, the present case indicated that DAA treatment for graft reinfection with HCV is safe and effective in LDLT from hepatitis B core antibody-positive donors.

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  • Sofosbuvir treatment and hepatitis C virus infection Invited Reviewed

    Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka

    World Journal of Hepatology   8 ( 3 )   183 - 190   2016

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    Hepatitis C virus (HCV) infection is a serious problem worldwide. The use of interferon-based therapy has made HCV eradication challenging. The recent appearance of direct-acting antiviral agents (DAAs) has changed HCV therapy. Combining the use of DAAs with peginterferon and ribavirin has improved treatment efficacy. Furthermore, the combination of different orally administered DAAs has enabled interferon-free therapy with much higher efficacy and safety. In particular, sofosbuvir, a nucleotide-based NS5B inhibitor, prevents HCV RNA synthesis by acting as a "chain terminator". Treatment with sofosbuvir has attained an extremely high rate of sustained virologic response. The current review summarizes the efficacy and safety of sofosbuvir therapy.

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  • Autoimmune hepatitis following drug-induced liver injury in an elderly patient. Reviewed

    Kumagai J, Kanda T, Yasui S, Haga Y, Sasaki R, Nakamura M, Wu S, Nakamoto S, Arai M, Iino Y, Yokosuka O.

    Clin J Gastroenterol.   9 ( 3 )   156 - 159   2016

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  • [History of the discovery of viral hepatitis].

    Miyamura T, Kanda T, Yokosuka O

    Nihon rinsho. Japanese journal of clinical medicine   2015.12

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  • [New antivirals for hepatitis B virus infection].

    Nakamoto S, Kanda T, Yokosuka O

    Nihon rinsho. Japanese journal of clinical medicine   2015.12

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  • MicroRNA-122 Inhibits the Production of Inflammatory Cytokines by Targeting the PKR Activator PACT in Human Hepatic Stellate Cells Reviewed

    Masato Nakamura, Tatsuo Kanda, Reina Sasaki, Yuki Haga, Xia Jiang, Shuang Wu, Shingo Nakamoto, Osamu Yokosuka

    PLOS ONE   10 ( 12 )   e0144295   2015.12

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    MicroRNA-122 (miR-122) is one of the most abundant miRs in the liver. Previous studies have demonstrated that miR-122 plays a role in inflammation in the liver and functions in hepatic stellate cells (HSCs), which reside in the space of Disse. Here, we showed that the transient inhibition of PKR-activating protein (PACT) expression, by miR-122 or siRNA targeting of PACT, suppressed the production of proinflammatory cytokines, such as interleukin (IL)-6, monocyte chemoattractant protein-1 (MCP-1) and IL-1 beta, in human HSC LX-2. Sequence and functional analyses confirmed that miR-122 directly targeted the 30-untranslated region of PACT. Immunofluorescence analysis revealed that miR-122 blocked NF-kappa B-nuclear translocation in LX-2 cells. We also showed that conditioned medium from miR-122-transfected LX-2 cells suppressed human monocyte-derived THP-1 cell migration. Taken together, our study indicates that miR-122 may downregulate cytokine production in HSCs and macrophage chemotaxis and that the targeting of miR-122 may have therapeutic potential for preventing the progression of liver diseases.

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  • Nonalcoholic fatty liver disease and hepatic cirrhosis: comparison with viral hepatitis-associated steatosis Reviewed

    Yuki Haga, Tatsuo Kanda, Reina Sasaki, Masato Nakamura, Shingo Nakamoto, Osamu Yokosuka

    WORLD JOURNAL OF GASTROENTEROLOGY   21 ( 46 )   12989 - 12995   2015.12

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    Nonalcoholic fatty liver disease (NAFLD) including nonalcoholic steatohepatitis (NASH) is globally increasing and has become a world-wide health problem. Chronic infection with hepatitis B virus or hepatitis C virus (HCV) is associated with hepatic steatosis. Viral hepatitis-associated hepatic steatosis is often caused by metabolic syndrome including obesity, type 2 diabetes mellitus and/or dyslipidemia. It has been reported that HCV genotype 3 exerts direct metabolic effects that lead to hepatic steatosis. In this review, the differences between NAFLD/NASH and viral hepatitis-associated steatosis are discussed.

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  • Factors associated with the effect of interferon-alpha sequential therapy in order to discontinue nucleoside/nucleotide analog treatment in patients with chronic hepatitis B Reviewed

    Akihiro Matsumoto, Hiroshi Yatsuhashi, Shinya Nagaoka, Yoshiyuki Suzuki, Tetsuya Hosaka, Masataka Tsuge, Kazuaki Chayama, Tatsuo Kanda, Osamu Yokosuka, Shuhei Nishiguchi, Masaki Saito, Shiho Miyase, Jong-Hon Kang, Noboru Shinkai, Yasuhito Tanaka, Takeji Umemura, Eiji Tanaka

    HEPATOLOGY RESEARCH   45 ( 12 )   1195 - 1202   2015.12

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    Aim: The factors associated with the outcome of sequential therapy with interferon-alpha (IFN-alpha) in order to halt nucleoside/nucleotide analog (NUC) maintenance treatment for chronic hepatitis B were analyzed.
    Methods: A total of 50 patients with chronic hepatitis B who underwent IFN-alpha sequential therapy for cessation of NUC were enrolled retrospectively. The subjects received NUC plus IFN-alpha for 4 weeks followed by IFN-alpha alone for 20 weeks. Natural IFN-alpha of 6-MU doses was administrated three times a week. A successful response to NUC/IFN-alpha sequential therapy was defined as serum hepatitis B virus (HBV) DNA below 4.0 log copies/mL, serum alanine aminotransferase (ALT) below 30 IU/L, and hepatitis B e-antigen negativity at 24 months after completing the treatment.
    Results: Multivariate analysis revealed that hepatitis B surface antigen (HBsAg) of 3.0 log U/mL or more (P &lt; 0.002) and hepatitis B core-related antigen (hepatitis B core-related antigen [HBcrAg]) of 4.5 log U/mL or more (P &lt; 0.003) at the start of IFN-alpha administration were significant factors associated with a 24-month non-response. Maximal levels of ALT and HBV DNA during the follow-up period after completing IFN-alpha therapy were significantly related (P &lt; 0.001), and receiver operating characteristic analysis showed that both maximal ALT (P &lt; 0.001) and HBV DNA(P &lt; 0.001) were significantly related to the final 24-month response.
    Conclusion: The combinational use of HBsAg and HBcrAg levels may be useful to predict the 24-month outcome of NUC/IFN-alpha sequential therapy. Maximal levels of ALT and HBV DNA during post-treatment follow-up may also help monitor responses to IFN-alpha sequential therapy.

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  • The sirtuin inhibitor sirtinol inhibits hepatitis A virus (HAV) replication by inhibiting HAV internal ribosomal entry site activity Reviewed

    Tatsuo Kanda, Reina Sasaki, Shingo Nakamoto, Yuki Haga, Masato Nakamura, Hiroshi Shirasawa, Hiroaki Okamoto, Osamu Yokosuka

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   466 ( 3 )   567 - 571   2015.10

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    Epigenetics plays a role in the regulation of gene expression. Epigenetic changes control gene expression at the transcriptional level. Our previous study suggested that the La protein, which is mainly localized in the nucleus, was associated with hepatitis A virus (HAV) internal ribosomal entry site (IRES)-mediated translation and HAV replication. The aim of this study was to investigate whether epigenetic compounds have effects on HAV IRES-mediated translation and HAV replication. Sirtinol, a sirtuin inhibitor, inhibited HAV IRES-mediated translation in COS7-HAV-IRES cells. Treatment with 10 mu M sirtinol resulted in a significant reduction in the intracellular RNA levels of HAV HA11-1299 genotype IIIA in Huh7 cells. Epigenetic treatment with a sirtuin inhibitor may represent a new treatment option for HAV infection. In conclusion, epigenetic control was involved in HAV IRES-dependent translation and HAV replication. Special attention should also be paid to underlying viral diseases in the clinical use of epigenetic treatments for malignancies. (C) 2015 Elsevier Inc. All rights reserved.

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  • 【ウイルス肝炎・肝癌研究の新展開】ウイルス肝炎の最新治療

    中村 昌人, 神田 達郎, 横須賀 收

    細胞   47 ( 11 )   546 - 549   2015.10

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    ウイルス肝炎、特に慢性B型肝炎及び慢性C型肝炎に対する治療は変革期を迎えている。B型肝炎、C型肝炎双方の治療法の進歩において、核酸アナログ製剤の開発が重要な位置を占めている。慢性B型肝炎の分野では、本邦では2000年から核酸アナログ製剤が使用可能となり、B型肝炎ウイルス増殖・複製を効率的に抑制することが可能となった。また、慢性C型肝炎治療においては、ウイルス構成成分を直接の標的とした薬剤の開発が盛んであるが、その中でも核酸アナログ製剤としてRNAポリメラーゼ作用を阻害する薬剤が優れた治療成績を挙げている。本稿では、核酸アナログ製剤を中心に、慢性B型肝炎及び慢性C型肝炎の最新治療を中心に概説した。(著者抄録)

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  • 【C型慢性肝炎治療のパラダイムシフト-治療から治癒へ-】Genotype2型に対する新薬NS5Bポリメラーゼ阻害薬Sofosbuvir 臨床効果

    横須賀 收, 中村 昌人, 神田 達郎

    肝胆膵   71 ( 4 )   651 - 655   2015.10

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  • Severe and fulminant hepatitis of indeterminate etiology in a Japanese center Reviewed

    Keiichi Fujiwara, Shin Yasui, Masayuki Nakano, Yutaka Yonemitsu, Makoto Arai, Tatsuo Kanda, Yoshihiro Fukuda, Shigeto Oda, Osamu Yokosuka

    HEPATOLOGY RESEARCH   45 ( 10 )   E141 - E149   2015.10

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    AimThe outcome of acute liver failure (ALF) is influenced by its etiology, making etiological consideration of ALF important. However, specific etiology could not be identified in 30-40% of adult patients in a Japanese nationwide survey. We examined our patients with severe (SH) and fulminant hepatitis (FH) of indeterminate etiology for the better understanding of ALF.
    MethodsWe investigated 106 adult patients with SH or FH including 24 of indeterminate etiology between 2000 and 2013, retrospectively.
    ResultsOf 24 patients, 12 were men. Seventeen were SH and seven FH (three FH acute type and four FH subacute type). Eighty-three percent of patients were positive for antinuclear antibody. Seventeen recovered without liver transplantation (LT), two received LT and five died without LT. Histology of 15 patients showed a pattern of acute hepatitis (massive necrosis in four, submassive necrosis in one, severe acute hepatitis in two and acute hepatitis in eight). The involvement of immune-mediated liver injury was histologically suggested in some patients.
    ConclusionThere was no large cluster of etiology in our patients with indeterminate cause. The causes of ALF of indeterminate etiology were the mixture of various minor or rare ones, if precise diagnosis of acute AIH was done. Outcome of our patients with indeterminate cause was not poor if they were treated as early as possible after the diagnosis of severe disease. Careful examination of unknown viral infection, drugs, toxins, undefined metabolic disorders and histology may help detect some of these etiologies.

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  • Features of hepatitis C virus infection, current therapies and ongoing clinical trials in ten Asian Pacific countries Reviewed

    Masao Omata, Tatsuo Kanda, Osamu Yokosuka, Darrell Crawford, Mamun Al-Mahtab, Lai Wei, Alaaeldin Ibrahim, George K. K. Lau, Barjesh C. Sharma, Saeed S. Hamid, Wan-Long Chuang, A. Kadir Dokmeci

    HEPATOLOGY INTERNATIONAL   9 ( 4 )   486 - 507   2015.10

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    Estimated hepatitis C virus (HCV) infection rates in the general populations were 1.3, 0.9, 0.4-1.0, 14.7, 0.1-0.3, 0.9-1.9, 1.0-2.0, 5, 4.4-8.6 and 0.5-1.3 % in Australia, Bangladesh, Mainland China, Egypt, Hong Kong, India, Japan, Pakistan, Taiwan and Turkey, respectively. The main HCV genotypes (Gs) are G1, G3, G1b, G4, G1b, G3, G1b, G3, G1b and G2, and G1 in Australia, Bangladesh, Mainland China, Egypt, Hong Kong, India, Japan, Pakistan, Taiwan and Turkey, respectively. Of IL28B genotypes, favorable alleles are similar to 50 % in Australia and Turkey, but 60-70 % in most of the other Asian countries. Peginterferon plus ribavirin is available in all ten Asian Pasific countries. In addition, HCV NS3/4A protease inhibitors with peginterferon plus ribavirin are currently available in several countries. Clinical trials of interferon-free regimens for HCV are ongoing in most of the ten Asian Pacific countries.

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  • Expression of microRNA-155 correlates positively with the expression of Toll-like receptor 7 and modulates hepatitis B virus via C/EBP-beta in hepatocytes Reviewed

    N. Sarkar, R. Panigrahi, A. Pal, A. Biswas, S. P. Singh, S. K. Kar, M. Bandopadhyay, D. Das, D. Saha, T. Kanda, M. Sugiyama, S. Chakrabarti, A. Banerjee, R. Chakravarty

    JOURNAL OF VIRAL HEPATITIS   22 ( 10 )   817 - 827   2015.10

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    Effective recognition of viral infection and successive activation of antiviral innate immune responses are vital for host antiviral defence, which largely depends on multiple regulators, including Toll-like receptors (TLRs) and microRNAs. Several early reports suggest that specific TLR-mediated immune responses can control hepatitis B virus (HBV) replication and express differentially with disease outcome. Considering the versatile function of miR-155 in the TLR-mediated innate immune response, we aimed to study the association between miR-155 and TLRs and their subsequent impact on HBV replication using both a HBV-replicating stable cell line (HepG2.2.15) and HBV-infected liver biopsy and serum samples. Our results showed that miR-155 was suppressed during HBV infection and a subsequent positive correlation of miR-155 with TLR7 activation was noted. Further, ectopic expression of miR-155 in vitro reduced HBV load as evidenced from reduced viral DNA, mRNA and subsequently reduced level of secreted viral antigens (HBsAg and HBeAg). Our results further suggested that CCAAT/enhancer-binding protein- (C/EBP-), a positive regulator of HBV transcription, was inhibited by miR-155. Taken together, our study established a correlation between miR-155 and TLR7 during HBV infection and also demonstrated in vitro that increased miR-155 level could help to reduce HBV viral load by targeting C/EBP-.

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  • Reappearance of Serum Hepatitis B Viral DNA in Patients With Hepatitis B Surface Antigen Seroclearance Reviewed

    Masato Nakamura, Tatsuo Kanda, Shingo Nakamoto, Yuki Haga, Reina Sasaki, Xia Jiang, Shin Yasui, Makoto Arai, Osamu Yokosuka

    HEPATOLOGY   62 ( 4 )   1329 - 1329   2015.10

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    DOI: 10.1002/hep.27693

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  • Direct-acting Antivirals and Host-targeting Agents against the Hepatitis A Virus. Invited Reviewed International journal

    Kanda T, Nakamoto S, Wu S, Nakamura M, Jiang X, Haga Y, Sasaki R, Yokosuka O.

    J Clin Transl Hepatol.   3 ( 3 )   205 - 210   2015.9

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    Hepatitis A virus (HAV) infection is a major cause of acute hepatitis and occasionally leads to acute liver failure in both developing and developed countries. Although effective vaccines for HAV are available, the development of new antivirals against HAV may be important for the control of HAV infection in developed countries where no universal vaccination program against HAV exists, such as Japan. There are two forms of antiviral agents against HAV: direct-acting antivirals (DAAs) and host-targeting agents (HTAs). Studies using small interfering ribonucleic acid (siRNA) have suggested that the HAV internal ribosomal entry site (IRES) is an attractive target for the control of HAV replication and infection. Among the HTAs, amantadine and interferon-lambda 1 (IL-29) inhibit HAV IRES-mediated translation and HAV replication. Janus kinase (JAK) inhibitors inhibit La protein expression, HAV IRES activity, and HAV replication. Based on this review, both DAAs and HTAs may be needed to control effectively HAV infection, and their use should continue to be explored.

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  • HBV Core Protein Enhances Cytokine Production. Reviewed International journal

    Kanda T, Wu S, Sasaki R, Nakamura M, Haga Y, Jiang X, Nakamoto S, Yokosuka O.

    Diseases.   3 ( 3 )   213 - 220   2015.9

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    Hepatitis B virus (HBV) infection, a cause of hepatocellular carcinoma (HCC), remains a serious global health concern. HCC development and human hepatocarcinogenesis are associated with hepatic inflammation caused by host interferons and cytokines. This article focused on the association between the HBV core protein, which is one of the HBV-encoding proteins, and cytokine production. The HBV core protein induced the production of interferons and cytokines in human hepatoma cells and in a mouse model. These factors may be responsible for persistent HBV infection and hepatocarcinogenesis. Inhibitors of programmed death (PD)-1 and HBV core and therapeutic vaccines including HBV core might be useful for the treatment of patients with chronic HBV infection. Inhibitors of HBV core, which is important for hepatic inflammation, could be helpful in preventing the progression of liver diseases in HBV-infected patients.

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  • [112th Scientific Meeting of the Japanese Society of Internal Medicine: Symposium: Viral Infection and Tumors: Hepatitis B Virus Infection and Hepatocellular Carcinoma].

    Yokosuka O, Nakamoto S, Kanda T

    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine   2015.9

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  • Effect of Hepatitis C Virus Genotype 1b Core and NS5A Mutations on Response to Peginterferon Plus Ribavirin Combination Therapy Reviewed

    Shingo Nakamoto, Fumio Imazeki, Makoto Arai, Shin Yasui, Masato Nakamura, Yuki Haga, Reina Sasaki, Tatsuo Kanda, Hiroshi Shirasawa, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES   16 ( 9 )   21177 - 21190   2015.9

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    We examined whether hepatitis C virus (HCV) genotype 1b core- and NS5A-region mutations are associated with response to peginterferon -2b plus ribavirin combination therapy. A total of 103 patients with high HCV genotype 1b viral loads (100 KIU/mL) were treated with the combination therapy. Pretreatment mutations in the core region and interferon sensitivity determining region (ISDR) in the NS5A region were analyzed. In univariate analysis, arginine and leucine at positions 70 and 91 in the core region, defined as double wild (DW)-type, were associated with early virologic response (p = 0.002), sustained virologic response (SVR) (p = 0.004), and non-response (p = 0.005). Non-threonine at position 110 was associated with SVR (p = 0.004). Multivariate analysis showed the following pretreatment predictors of SVR: hemoglobin level 14 g/dL (odds ratio (OR) 6.2, p = 0.04); platelet count 14 x 10(4)/mm(3) (OR 5.2, p = 0.04); aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio &lt; 0.9 (OR 6.17, p = 0.009); DW-type (OR 6.8, p = 0.02); non-threonine at position 110 (OR 14.5, p = 0.03); and 2 mutations in the ISDR (OR 12.3, p = 0.02). Patients with non-DW-type, non-threonine at position 110, and &lt;2 ISDR mutations showed significantly lower SVR rates than others (11/45 (24.4%) vs. 27/37 (73.0%), respectively; p &lt; 0.001). SVR can be predicted through core and NS5A region mutations and host factors like hemoglobin, platelet count, and AST/ALT ratio in HCV genotype 1b-infected patients treated with peginterferon and ribavirin combination therapy.

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  • Association between hepatitis B virus and MHC class I polypeptide-related chain A in human hepatocytes derived from human-mouse chimeric mouse liver Reviewed

    Reina Sasaki, Tatsuo Kanda, Shuang Wu, Shingo Nakamoto, Yuki Haga, Xia Jiang, Masato Nakamura, Hiroshi Shirasawa, Osamu Yokosuka

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   464 ( 4 )   1192 - 1195   2015.9

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    Due to the lack of efficient hepatitis B virus (HBV) infection systems, progress in understanding the role of innate immunity in HBV infection has remained challenging. Here we used human hepatocytes from a humanized severe combined immunodeficiency albumin promoter/enhancer driven-urokinase-type plasminogen activator mouse model for HBV infection. HBV DNA levels in culture medium from these human hepatocytes were 4.8-5.7 log IU/mL between day 16 and day 66 post-infection by HBV genotype C inoculum. HBV surface antigen (HBsAg) was also detected by chemiluminescent immunoassay from day 7 to day 66 post-infection. Western blot analysis revealed that major histocompatibility complex class I-related chain A (MICA), which plays a role in the innate immune system, was induced in HBV-infected human hepatocytes 27 days after infection compared with the uninfected control. MICA was reduced at day 62 and undetectable at day 90. Of interest, MICA expression by human hepatocytes increased after HBV infection and decreased before HBsAg loss. Human hepatocytes derived from chimeric mice with hepatocyte-humanized liver could support HBV genome replication. Further studies of the association between HBV replication and MICA induction should be conducted. (C) 2015 Elsevier Inc. All rights reserved.

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  • Is the use of IL28B genotype justified in the era of interferon-free treatments for hepatitis C? Reviewed International journal

    Kanda T, Nakamoto S, Yokosuka O

    World journal of virology   4 ( 3 )   178 - 184   2015.8

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    In 2009, several groups reported that interleukin-28B (IL28B) genotypes are associated with the response to peginterferon plus ribavirin therapy for chronic hepatitis C virus (HCV) infection in a genome-wide association study, although the mechanism of this association is not yet well understood. However, in recent years, tremendous progress has been made in the treatment of HCV infection. In Japan, some patients infected with HCV have the IL28B major genotype, which may indicate a favorable response to interferon-including regimens; however, certain patients within this group are also interferon-intolerant or ineligible. In Japan, interferon-free 24-wk regimens of asunaprevir and daclatasvir are now available for HCV genotype 1b-infected patients who are interferon-intolerant or ineligible or previous treatment null-responders. The treatment response to interferon-free regimens appears better, regardless of IL28B genotype. Maybe other interferon-free regimens will widely be available soon. In conclusion, although some HCV-infected individuals have IL28B favorable alleles, importance of IL28B will be reduced with availability of oral interferon free regimen.

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  • Importance of the poor prognosis of severe and fulminant hepatitis in the elderly in an era of a highly aging society: Analysis in a Japanese center Reviewed

    Keiichi Fujiwara, Shin Yasui, Yutaka Yonemitsu, Makoto Arai, Tatsuo Kanda, Masayuki Nakano, Shigeto Oda, Osamu Yokosuka

    HEPATOLOGY RESEARCH   45 ( 8 )   863 - 871   2015.8

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    AimOlder age has been widely believed to be associated with a poor prognosis of acute liver failure. We aimed to evaluate the impact of older age on outcomes of Japanese patients with severe and fulminant hepatitis in an era of a highly aging society.
    MethodsWe investigated 105 consecutive adult patients with fulminant hepatitis (FH) or severe hepatitis (SH) admitted to our liver unit between 2000 and 2013, consisting of 14 elderly patients (65 years) and 91 younger ones (&lt;65 years).
    ResultsIn elderly patients, the proportion of women was greater (P&lt;0.001), the levels of aspartate aminotransferase and lactate dehydrogenase on admission were lower (P=0.011 and P=0.010, respectively), and the survival rate without liver transplantation was lower (P=0.024) than younger ones. Two of seven SH and all seven FH elderly patients died, whereas all 45 SH and 16 of 46 FH younger patients recovered. Seventy-one percent of elderly patients had underlying diseases with medications, and 57% had additional complications after the start of treatment for acute liver failure. Patients aged 70 years or more showed even poorer prognoses than younger ones and those aged 65-69 years (P=0.0052 and P=0.036, respectively).
    ConclusionOlder age was associated with a poor prognosis of patients with SH and FH. One of the reasons other than complications and loss of organ reserve by aging would be that elderly patients consulted us at a more advanced stage of illness than younger ones.

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  • Hepatitis C Virus Nonstructural Protein 5A Inhibits MG132-Induced Apoptosis of Hepatocytes in Line with NF-kappa B-Nuclear Translocation Reviewed

    Xia Jiang, Tatsuo Kanda, Shuang Wu, Shingo Nakamoto, Masato Nakamura, Reina Sasaki, Yuki Haga, Takaji Wakita, Hiroshi Shirasawa, Osamu Yokosuka

    PLOS ONE   10 ( 7 )   e0131973   2015.7

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    Background
    Hepatitis C virus (HCV) infection is one of the major causes of cirrhosis and hepatocellular carcinoma. HCV nonstructural protein 5A (NS5A) is an attractive antiviral target and plays an important role in HCV replication as well as hepatocarcinogenesis. The aim of this study was to assess the effect of HCV NS5A protein in the abrogation of apoptotic cell death induced by the proteasome inhibitor MG132.
    Methods
    Apoptotic responses to MG132 and the expression of molecules involved in NF-kappa B signaling pathways in human hepatocytes were investigated with or without the expression of HCV NS5A.
    Results
    HCV NS5A protected HepG2 cells against MG132-induced apoptosis, in line with NF-kappa B-nuclear translocation. A similar NF-kappa B-nuclear translocation was observed in Huh7 cells infected with HCV JFH1. In agreement with this, after treatment with MG132, HCV NS5A could elevate the transcription of several NF-kappa B target genes such as BCL2 and BCLXL to inhibit MG132-induced apoptosis in hepatocytes. HCV HCV NS5A also enhanced phosphorylation of I kappa B alpha. Consistent with a conferred prosurvival advantage, HCV NS5A reduced MG132-induced poly(adenosine diphosphate-ribose) polymerase cleavage.
    Conclusions
    HCV NS5A expression enhances phosphorylation of I kappa B alpha, liberates NF-kappa B for nuclear translocation and downregulates MG132-induced apoptotic pathways in human hepatocytes. It is possible that the disruption of proteasome-associated apoptosis plays a role in the pathogenesis of HCV infection.

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  • HCV NS5A resistance-associated variants in a group of real-world Japanese patients chronically infected with HCV genotype 1b Reviewed

    Yosuke Hirotsu, Tatsuo Kanda, Hiroshi Matsumura, Mitsuhiko Moriyama, Osamu Yokosuka, Masao Omata

    HEPATOLOGY INTERNATIONAL   9 ( 3 )   424 - 430   2015.7

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    Recent advances in interferon-free treatment could lead to the eradication of hepatitis C virus (HCV) from patients infected with HCV. One of the direct-acting anti-viral agents, HCV NS5A inhibitor, is available for these combination therapies. However, naturally occurring resistance-associated variants (RAVs) to HCV NS5A inhibitors in treatment-na &lt; ve patients chronically infected with HCV genotype 1b are still unknown.
    We performed ultra-deep sequencing and analysed previously reported RAVs in a total 132 HCV genotype 1b-infected Japanese patients who had never used HCV NS5A inhibitors. We also performed direct-sequencing by Sanger method in consecutively selected 50 of the total 132 samples, and the differences between the results of the two methods were compared.
    In the comparison of the variant frequencies of ultra-deep sequencing with RAVs of direct-sequencing by Sanger method in 50 patients, we identified 32 RAVs by direct-sequencing with the Sanger method; minimum variant frequency was shown by ultra-deep sequencing to be 9 %. A total of 110 RAVs were identified only by ultra-deep sequencing. In the samples from all 132 patients, L31W (2.3 %), L31V (49.2 %), L31F (41.7 %), L31M (1.5 %), L31I (5.3 %), L31S (2.0 %), L31P (3.0 %) and L31R (0.8 %), and Y93N (2.3 %), Y93H (25 %), Y93C (0.8 %), Y93P (2.3 %) and Y93D (0.8 %) were identified.
    We demonstrated naturally-occurring RAVs of HCV NS5A inhibitors by ultra-deep sequencing and that several mutations including Y93H are common in HCV NS5A inhibitor-treatment-na &lt; ve patients with chronic HCV genotype 1b. Careful attention should be paid to these RAVs, and further improvement of treatment options might be needed.

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  • Sustained virologic response achieved after curative treatment of hepatitis C virus-related hepatocellular carcinoma as an independent prognostic factor Reviewed

    Naoya Kanogawa, Sadahisa Ogasawara, Tetsuhiro Chiba, Tomoko Saito, Tenyu Motoyama, Eiichiro Suzuki, Yoshihiko Ooka, Akinobu Tawada, Tatsuo Kanda, Shigeru Mikami, Ryosaku Azemoto, Takashi Kaiho, Masami Shinozaki, Masayuki Ohtsuka, Masaru Miyazaki, Osamu Yokosuka

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   30 ( 7 )   1197 - 1204   2015.7

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    Background and AimWhether an antiviral interferon (IFN)-based therapy (IBT) after curative treatment of hepatocellular carcinoma (HCC) improves the prognosis in patients with hepatitis C virus (HCV)-related HCC remains to be elucidated.
    MethodsA total of 178 patients within the Milan criteria underwent curative treatment for HCV-related HCC. Both the time to beyond the Milan criteria (TTBMC) and overall survival (OS) were compared between the sustained virologic response (SVR) (IFN with SVR, n=22), non-SVR (IFN without SVR, n=19), and non-IBT (control, n=82) groups using propensity score matching analysis. Prognostic factors to predict survival were also determined by the Cox proportional-hazards model.
    ResultsTTBMC in the IFN with SVR group was significantly longer than those in the control and IFN without SVR groups (P&lt;0.001 and P=0.006, respectively), although no significant difference existed between the IFN without SVR and control groups. Similarly, OS of the IFN with SVR group was significantly longer than that of the control and IFN without SVR groups (P&lt;0.001 and P=0.029, respectively), although no significant difference existed between the IFN without SVR and control groups. The Cox proportional-hazards model identified SVR as an independent prognostic factor in these patients. The IFN with SVR group showed a 0.096-fold decrease in mortality risk compared with the control group (95% confidence intervals=0.023-0.405; P=0.001).
    ConclusionElimination of HCV after curative treatment of patients with HCC within the Milan criteria inhibits recurrence and contributes to a preferential prognosis.

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  • The androgen receptor as an emerging target in hepatocellular carcinoma. Invited Reviewed International journal

    Kanda T, Yokosuka O

    Journal of hepatocellular carcinoma   2   91 - 99   2015.6

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    Hepatocellular carcinoma (HCC) is one of the male-dominant liver diseases with poor prognosis, although treatments for HCC have been progressing in the past decades. Androgen receptor (AR) is a member of the nuclear receptor superfamily. Previous studies reported that AR was expressed in human HCC and non-HCC tissues. AR is activated both ligand-dependently and ligand-independently. The latter is associated with a mitogen-activated protein kinase-, v-akt murine thymoma viral oncogene homolog 1-, or signal-transducer and activator of transcription-signaling pathway, which has been implicated in the development of HCC. It has been reported that more than 200 RNA expression levels are altered by androgen treatment. In the liver, androgen-responsive genes are cytochrome P450s, transforming growth factor β, vascular endothelial growth factor, and glucose-regulated protein 78 kDa, which are also associated with human hepatocarcinogenesis. Recent studies also revealed that AR plays a role in cell migration and metastasis. It is possible that cross-talk among AR-signaling, endoplasmic reticulum stress, and innate immune response is important for human hepatocarcinogenesis and HCC development. This review shows that AR could play a potential role in human HCC and represent one of the important target molecules for the treatment of HCC.

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  • Sustained virological response after 8-week treatment of simeprevir with peginterferon α-2a plus ribavirin in a Japanese female with Hepatitis C virus genotype 1b and IL28B minor genotype Reviewed

    Tatsuo Kanda, Masato Nakamura, Reina Sasaki, Shin Yasui, Shingo Nakamoto, Yuki Haga, Xia Jiang, Shuang Wu, Akinobu Tawada, Makoto Arai, Fumio Imazeki, Osamu Yokosuka

    Case Reports in Gastroenterology   9 ( 2 )   215 - 220   2015.5

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    Direct-acting antivirals with or without peginterferon α (PEG-IFN α) plus ribavirin are now available for the treatment of hepatitis C virus (HCV) infection. Direct-acting antivirals are potent inhibitors of HCV replication, but some of them occasionally possess serious adverse events. We experienced a 64-year-old female with chronic HCV genotype 1b infection who showed elevated alanine aminotransferase of 528 IU/l at week 9 after the commencement of treatment of simeprevir with PEG-IFN α-2a plus ribavirin. However, she achieved sustained virological response at week 24 after the end of treatment. In Japan, we also have to treat elderly patients infected with HCV and/or advanced hepatic fibrosis. Until an effective interferon-free regimen is established, direct-acting antivirals with PEG-IFN plus ribavirin may still play a role in the treatment for certain patients. To avoid serious results from adverse events, careful attention and follow-up will be needed in the treatment course of simeprevir with PEG-IFN plus ribavirin for chronic HCV infection.

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  • The JAK2 inhibitor AZD1480 inhibits hepatitis A virus replication in Huh7 cells Reviewed

    Xia Jiang, Tatsuo Kanda, Shingo Nakamoto, Kengo Saito, Masato Nakamura, Shuang Wu, Yuki Haga, Reina Sasaki, Naoya Sakamoto, Hiroshi Shirasawa, Hiroaki Okamoto, Osamu Yokosuka

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   458 ( 4 )   908 - 912   2015.3

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    The JAK2 inhibitor AZD1480 has been reported to inhibit La protein expression. We previously demonstrated that the inhibition of La expression could inhibit hepatitis A virus (HAV) internal ribosomal entry-site (IRES)-mediated translation and HAV replication in vitro. In this study, we analyzed the effects of AZD1480 on HAV IRES-mediated translation and replication. HAV IRES-mediated translation in COS7-HAV-IRES cells was inhibited by 0.1-1 mu M AZD1480, a dosage that did not affect cell viability. Results showed a significant reduction in intracellular HAV HA11-1299 genotype IIIA RNA levels in Huh7 cells treated with AZD1480. Furthermore, AZD1480 inhibited the expression of phosphorylated-(Tyr-705)-signal transducer and activator of transcription 3 (STAT3) and La in Huh7 cells. Therefore, we propose that AZD1480 can inhibit HAV IRES activity and HAV replication through the inhibition of the La protein. (C) 2015 Elsevier Inc. All rights reserved.

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  • Faldaprevir for the Treatment of Hepatitis C Reviewed

    Tatsuo Kanda, Osamu Yokosuka, Masao Omata

    INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES   16 ( 3 )   4985 - 4996   2015.3

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    The current treatments for chronic hepatitis C virus (HCV) genotype 1 infection are combinations of direct-acting antivirals, and faldaprevir is one of the new generation of HCV NS3/4A protease inhibitors. At the end of 2013, the US Food and Drug Administration (FDA) approved the HCV NS3/4A protease inhibitor simeprevir and the HCV NS5B polymerase inhibitor sofosbuvir. Simeprevir or sofosbuvir in combination with pegylated interferon and ribavirin are available for clinical use. Faldaprevir, another HCV NS3/4A protease inhibitor that also has fewer adverse events than telaprevir or boceprevir, is under development. Of interest, faldaprevir in combination with pegylated interferon and ribavirin, and interferon-free treatment with faldaprevir in combination with deleobuvir plus ribavirin provides high sustained virological response rates for HCV genotype 1 infection. The aim of this article is to review these data concerning faldaprevir. Faldaprevir in combination with pegylated interferon and ribavirin treatment appears to be associated with fewer adverse events than telaprevir or boceprevir in combination with pegylated interferon and ribavirin, and may be one of the therapeutic options for treatment-naive patients with HCV genotype 1. The interferon-free combination of faldaprevir and deleobuvir with ribavirin was effective for HCV genotype 1 infection and may hold promise for interferon-ineligible and interferon-intolerant patients.

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  • A semi-supervised tensor regression model for siRNA efficacy prediction Reviewed

    Bui Ngoc Thang, Tu Bao Ho, Tatsuo Kanda

    BMC BIOINFORMATICS   16   80   2015.3

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    Background: Short interfering RNAs (siRNAs) can knockdown target genes and thus have an immense impact on biology and pharmacy research. The key question of which siRNAs have high knockdown ability in siRNA research remains challenging as current known results are still far from expectation.
    Results: This work aims to develop a generic framework to enhance siRNA knockdown efficacy prediction. The key idea is first to enrich siRNA sequences by incorporating them with rules found for designing effective siRNAs and representing them as enriched matrices, then to employ the bilinear tensor regression to predict knockdown efficacy of those matrices. Experiments show that the proposed method achieves better results than existing models in most cases.
    Conclusions: Our model not only provides a suitable siRNA representation but also can predict siRNA efficacy more accurate and stable than most of state-of-the-art models.

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  • Fixed point observation of etiology of acute liver failure according to the novel Japanese diagnostic criteria Reviewed

    Keiichi Fujiwara, Shin Yasui, Yutaka Yonemitsu, Makoto Arai, Tatsuo Kanda, Masayuki Nakano, Shigeto Oda, Osamu Yokosuka

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   22 ( 3 )   225 - 229   2015.3

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    BackgroundThere has existed important differences in the definition of acute liver failure (ALF) between Japanese criteria and those of other countries. The novel diagnostic criteria for ALF in Japanese patients were established by the Intractable Hepato-Biliary Diseases Study Group of Japan, in order to correspond to those for ALF in Europe and the USA. We prospectively diagnosed our ALF patients based on this novel criteria, and discussed the etiology by a fixed point observation.
    MethodsWe investigated the etiology of 54 adult inpatients and outpatients with ALF between 2010 and 2012.
    ResultsOf 54 patients, 36 were ALF without coma, 17 ALF with coma and one late onset hepatic failure. The etiology was due to viral infections in 38.9%, autoimmune hepatitis in 11.1%, drug-induced liver injury in 13.0%, etiologies without hepatitis in 29.6% (circulatory disturbance in 18.5%, infiltration of the liver by malignant cells in 7.4%, and metabolic diseases in 3.7%) and indeterminate causes in 7.4%.
    ConclusionsCirculatory disturbance was the most frequent etiology according to the novel criteria. Indeterminate etiology was less observed in our study than the nation-wide survey with significance (P = 0.0014).

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  • Mosapride Citrate Increases Postprandial Glucagon-Like Peptide-1, Insulin, and Gene Expression of Sweet Taste Receptors Reviewed

    Daisuke Maruoka, Makoto Arai, Takeshi Tanaka, Kenichiro Okimoto, Arata Oyamada, Shoko Minemura, Masaru Tsuboi, Tomoaki Matsumura, Tomoo Nakagawa, Tatsuo Kanda, Tatsuro Katsuno, Fumio Imazeki, Osamu Yokosuka

    DIGESTIVE DISEASES AND SCIENCES   60 ( 2 )   345 - 353   2015.2

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    Mosapride citrate-a prokinetic agent-improves hemoglobin A1c levels in diabetic patients; however, the underlying mechanism is unclear. We aimed to clarify this mechanism.
    Preprandial and postprandial (90 min after a meal) blood was obtained from 12 healthy men, and serum insulin and plasma active glucagon-like peptide-1 concentrations were measured. Measurements were also taken after the administration of 5 mg of mosapride citrate three times per day after every meal for 14 days. In addition, C57BL/6 mice were permitted free access to water containing 0.04 % domperidone (D group) or 0.02 % mosapride citrate (M group) for 2 weeks (four mice per group). T1r2 (taste receptor, type 1, member 2), T1r3, and Gnat3 (guanine nucleotide-binding protein, alpha transducing 3) mRNA expression levels of the stomach, duodenum, and proximal and mid-jejunum were evaluated.
    In human subjects, postprandial plasma active glucagon-like peptide-1 and serum insulin concentrations after administration of mosapride citrate were significantly higher than those pre-administration (4.8 +/- A 2.2 pmol/L, 45.6 +/- A 41.6 mu IU/mL, and 3.7 +/- A 1.2 pmol/L, 34.1 +/- A 28.4 mu IU/mL, respectively). The mouse expression levels of T1r2 and Gnat3 in the proximal jejunum and mid-jejunum in the M group (4.1 +/- A 1.8-fold, 3.1 +/- A 1.6-fold, and 4.6 +/- A 0.8-fold, 3.1 +/- A 0.9-fold increases, respectively), were significantly higher than those of the control group.
    The administration of mosapride citrate for 2 weeks enhanced postprandial plasma active glucagon-like peptide-1 and serum insulin concentration and increased the expression of sweet taste receptors in the upper intestine.

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  • Virological efficacy of combination therapy with corticosteroid and nucleoside analogue for severe acute exacerbation of chronic hepatitis B Reviewed

    S. Yasui, K. Fujiwara, M. Nakamura, T. Miyamura, Y. Yonemitsu, R. Mikata, M. Arai, T. Kanda, F. Imazeki, S. Oda, O. Yokosuka

    JOURNAL OF VIRAL HEPATITIS   22 ( 2 )   94 - 102   2015.2

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    The short-term prognosis of patients with severe acute exacerbation of chronic hepatitis B (CHB) leading to acute liver failure is extremely poor. We have reported the efficacy of corticosteroid in combination with nucleoside analogue in the early stages, but virological efficacy has not been documented. Our aim was to elucidate the virological efficacy of this approach. Thirteen patients defined as severe acute exacerbation of CHB by our uniform criteria were prospectively examined for virological responses to treatment. Nucleoside analogue and sufficient dose of corticosteroids were introduced as soon as possible after the diagnosis of severe disease. Of the 13 patients, 7 (54%) survived, 5 (38%) died and 1 (8%) received liver transplantation. The decline of HBV DNA was significant between the first 2 weeks (P = 0.02) and 4 weeks (P &lt; 0.01). Mean reduction in HBV DNA during the first 2 weeks was 1.7 +/- 0.9 log copies per mL in overall patients, 2.1 +/- 0.8 in survived patients and 1.2 +/- 0.9 in dead/transplanted patients. The decline of HBV DNA was significant between the first 2 weeks (P = 0.03) and 4 weeks (P = 0.02) in survived patients, but not in dead/transplanted patients. Our study shows that corticosteroid treatment in combination with nucleotide analogue has sufficient virological effect against severe acute exacerbation of CHB, and a rapid decline of HBV DNA is conspicuous in survived patients.

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  • Recent trend of Hepatitis E virus infection in Chiba Area, Japan: 3 of 5 cases with rheumatoid arthritis Reviewed

    Tatsuo Kanda, Shin Yasui, Masato Nakamura, Makoto Arai, Reina Sasaki, Yuki Haga, Shuang Wu, Shingo Nakamoto, Hiroaki Okamoto, Osamu Yokosuka

    Case Reports in Gastroenterology   9 ( 3 )   317 - 326   2015

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    Hepatitis E virus (HEV) infection is an emerging health concern in developing and developed countries, such as Japan. Five cases have recently been diagnosed as hepatitis E. Of interest, 3 of them had rheumatoid arthritis (RA), although a previous study demonstrated a lack of association between HEV and RA. One of the other patients developed autoimmune hepatitis and was successfully treated with corticosteroids approximately 150 days after the diagnosis of hepatitis E. In RA patients with liver dysfunction, the presence of HEV infection should be evaluated immediately because these patients are often relatively old. Further investigation of the association between HEV and autoimmune hepatitis is needed.

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  • Current and future directions for treating hepatitis B virus infection Invited Reviewed

    Akinobu Tawada, Tatsuo Kanda, Osamu Yokosuka

    World Journal of Hepatology   7 ( 11 )   1541 - 1552   2015

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    Hepatitis B virus (HBV) persistently infects approximately 350 million people, and approximately 600000 liverrelated deaths are observed per year worldwide. HBV infection is also one of the major risk factors for hepatocellular carcinoma (HCC). The persistence of serum hepatitis B e antigen (HBeAg) and high level of serum HBV DNA are thought to reflect a high HBV replication status in hepatocytes, causing cirrhosis, HCC and liver-related deaths. It has been reported that antiviral therapy, such as peginterferon and nucleos(t)ide analogues (NUCs), could suppress liver-related death by inhibiting the HBV DNA levels and inducing seroconversion from HBeAg to antibody to HBe antigen. Currently, peginterferon is widely used, but there are also several disadvantages in the use of peginterferon, such as various adverse events, the administration route and duration. It is difficult to predict the effects of treatment and interferon is contraindicated for the patients with advanced fibrosis of the liver and cirrhosis. With respect to NUCs, entecavir and tenofovir disoproxil fumarate are current the first-choice drugs. NUCs can be administered orally, and their anti-viral effects are stronger than that of peginterferon. However, because cessation of NUC administration leads to high levels of viral replication and causes severe hepatitis, they must be administered for a long time. On the other hand, the use of both interferon and NUCs cannot eliminate covalently closed circular DNA of HBV. In this review, we evaluate the natural course of chronic HBV infection and then provide an outline of these representative drugs, such as peginterferon, entecavir and tenofovir disoproxil fumarate.

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  • Current management of patients with hepatocellular carcinoma Invited Reviewed

    Tatsuo Kanda, Sadahisa Ogasawara, Tetsuhiro Chiba, Yuki Haga, Masao Omata, Osamu Yokosuka

    World Journal of Hepatology   7 ( 15 )   1913 - 1920   2015

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    The current management therapies for hepatocellular carcinoma (HCC) patients are discussed in this review. Despite the development of new therapies, HCC remains a "difficult to treat" cancer because HCC typically occurs in advanced liver disease or hepatic cirrhosis. The progression of multistep and multicentric HCC hampers the prevention of the recurrence of HCC. Many HCC patients are treated with surgical resection and radiofrequency ablation (RFA), although these modalities should be considered in only selected cases with a certain HCC number and size. Although there is a shortage of grafts, liver transplantation has the highest survival rates for HCC. Several modalities are salvage treatments
    however, intensive care in combination with other modalities or in combination with surgical resection or RFA might offer a better prognosis. Sorafenib is useful for patients with advanced HCC. In the near future, HCC treatment will include stronger molecular targeted drugs, which will have greater potency and fewer adverse events. Further studies will be ongoing.

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  • Natural interferon-beta treatment for patients with chronic hepatitis C in Japan Reviewed

    Reina Sasaki, Tatsuo Kanda, Shingo Nakamoto, Yuki Haga, Masato Nakamura, Shin Yasui, Xia Jiang, Shuang Wu, Makoto Arai, Osamu Yokosuka

    World Journal of Hepatology   7 ( 8 )   1125 - 1132   2015

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    Chronic hepatitis C virus (HCV) infection can cause liver cirrhosis and hepatocellular carcinoma (HCC). Several studies have demonstrated that the eradication of HCV reduces the occurrence of HCC. In Japan, as many people live to an advanced age, HCV-infected patients are also getting older, and the age at HCC diagnosis has also increased. Although older HCV-infected patients have a risk of developing HCC, the treatment response to peginterferon-alpha plus ribavirin therapy is relatively poor in these patients because of drop-out or discontinuation of this treatment due to adverse events. It is established that the mechanism of action between interferon-alpha and interferon-beta is slightly different. Short-term natural interferon-beta monotherapy is effective for patients with acute hepatitis C and patients infected with HCV genotype 2 and low viral loads. Natural interferon-beta plus ribavirin for 48 wk or for 24 wk are also effective for some patients with HCV genotype 1 or HCV genotype 2. Natural interferon-beta plus ribavirin has been used for certain "difficult-to-treat" HCV-infected patients. In the era of direct-acting anti-virals, natural interferon-beta plus ribavirin may be one of the therapeutic options for special groups of HCV-infected patients. In the near future, signal transduction pathways of interferon-beta will inform further directions.

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  • Antiviral therapies for chronic hepatitis C virus infection with cirrhosis Invited Reviewed

    Shingo Nakamoto, Tatsuo Kanda, Hiroshi Shirasawa, Osamu Yokosuka

    World Journal of Hepatology   7 ( 8 )   1133 - 1141   2015

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    Patients who are infected with hepatitis C virus (HCV) and also have advanced fibrosis or cirrhosis have been recognized as "difficult-to-treat" patients during an era when peginterferon and ribavirin combination therapy is the standard of care. Recent guidelines have clearly stated that treatment should be prioritized in this population to prevent complications such as decompensation and hepatocellular carcinoma. Recent advances in the treatment of chronic hepatitis C have been achieved through the development of direct-acting antiviral agents (DAAs). Boceprevir and telaprevir are first-generation DAAs that inhibit the HCV NS3/4A protease. Boceprevir or telaprevir, in combination with peginterferon and ribavirin, improved the sustained virological response rates compared with peginterferon and ribavirin alone and were tolerated in patients with HCV genotype 1 infection without cirrhosis or compensated cirrhosis. However, the efficacy is lower especially in prior non-responders with or without cirrhosis. Furthermore, a high incidence of adverse events was observed in patients with advanced liver disease, including cirrhosis, in real-life settings. Current guidelines in the United States and in some European countries no longer recommend these regimens for the treatment of HCV. Next-generation DAAs include second-generation HCV NS3/4A protease inhibitors, HCV NS5A inhibitors and HCV NS5B inhibitors, which have a high efficacy and a lower toxicity. These drugs are used in interferon-free or in interferon-based regimens with or without ribavirin in combination with different classes of DAAs. Interferon-based regimens, such as simeprevir in combination with peginterferon and ribavirin, are well tolerated and are highly effective especially in treatment-naïve patients and in patients who received treatment but who relapsed. The efficacy is less pronounced in null-responders and in patients with cirrhosis. Interferon-free regimens in combination with ribavirin and/or two or more DAAs could be used for treatment-naïve, treatment-experienced and even for interferon-ineligible or interferon-intolerant patients. Some clinical trials have demonstrated promising results, and have shown that the efficacy and safety were not different between patients with and without cirrhosis. There are also promising regimens for genotypes other than genotype 1. Interferon is contraindicated in patients with decompensated cirrhosis, and further studies are needed to establish the optimal treatment regimen for this population. In the future, interferon-free and ribavirin-free regimens with high efficacy and improved safety are expected for HCV-infected patients with advanced liver diseases.

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  • IFNL4 ss469415590 variant is associated with treatment response in Japanese HCV genotype 1 infected individuals treated with IFN-including regimens Reviewed

    Tatsuo Miyamura, Tatsuo Kanda, Shingo Nakamoto, Makoto Arai, Masato Nakamura, Shuang Wu, Xia Jiang, Reina Sasaki, Yuki Haga, Shin Yasui, Yoshihiko Ooka, Tetsuhiro Chiba, Fumio Imazeki, Shigeru Mikami, Osamu Yokosuka

    International Journal of Hepatology   2014   723868   2014.12

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    Aim. Eradication of hepatitis C virus (HCV) is still challenging even if interferon- (IFN-) free regimens with direct-acting antiviral agents (DAAs) for HCV-infected individuals are available in clinical practice. IFNL4 is a newly described protein, associated with human antiviral defenses. We investigated whether IFNL4 ss469415590 variant has an effect on the prediction of treatment response in HCV-infected patients treated with IFN-including regimens.
    Patients and Methods. In all, 185 patients infected with HCV genotype 1 treated with peg-IFN plus ribavirin, with or without telaprevir, were genotyped for IFNL4 ss469415590. We retrospectively investigated whether the role of IFNL4 ss469415590 variant and other factors could predict sustained virological response (SVR) in Japanese patients infected with HCV genotype 1.
    Results. There were 65.7%, 31.5%, and 2.8% patients in the IFNL4 ss469415590 TT/TT, TT/-G, and -G/-G groups, respectively. SVR rates were 82.1% or 49.3% in patients treated with peg-IFN plus ribavirin with or without telaprevir, respectively. IFNL4 ss469415590 variant and HCV viral loads or IFNL4 ss469415590 variant and early virological response were better predictors of SVR in patients treated with peg-IFN plus ribavirin with or without telaprevir, respectively.
    Conclusion. In the era of DAAs, measurement of IFNL4 ss469415590 variant could help the prediction of SVR in Japanese HCV genotype 1 infected individuals treated with IFN-including regimens.

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  • Knockdown of glucose-regulated protein 78 enhances poly(ADP-ribose) polymerase cleavage in human pancreatic cancer cells exposed to endoplasmic reticulum stress Reviewed

    Xia Jiang, Tatsuo Kanda, Shingo Nakamoto, Yuki Haga, Reina Sasaki, Masato Nakamura, Shuang Wu, Rintaro Mikata, Osamu Yokosuka

    ONCOLOGY REPORTS   32 ( 6 )   2343 - 2348   2014.12

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    The present study examined the expression of glucose-regulated protein 78 (GRP78/Bip) in human pancreatic cancer cell lines and the effect of knockdown of GRP78 on the cleavage of poly(ADP-ribose) polymerase (PARP). Human pancreatic cancer cell lines (KP-2, MIAPaCa-2, Panc-1 and SUIT-2), constitutively expressed GRP78. We also demonstrated that ER stress induced by thapsigargin upregulated protein levels of GRP78. In the presence of thapsigargin, knockdown of GRP78 enhanced the PARP cleavage in the human pancreatic cancer cells. These results provide evidence that GRP78 is a potential therapeutic target for 'difficult-to-treat' pancreatic cancer, in which ER stress signaling in part falls into disorder.

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  • Reactivation of Hepatitis B Virus in Hematopoietic Stem Cell Transplant Recipients in Japan: Efficacy of Nucleos(t)ide Analogues for Prevention and Treatment Invited Reviewed

    Shingo Nakamoto, Tatsuo Kanda, Chiaki Nakaseko, Emiko Sakaida, Chikako Ohwada, Masahiro Takeuchi, Yusuke Takeda, Naoya Mimura, Tohru Iseki, Shuang Wu, Makoto Arai, Fumio Imazeki, Kengo Saito, Hiroshi Shirasawa, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES   15 ( 11 )   21455 - 21467   2014.11

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    We retrospectively reviewed 413 recipients with hematologic malignancies who underwent hematopoietic stem cell transplantation (HSCT) between June 1986 and March 2013. Recipients with antibody to hepatitis B core antigen (anti-HBc) and/or to hepatitis B surface antigen (anti-HBs) were regarded as experiencing previous hepatitis B virus (HBV) infection. Clinical data of these recipients were reviewed from medical records. We defined &gt;= 1 log IU/mL increase in serum HBV DNA from nadir as HBV reactivation in hepatitis B surface antigen (HBsAg)-positive recipients, and also defined &gt;= 1 log IU/mL increase or re-appearance of HBV DNA and/or HBsAg as HBV reactivation in HBsAg-negative recipients. In 5 HBsAg-positive recipients, 2 recipients initially not administered with nucleos(t) ide analogues (NUCs) experienced HBV reactivation, but finally all 5 were successfully controlled with NUCs. HBV reactivation was observed in 11 (2.7%) of 408 HBsAg-negative recipients; 8 of these were treated with NUCs, and fortunately none developed acute liver failure. In 5 (6.0%) of 83 anti-HBc and/or anti-HBs-positive recipients, HBV reactivation occurred. None of 157 (0%) recipients without HBsAg, anti-HBs or anti-HBc experienced HBV reactivation. In HSCT recipients, HBV reactivation is a common event in HBsAg-positive recipients, or in HBsAg-negative recipients with anti-HBc and/or anti-HBs. Further attention should be paid to HSCT recipients with previous exposure to HBV.

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  • Hepatitis C Virus Nonstructural Protein 5A Inhibits Thapsigargin-Induced Apoptosis Reviewed

    Xia Jiang, Tatsuo Kanda, Shuang Wu, Shingo Nakamoto, Takaji Wakita, Hiroshi Shirasawa, Osamu Yokosuka

    PLOS ONE   9 ( 11 )   e113499   2014.11

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    Background: We previously reported that the hepatitis C virus (HCV) nonstructural protein 5A (NS5A) down-regulates TLR4 signaling and lipopolysaccharide-induced apoptosis of hepatocytes. There have been several reports regarding the association between HCV infection and endoplasmic reticulum (ER) stress. Here, we examined the regulation of HCV NS5A on the apoptosis of hepatocytes induced by thapsigargin, an inducer of ER stress.
    Methods: The apoptotic response to thapsigargin and the expression of molecules involved in human hepatocyte apoptotic pathways were examined in the presence or absence of HCV NS5A expression.
    Results: HCV JFH1 infection induced ER stress in the Huh7 cell line. HCV NS5A protected HepG2 cells against thapsigargin-induced apoptosis, the effect of which was linked to the enhanced expression of the 78-kDa glucose-regulated protein/immunoglobulin heavy-chain binding protein (GRP78). Consistent with a conferred pro-survival advantage, HCV NS5A reduced poly(adenosine diphosphate-ribose) polymerase cleavage and activation of caspases-3, -7 and -9, and Bax expression, while increasing the expressions of the anti-apoptotic molecules XIAP and c-FLIP. HCV NS5A weakly interacts with GRP78 and enhances GRP78 expression in hepatocytes.
    Conclusion: HCV NS5A enhances GRP78 expression, resulting in the inhibition of apoptotic properties, and inhibits thapsigargin-induced apoptotic pathways in human hepatocytes, suggesting that disruption of ER stress-mediated apoptosis may have a role in the pathogenesis of HCV infection. Thus, HCV NS5A might engender the survival of HCV-infected hepatocytes contributing to the establishment of persistent infection.

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  • Fixed point observation of etiology of acute liver failure according to the novel Japanese diagnostic criteria.

    Fujiwara K, Yasui S, Yonemitsu Y, Arai M, Kanda T, Nakano M, Oda S, Yokosuka O

    Journal of hepato-biliary-pancreatic sciences   2014.10

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    There has existed important differences in the definition of acute liver failure (ALF) between Japanese criteria and those of other countries. The novel diagnostic criteria for ALF in Japanese patients were established by the Intractable Hepato-Biliary Diseases Study Group of Japan, in order to correspond to those for ALF in Europe and the USA. We prospectively diagnosed our ALF patients based on this novel criteria, and discussed the etiology by a fixed point observation.We investigated the etiology of 54 adult inpatients and outpatients with ALF between 2010 and 2012.Of 54 patients, 36 were ALF without coma, 17 ALF with coma and one late onset hepatic failure. The etiology was due to viral infections in 38.9%, autoimmune hepatitis in 11.1%, drug-induced liver injury in 13.0%, etiologies without hepatitis in 29.6% (circulatory disturbance in 18.5%, infiltration of the liver by malignant cells in 7.4%, and metabolic diseases in 3.7%) and indeterminate causes in 7.4%.Circulatory disturbance was the most frequent etiology according to the novel criteria. Indeterminate etiology was less observed in our study than the nation-wide survey with significance (P = 0.0014).

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  • Suppression of La Antigen Exerts Potential Antiviral Effects against Hepatitis A Virus Reviewed

    Xia Jiang, Tatsuo Kanda, Shuang Wu, Shingo Nakamoto, Kengo Saito, Hiroshi Shirasawa, Tomoko Kiyohara, Koji Ishii, Takaji Wakita, Hiroaki Okamoto, Osamu Yokosuka

    PLOS ONE   9 ( 7 )   e101993   2014.7

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    Background: Despite the development and availability of hepatitis A virus (HAV) vaccine, HAV infection is still a major cause of acute hepatitis that occasionally leads to fatal liver disease. HAV internal ribosomal entry-site (IRES) is one of the attractive targets of antiviral agents against HAV. The aim of the present study is to evaluate the impact of La, one of the cellular proteins, on HAV IRES-mediated translation and HAV replication.
    Methods and Findings: We investigated the therapeutic feasibility of siRNAs specific for cellular cofactors for HAV IRES-mediated translation in cell culture. It was revealed that siRNA against La could inhibit HAV IRES activities as well as HAV subgenomic replication. We also found that the Janus kinase (JAK) inhibitors SD-1029 and AG490, which reduce La expression, could inhibit HAV IRES activities as well as HAV replication.
    Conclusions: Inhibition of La by siRNAs and chemical agents could lead to the efficient inhibition of HAV IRES-mediated translation and HAV replication in cell culture models. La might play important roles in HAV replication and is being exploited as one of the therapeutic targets of host-targeting antivirals.

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  • Androgen receptor signaling in hepatocellular carcinoma and pancreatic cancers Invited Reviewed

    Tatsuo Kanda, Xia Jiang, Osamu Yokosuka

    WORLD JOURNAL OF GASTROENTEROLOGY   20 ( 28 )   9229 - 9236   2014.7

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    Hepatocellular carcinoma (HCC) and pancreatic cancer remain difficult to treat, and despite the ongoing development of new treatments, the overall survival rate has only modestly improved over the past decade. Liver and pancreatic progenitors commonly develop from endoderm cells in the embryonic foregut. A previous study showed that HCC and pancreatic cancer cell lines variably express androgen receptor (AR), and these cancers and the surrounding tissues also express AR. AR is a ligand-dependent transcription factor that belongs to the nuclear receptor superfamily. Androgen response element is present in regulatory elements on the AR-responsive target genes, such as transforming growth factor beta-1 (TGF beta-1) and vascular endothelial growth factor (VEGF). It is well known that the activation of AR is associated with human carcinogenesis in prostate cancer as well as HCC and pancreatic cancer and that GRP78, TGF beta, and VEGF all play important roles in carcinogenesis and cancer development in these cancers. HCC is a male-dominant cancer irrespective of its etiology. Previous work has reported that vertebrae forkhead box A 1/2 are involved in estrogen receptors and/or AR signaling pathways, which may contribute to the gender differences observed with HCC. Our recent work also showed that AR has a critical role in pancreatic cancer development, despite pancreatic cancer not being a male dominant cancer. Aryl hydrocarbon (or dioxin) receptor is also involved in both HCC and pancreatic cancer through the formation of complex with AR. It is possible that AR might be involved in their carcinogenesis through major histocompatibility complex class I chain-related gene A/B. This review article describes AR and its role in HCC and pancreatic cancer and suggests that more specific AR signaling-inhibitors may be useful in the treatment of these "difficult to treat" cancers. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

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  • 18F-fluorodeoxyglucose positron emission tomography might be useful for diagnosis of hepatic amyloidosis Reviewed

    Akinobu Tawada, Tatsuo Kanda, Takashi Oide, Toshio Tsuyuguchi, Fumio Imazeki, Yukio Nakatani, Osamu Yokosuka

    International Medical Case Reports Journal   7 ( 1 )   103 - 109   2014.6

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    We report on a woman with hepatic involvement of primary systemic (immunoglobulin light chain, AL) amyloidosis. Her diagnosis was confirmed by liver biopsy. Clinical symptoms of hepatic amyloidosis are generally mild at its first stage, with most frequent findings being hepatomegaly and alkaline phosphatase elevation. Recent advances in the understanding of the pathophysiology of systemic amyloidosis have made several treatments available. However, its prognosis is occasionally poor. Because liver biopsy is not always safe, other modalities for the diagnosis are needed. Of interest was that fluorodeoxyglucose (FDG) uptake into the liver was observed, compared with that into the spleen, in this patient, indicating that FDG positron emission tomography and computed tomography might be useful for the diagnosis of hepatic amyloidosis with mild liver dysfunction. © 2014 Tawada et al.

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  • Regulation of microRNA by hepatitis B virus infection and their possible association with control of innate immunity Invited Reviewed

    Xia Jiang, Tatsuo Kanda, Shuang Wu, Masato Nakamura, Tatsuo Miyamura, Shingo Nakamoto, Arup Banerjee, Osamu Yokosuka

    WORLD JOURNAL OF GASTROENTEROLOGY   20 ( 23 )   7197 - 7206   2014.6

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    Hepatitis B virus (HBV) chronically infects more than 350 million people worldwide. HBV causes acute and chronic hepatitis, and is one of the major causes of cirrhosis and hepatocellular carcinoma. There exist complex interactions between HBV and the immune system including adaptive and innate immunity. Toll-like receptors (TLRs) and TLR-signaling pathways are important parts of the innate immune response in HBV infections. It is well known that TLR-ligands could suppress HBV replication and that TLRs play important roles in anti-viral defense. Previous immunological studies demonstrated that HBV e antigen (HBeAg) is more efficient at eliciting T-cell tolerance, including production of specific cytokines IL-2 and interferon gamma, than HBV core antigen. HBeAg downregulates cytokine production in hepatocytes by the inhibition of MAPK or NF-kappa B activation through the interaction with receptor-interacting serine/threonine protein kinase. MicroRNAs (miRNAs) are also able to regulate various biological processes such as the innate immune response. When the expressions of approximately 1000 miRNAs were compared between human hepatoma cells HepG2 and HepG2.2.15, which could produce HBV virion that infects chimpanzees, using real-time RT-PCR, we observed several different expression levels in miRNAs related to TLRs. Although we and others have shown that HBV modulates the host immune response, several of the miRNAs seem to be involved in the TLR signaling pathways. The possibility that alteration of these miRNAs during HBV infection might play a critical role in innate immunity against HBV infection should be considered. This article is intended to comprehensively review the association between HBV and innate immunity, and to discuss the role of miRNAs in the innate immune response to HBV infection. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

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  • Downregulation of microRNA-431 by human interferon-beta inhibits viability of medulloblastoma and glioblastoma cells via upregulation of SOCS6 Reviewed

    Takeshi Tanaka, Makoto Arai, Xia Jiang, Shigeru Sugaya, Tatsuo Kanda, Katsunori Fujii, Kazuko Kita, Katsuo Sugita, Fumio Imazeki, Toshiyuki Miyashita, Atsushi Kaneda, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF ONCOLOGY   44 ( 5 )   1685 - 1690   2014.5

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    miRNAs are small non-coding RNAs that inhibit gene expression by cleaving or hindering the translation of target mRNAs. In this study, we focused on miR-431, which mediated inhibition of cell viability by human interferon-beta (HuIFN-beta). We aimed to demonstrate an antineoplastic effect of HuIFN-beta via miR-431 expression against medulloblastoma and glioblastoma, because HuIFN-beta is frequently used in adjuvant therapy of these tumors. Addition of HuIFN-beta to medulloblastoma and glioblastoma cells reduced viability, significantly decreased miR-431 expression, upregulated expression of SOCS6 (putative miR-431 target genes) and inhibited Janus kinase (JAK) 1 and signal transducer and activator of transcription (STAT) 2. The mitogen-activated protein kinase (MAPK) pathway, but not the phosphoinositide 3-kinase (PI3K)-Akt pathway, was downregulated in medulloblastoma cells, whereas the PI3K-Akt pathway, but not the MAPK pathway, was downregulated in glioblastoma cells. Addition of HuIFN-beta and transient transfection with miR-431 to medulloblastoma and glioblastoma cells did not reduce viability, downregulated expression of SOCS6, and concomitantly activated the JAK1 and STAT2. We propose that, in medulloblastoma and glioblastoma cells, HuIFN-beta decreases miR-431 expression and upregulates SOCS6 expression, and consequently inhibit cell proliferation by suppressing the JAK-STAT signaling pathway.

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  • Efficacy of high-dose corticosteroid in the early stage of viral acute liver failure Reviewed

    Keiichi Fujiwara, Shin Yasui, Yutaka Yonemitsu, Rintaro Mikata, Makoto Arai, Tatsuo Kanda, Fumio Imazeki, Shigeto Oda, Osamu Yokosuka

    HEPATOLOGY RESEARCH   44 ( 5 )   491 - 501   2014.5

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    Aim
    Acute liver failure (ALF) is a worldwide problem despite its rare incidence because of its extremely high mortality. There are no beneficial therapies except for emergency liver transplantation for ALF. However, in Japan where the problem of a shortage of donor livers still remains, therapies other than transplantation must be further investigated for patients with ALF. Our aim was to elucidate the efficacy of high-dose corticosteroid (CS) in decreasing liver enzyme levels in the early stage of ALF.
    Methods
    Thirty-one consecutive Japanese patients with viral ALF in the early stage were prospectively examined for their clinical and biochemical features and treatment responses during 2 weeks after the start of treatment. Nineteen were treated with high-dose methylprednisolone, and 12 having clinical and biochemical backgrounds with no significant difference were treated without CS.
    Results
    The aspartate aminotransferase : alanine aminotransferase ratio became lower in patients treated with CS than in controls (P &lt; 0.05). Fifteen of 19 patients in the CS group and eight of 12 in the control group recovered (P = 0.36). Hepatitis B viral infection and advanced liver damage at the start of treatment were associated with poor prognosis (P &lt; 0.05). Complications during the therapy were not greater in the CS group than control (P = 0.64).
    Conclusion
    The introduction of high-dose CS in the early stage of ALF was effective in suppressing the destruction of hepatocytes. CS-treated patients showed slightly higher survival rates and slightly more improved liver regeneration than controls, although the differences were not statistically significant.

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  • Involvement of androgen receptor and glucose-regulated protein 78 KDa in human hepatocarcinogenesis Reviewed

    Xia Jiang, Tatsuo Kanda, Shingo Nakamoto, Tatsuo Miyamura, Shuang Wu, Osamu Yokosuka

    EXPERIMENTAL CELL RESEARCH   323 ( 2 )   326 - 336   2014.5

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    Previous studies demonstrated that androgen receptor (AR) is expressed in human hepatocellular carcinoma (HCC), one of the male-dominant diseases. Glucose-regulated protein 78 kDa (GRP78/ Bip), which has a role in cancer development, is one of the androgen response genes in prostate cell lines. The aim of this study was to investigate the impact of AR on endoplasmic reticulum (ER)-stress signaling in human hepatoma. AR and GRP78 expressions were examined in human liver tissue panels. Human hepatoma cells stably expressing short hairpin RNA targeting AR and cells over-expressing AR were generated. The expressions of ER-stress molecules and AR were measured by real-time RT-PCR and Western blotting. The effect of AR on ER-stress responsive gene expression was examined by reporter assay. Strong positive correlation between AR mRNA and GRP78 mRNA was observed in stage I/II-HCCs. AR enhanced ER-stress responsive element activities and GRP78 expression, and regulated ER-stress response in hepatocytes. Sorafenib strongly induced significant apoptosis in HepG2 cells by the inhibition of AR and inhibition of the downstream GRP78. AR seems a co-regulator of GRP78 especially in earlier-stage HCC. AR plays a critical role in controlling ER-stress, providing new therapeutic options against HCC. (c) 2014 Elsevier Inc. All rights reserved.

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  • Expression level of sonic hedgehog correlated with the speed of gastric mucosa regeneration in artificial gastric ulcers Reviewed

    Takeshi Tanaka, Makoto Arai, Shoko Minemura, Arata Oyamada, Keiko Saito, Xia Jiang, Masaru Tsuboi, Sayuri Sazuka, Daisuke Maruoka, Tomoaki Matsumura, Tomoo Nakagawa, Shigeru Sugaya, Tatsuo Kanda, Tatsuro Katsuno, Kazuko Kita, Takashi Kishimoto, Fumio Imazeki, Atsushi Kaneda, Osamu Yokosuka

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   29 ( 4 )   736 - 741   2014.4

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    Background and AimGastric ulcer healing is a complex process involving cell proliferation and tissue remodeling. Sonic hedgehog (Shh) activates the Shh signaling pathway, which plays a key role in processes such as tissue repair. Shh and interleukin 1 (IL1) have been reported to influence the proliferation of gastric mucosa. We evaluated the relationships between the speed of gastric ulcer healing and the levels of expression of Shh and IL1.
    MethodsThe study included 45 patients (mean age 71.99.0 years; M/F, 30/15) who underwent endoscopic submucosal dissection (ESD) for gastric cancer, followed by standard dose of oral proton-pump inhibitor for 4 weeks. Subsequently, the size of ESD-induced artificial ulcers were measured to determine the speed of gastric ulcer healing, and regenerating mucosa around the ulcers and appropriately matched controls were collected from patients by endoscopic biopsy. Polymerase chain reaction (PCR) array analysis of genes in the Shh signaling pathway was performed, and quantitative reverse transcription (RT)-PCR was used to measure IL1 mRNA.
    ResultsThe levels of Shh and IL1 mRNA were 3.0 +/- 2.7-fold and 2.5 +/- 2.5-fold higher, respectively, in regenerating mucosa of artificial ulcers than in appropriately matched controls, with the two being positively correlated (r=0.9, P&lt;0.001). Shh (r=0.8, P&lt;0.001) and IL1 (r=0.7, P&lt;0.005) expression was each positively correlated with the speed of gastric ulcer healing, but multivariate analysis showed that Shh expression was the only significant parameter (P=0.045).
    ConclusionsExpression of Shh was correlated with the speed of gastric ulcer healing, promoting the regeneration of gastric mucosa.

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  • New therapies for patients infected with hepatitis C virus Invited Reviewed

    90 ( 2 )   39 - 45   2014.4

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    Other Link: http://opac.ll.chiba-u.jp/da/curator/900117600/

  • Opportunistic infection in patients with acute liver failure Reviewed

    Makoto Arai, Tatsuo Kanda, Shin Yasui, Keiichi Fujiwara, Fumio Imazeki, Akira Watanabe, Takeyuki Sato, Shigeto Oda, Osamu Yokosuka

    HEPATOLOGY INTERNATIONAL   8 ( 2 )   233 - 239   2014.4

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    Treatment with systemic corticosteroids is often used for acute liver failure (ALF), but this has increased the number of profoundly immunocompromised patients and cases of opportunistic infection.
    Between January 2007 and December 2012, all patients (n = 51) referred to the Chiba University Hospital for treatment of ALF were studied. Patients with prothrombin activity of 40 % or less of the standardized values were defined as having ALF. Patient age, sex, cause of ALF, alanine aminotransferase and total bilirubin levels, prothrombin activity and total amount of corticosteroid were analyzed to determine the factors associated with the occurrence of opportunistic infection.
    Opportunistic infections occurred in 21.6 % (n = 11) of ALF patients. Thirty-five patients underwent systemic corticosteroid therapy, and 31.4 % of those patients showed opportunistic infections. Cytomegalovirus (n = 9, 81.8 %) and Pneumocystis jiroveci (n = 6, 54.5 %) were the microorganisms frequently suspected as the causes of opportunistic infection. In 7 (63.6 %) of the 11 cases of opportunistic infection, 2 or more species of microorganism were detected. Seven patients (63.6 %) with opportunistic infection were cured by treatment. Cox regression analysis for the patients who underwent systemic corticosteroid therapy steroid treatment revealed that age over 52 years (compared to younger patients: odds ratio = 9.62, 95 % confidence interval = 1.22-76.9) was only the predictive factor for the occurrence of opportunistic infection.
    Opportunistic infections are not rare in ALF patients, and the appropriate diagnosis and treatment of these infections are critical during ALF treatment.

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  • Occurrence and recurrence of hepatocellular carcinoma were not rare events during phlebotomy in older hepatitis C virus-infected patients Reviewed

    Tatsuo Kanda, Shingo Nakamoto, Shin Yasui, Masato Nakamura, Tatsuo Miyamura, Shuang Wu, Xia Jiang, Makoto Arai, Fumio Imazeki, Osamu Yokosuka

    Case Reports in Oncology   7 ( 2 )   288 - 296   2014.3

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    The use of phlebotomy is relatively common for 'difficult-to-treat by antiviral therapies' hepatitis C virus (HCV)-infected patients and for certain patients having chronic liver diseases with an iron overload of the liver. In the present study, we retrospectively analyzed patients treated with phlebotomy and their adverse events. We observed the occurrence and recurrence of hepatocellular carcinoma, and the appearance of ascites in some patients infected with HCV as well as the reduction of serum ferritin and alanine aminotransferase levels. Severe adverse events necessitating a cessation of phlebotomy occurred independently of α-fetoprotein (≥10 ng/ml) in patients infected with HCV according to multivariate logistic regression analysis. These findings may serve as a basis for phlebotomy especially in older patients with chronic hepatitis C.

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  • Hepatitis C virus NS5A inhibitors and drug resistance mutations Invited Reviewed

    Shingo Nakamoto, Tatsuo Kanda, Shuang Wu, Hiroshi Shirasawa, Osamu Yokosuka

    WORLD JOURNAL OF GASTROENTEROLOGY   20 ( 11 )   2902 - 2912   2014.3

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    Some direct-acting antiviral agents for hepatitis C virus (HCV), such as telaprevir and boceprevir have been available since 2011. It was reported that HCV NS5A is associated with interferon signaling related to HCV replication and hepatocarcinogenesis. HCV NS5A inhibitors efficiently inhibited HCV replication in vitro. Human studies showed that dual, triple and quad regimens with HCV NS5A inhibitors, such as daclatasvir and ledipasvir, in combination with other direct-acting antiviral agents against other regions of HCV with or without peginterferon/ribavirin, could efficiently inhibit HCV replication according to HCV genotypes. These combinations might be a powerful tool for "difficult-to-treat" HCV-infected patients. "First generation" HCV NS5A inhibitors such as daclatasvir, ledipasvir and ABT-267, which are now in phase. clinical trials, could result in resistance mutations. "Second generation" NS5A inhibitors such as GS-5816, ACH-3102, and MK-8742, have displayed improvements in the genetic barrier while maintaining potency. HCV NS5A inhibitors are safe at low concentrations, which make them attractive for use despite low genetic barriers, although, in fact, HCV NS5A inhibitors should be used with HCV NS3/4A inhibitors, HCV NS5B inhibitors or peginterferon plus ribavirin. This review article describes HCV NS5A inhibitor resistance mutations and recommends that HCV NS5A inhibitors be used in combination regimens potent enough to prevent the emergence of resistant variants. (c) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

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  • C型肝炎ウイルス関連肝細胞癌の早期発症における潜在性B型肝炎ウイルス感染の影響

    中野 聖士, 川口 巧, 中本 晋吾, 川口 淳, 神田 達郎, 今関 文夫, 黒松 亮子, 住江 修治, 佐谷 学, 山田 慎吾, 鳥村 拓司, 角間 辰之, 横須賀 収, 佐田 通夫

    日本消化器病学会雑誌   111 ( 臨増総会 )   A426 - A426   2014.3

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  • Paradoxical Role Of Helicobacter Pylori In Gastric Cancer Invited Reviewed International journal

    Tatsuo Kanda

    Biohelikon: Cancer and Clinical Research   2   a12   2014.1

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    In Japan and other countries, <em>Helicobacter pylori</em> infection is one of the major causative agents of gastric cancer [1]. Gastric cancer is the second leading cause of cancer mortality worldwide. However, interestingly, the prevalence of H. pylori does not predict the incidence of gastric cancer.

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  • Acute liver injury in a patient with alcohol dependence: A case resembling autoimmune hepatitis or drug-induced liver injury Reviewed

    Masahiro Hayashi, Tatsuo Kanda, Masato Nakamura, Tatsuo Miyamura, Shin Yasui, Shingo Nakamoto, Shuang Wu, Makoto Arai, Fumio Imazeki, Osamu Yokosuka

    Case Reports in Gastroenterology   8 ( 1 )   129 - 133   2014

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    Some patients with alcohol dependence may initially present with atypical laboratory and histological features resembling autoimmune hepatitis (AIH) or drug-induced liver injury (DILI). Even with liver biopsy, it may be difficult to diagnose certain patients with alcohol dependence. However, careful follow-up of our patient and consultations with the attending psychiatrist were successful in diagnosing alcohol dependence and its liver injury. The immune mechanisms of alcoholic liver diseases, AIH and DILI may be overlapping. Certain patients are suffering from AIH with flares on a background of alcohol abuse. Certain patients with alcohol abuse may have a past history of DILI. This might be consistent with the fact that alcohol dependence initially presents with atypical laboratory features of AIH or DILI. With careful observation, the clinician should remind himself that alcohol dependence is not always required for developing liver disease, since many patients with liver disease do not meet the criteria for alcohol dependence. © 2014 S. Karger AG, Basel.

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  • Pulmonary nocardiosis associated with the treatment of severe liver injury Reviewed

    YAMATO Mutsumi, KANDA Tatsuo, YASUI Shin, NAKAMURA Masato, MIYAMURA Tatsuo, ARAI Makoto, MARUYAMA Hitoshi, YOKOSUKA Osamu

    Nippon Shokakibyo Gakkai Zasshi   111 ( 2 )   318 - 325   2014

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    <i>Nocardia</i> infection is a fatal complication in compromised hosts and is often associated with a poor prognosis. Here we report the case of a 42-year-old man with acute liver injury treated with steroids who developed pulmonary nocardiosis. Pulmonary computed tomography was performed followed by bronchoscopy, which confirmed the diagnosis of pulmonary nocardiosis. This facilitated expedient and successful treatment of the pulmonary infection. Computed tomography is a useful tool for screening respiratory tract infection in immunocompromised patients, such as those with acute liver injury.<br>

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  • New treatments for genotype 1 chronic hepatitis C - focus on simeprevir Reviewed

    Tatsuo Kanda, Shingo Nakamoto, Shuang Wu, Osamu Yokosuka

    THERAPEUTICS AND CLINICAL RISK MANAGEMENT   10   387 - 394   2014

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    Chronic hepatitis C virus (HCV) infection causes end-stage liver diseases and hepato-cellular carcinoma. In the USA, Canada, and Japan, simeprevir - one of the second-generation HCV NS3/4A protease inhibitors - in combination with peginterferon alpha-2a or 2b plus ribavirin has recently been approved for HCV genotype 1-infected patients and is now used in daily clinical practice. This review summarizes the mechanism of action of simeprevir and the results of clinical trials of simeprevir and peginterferon plus ribavirin for HCV genotype 1 patients. In general, the simeprevir and peginterferon plus ribavirin treatment is highly effective and its adverse events are similar to those of peginterferon plus ribavirin only, the exception being milder, reversible jaundice. In the near future, the development of interferon-free regimens with simeprevir is expected. Careful attention should be paid to new results of clinical trials with simeprevir.

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  • Ultra-Deep Sequencing Analysis of the Hepatitis A Virus 5 '-Untranslated Region among Cases of the Same Outbreak from a Single Source Reviewed

    Shuang Wu, Shingo Nakamoto, Tatsuo Kanda, Xia Jiang, Masato Nakamura, Tatsuo Miyamura, Hiroshi Shirasawa, Nobuyuki Sugiura, Azusa Takahashi-Nakaguchi, Tohru Gonoi, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MEDICAL SCIENCES   11 ( 1 )   60 - 64   2014

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    Hepatitis A virus (HAV) is a causative agent of acute viral hepatitis for which an effective vaccine has been developed. Here we describe ultra-deep pyrosequences (UDPSs) of HAV 5'-untranslated region (5'UTR) among cases of the same outbreak, which arose from a single source, associated with a revolving sushi bar. We determined the reference sequence from HAV-derived clone from an attendant by the Sanger method. Sixteen UDPSs from this outbreak and one from another sporadic case were compared with this reference. Nucleotide errors yielded a UDPS error rate of &lt; 1%. This study confirmed that nucleotide substitutions of this region are transition mutations in outbreak cases, that insertion was observed only in non-severe cases, and that these nucleotide substitutions were different from those of the sporadic case. Analysis of UDPSs detected low-prevalence HAV variations in 5'UTR, but no specific mutations associated with severity in these outbreak cases. To our surprise, HAV strains in this outbreak conserved HAV IRES sequence even if we performed analysis of UDPSs. UDPS analysis of HAV 5'UTR gave us no association between the disease severity of hepatitis A and HAV 5'UTR substitutions. It might be more interesting to perform ultra-deep sequencing of full length HAV genome in order to reveal possible unknown genomic determinants associated with disease severity. Further studies will be needed.

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  • Effect of Previous Interferon-based Therapy on Recurrence after Curative Treatment of Hepatitis C Virus-related Hepatocellular Carcinoma Reviewed

    Tomoko Saito, Tetsuhiro Chiba, Eiichiro Suzuki, Masami Shinozaki, Nobuaki Goto, Naoya Kanogawa, Tenyu Motoyama, Sadahisa Ogasawara, Yoshihiko Ooka, Akinobu Tawada, Tatsuo Kanda, Masaru Miyazaki, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MEDICAL SCIENCES   11 ( 7 )   707 - 712   2014

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    Previous reports have shown that interferon (IFN)-based therapy decreases the risk of development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C virus (HCV) infection. However, it remains to be fully elucidated whether elimination of HCV by IFN-based therapy inhibits HCC recurrence after curative treatment, such as surgical resection and local ablation therapies. In this study, we aimed to clarify the influence of a sustained virological response (SVR) after IFN-based therapy on recurrence and survival after curative treatment of HCC. Fifty-one patients who underwent curative treatment of HCV-related HCC after receiving IFN-based therapy were analyzed retrospectively. They were classified into SVR (N = 14) and non-SVR groups (N = 37). In the SVR group, serum levels of aspartate aminotransferase and alanine aminotransferase, the indocyanine green retention rate at 15 min, and the percentages of patients with liver cirrhosis and HCV serotype 1 were significantly lower, whereas serum albumin level and platelet count were significantly higher upon HCC occurrence. Recurrence-free survival (RFS) for the first recurrence was significantly higher in the SVR group (P &lt; 0.01). Multivariate analysis showed that SVR at initial HCC treatment (P &lt; 0.01) and multiple tumors (P &lt; 0.01) are prognostic factors for RFS. Moreover, RFS for the second recurrence showed a similar trend to that for the first recurrence. In conclusion, patients who underwent IFN-based therapy before initial curative treatment of HCC had a favorable clinical outcome compared with non-SVR patients.

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  • Impact of Aging on Liver Histological Findings of Autoimmune Liver Diseases Reviewed International journal

    Yuki Haga, Tatsuo Kanda, Katsuhiro Hagiwara, Reina Sasaki, Masato Nakamura, Shin Yasui, Makoto Arai, Xia Jiang, Shuang Wu, Shingo Nakamoto, Osamu Yokosuka

    Diseases   2   308 - 321   2014

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  • Autoimmune hepatitis in a patient with pulmonary arterial hypertension treated with endothelin receptor antagonists. Reviewed

    Akira Naito, Jiro Terada, Nobuhiro Tanabe, Toshihiko Sugiura, Seiichiro Sakao, Tatsuo Kanda, Osamu Yokosuka, Koichiro Tatsumi

    Internal medicine (Tokyo, Japan)   53 ( 7 )   771 - 5   2014

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    A 48-year-old woman was diagnosed with idiopathic pulmonary arterial hypertension (PAH) and administered PAH-specific therapies, including bosentan. Four years after the initiation of treatment with bosentan, liver dysfunction appeared, and ambrisentan was substituted for bosentan. One-and-a half years later, a second episode of liver dysfunction occurred. The pathological findings of a liver biopsy specimen were not definitive, although drug-induced hepatotoxicity caused by ambrisentan was considered. However, the patient's liver dysfunction did not improve even after the discontinuation of ambrisentan. Finally, we diagnosed her with autoimmune hepatitis (AIH). Providing careful observation with a suspicion of AIH is important when treating PAH patients with autoantibodies.

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  • Direct-acting Antiviral Agents for the Treatment of Chronic Hepatitis C Virus Infection. Reviewed International journal

    Kanda T, Nakamoto S, Nakamura M, Jiang X, Miyamura T, Wu S, Yokosuka O.

    J Clin Transl Hepatol.   2 ( 1 )   1 - 6   2014

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    Hepatitis C virus (HCV) is a leading cause of cirrhosis and hepatocellular carcinoma (HCC) in the US and Japan. Therefore, eradication of HCV may reduce the occurrence of HCC in HCV-infected individuals. In 2011, the use of first-generation HCV NS3/4A protease inhibitors such as telaprevir and boceprevir was initiated for clinical treatment of HCV. Administration of telaprevir and boceprevir plus peginterferon and ribavirin increased rates of sustained virological response (SVR) in HCV genotype 1-infected patients. However, this treatment regimen also led to severe adverse events. Second-generation direct-acting antiviral agents (DAAs) for HCV, such as simeprevir plus peg-interferon and ribavirin also resulted in higher SVR rates, with similar adverse events to other peg-interferon and ribavirin treatments. Higher SVR rates in HCV genotype 1- and 2-infected patients were achieved with 12-16 weeks of sofosbuvir plus other class DAAs with/without ribavirin and 12 weeks of sofosbuvir plus ribavirin, respectively. For "difficult-to-treat" HCV-infected patients, more therapeutic options are needed. Further studies examining the efficacy and adverse effects of such therapies will be required for the development of additional treatments.

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  • No Correlation between PNPLA3 rs738409 Genotype and Fatty Liver and Hepatic Cirrhosis in Japanese Patients with HCV Reviewed

    Masato Nakamura, Tatsuo Kanda, Shingo Nakamoto, Tatsuo Miyamura, Xia Jiang, Shuang Wu, Osamu Yokosuka

    PLOS ONE   8 ( 12 )   e81312   2013.12

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    Background: Hepatitis C virus (HCV) infection is associated with the development of cirrhosis and hepatocellular carcinoma and is also related to fatty change of the liver. Variation in patatin-like phospholipase domain-containing 3 (PNPLA3) gene is associated with disease progression in nonalcoholic fatty liver disease (NAFLD). Recent reports have suggested that PNPLA3, IL28B and TLR4-associated single nucleotide polymorphisms (SNPs) may have an impact on hepatic steatosis or fibrosis in patients with chronic HCV infection.
    Methods and Findings: Four SNPs (PNPLA3 rs738409, TLR4 rs4986790, TLR4 rs4986791, IL28B rs8099917) were identified in Japanese patients infected with HCV. We examined the association between the distribution of these SNP alleles and fatty change of the liver or existence of hepatic cirrhosis diagnosed by ultrasonography, one of the widely accessible and easy-to-use methods. PNPLA3 rs738409 G-allele and IL28B rs 8099917 minor allele were found in 70.0% and 31.1%, respectively. These two TLR4 SNPs were uniform in Japanese. Fatty change of the liver developed independent of the abscence of hepatic cirrhosis on sonographic findings and younger age. Hepatic cirrhosis was associated with a higher aspartate aminotransferase/platelet ratio index (APRI), no fatty change of the liver, higher BMI and higher AFP levels. No association between PNPLA3 rs738409/IL28B rs8099917 genotypes and hepatic steatosis or liver fibrosis was observed.
    Conclusions: According to ultrasound examinations, no association between PNPLA3 rs738409 genotype and fatty change of the liver or hepatic cirrhosis was found in Japanese patients infected with HCV. Together, our results suggested that the mechanism of hepatic steatosis underlying HCV infection might differ from that of NAFLD and should be explored.

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  • Hepatitis C virus protease inhibitor-resistance mutations: Our experience and review Invited Reviewed

    Shuang Wu, Tatsuo Kanda, Shingo Nakamoto, Fumio Imazeki, Osamu Yokosuka

    WORLD JOURNAL OF GASTROENTEROLOGY   19 ( 47 )   8940 - 8948   2013.12

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    Direct-acting antiviral agents (DAAs) for hepatitis C virus (HCV) infection are one of the major advances in its medical treatment. The HCV protease inhibitors boceprevir and telaprevir were the first approved DAAs in the United States, Europe, and Japan. When combined with peginterferon plus ribavirin, these agents increase sustained virologic response rates to 70%-80% in treatment-naive patients and previous-treatment relapsers with chronic HCV genotype 1 infection. Without peginterferon plus ribavirin, DAA monotherapies increased DAA-resistance mutations. Several new DAAs for HCV are now in clinical development and are likely to be approved in the near future. However, it has been reported that the use of these drugs also led to the emergence of DAA-resistance mutations in certain cases. Furthermore, these mutations exhibit cross-resistance to multiple drugs. The prevalence of DAA-resistance mutations in HCV-infected patients who were not treated with DAAs is unknown, and it is as yet uncertain whether such variants are sensitive to DAAs. We performed a population sequence analysis to assess the frequency of such variants in the sera of HCV genotype 1-infected patients not treated with HCV protease inhibitors. Here, we reviewed the literature on resistance variants of HCV protease inhibitors in treatment naive patients with chronic HCV genotype 1, as well as our experience. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.

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  • Role ofIL28Bgenotype in older hepatitis C virus-infected patients Invited Reviewed International journal

    Tatsuo Kanda

    World Journal of Immunology   3   15 - 17   2013.11

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  • Effect of occult hepatitis B virus infection on the early-onset of hepatocellular carcinoma in patients with hepatitis C virus infection Reviewed

    Masahito Nakano, Takumi Kawaguchi, Shingo Nakamoto, Atsushi Kawaguchi, Tatsuo Kanda, Fumio Imazeki, Ryoko Kuromatsu, Shuji Sumie, Manabu Satani, Shingo Yamada, Takuji Torimura, Tatsuyuki Kakuma, Osamu Yokosuka, Michio Sata

    Oncology Reports   30 ( 5 )   2049 - 2055   2013.11

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    Although overt hepatitis B virus (HBV) infection promotes the onset of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-infected patients, the effect of occult HBV infection remains unclear. The aim of this study was to investigate the effect of occult HBV infection on the early-onset of HCC in HCV-infected patients. A total of 173 HCC patients with HCV infection were enrolled and classified into 2 groups according to the median age of HCC onset: the early-onset group (n=91
    61.1±5.6 years) and the late-onset group (n=82
    73.8±3.7 years). Independent factors associated with the early-onset of HCC were assessed by multivariate analysis. In the overall analysis, independent risk factors for the early-onset of HCC were the white blood cell count and alanine aminotransferase level, but not the presence of HBV DNA. In a stratification analysis according to albumin levels of ≥3.5 g/dl, the presence of HBV DNA was a significant independent risk factor for the early-onset of HCC (OR 145.18, 95% CI 1.38-15296.61, P=0.036), whereas the presence of antibodies against hepatitis B core antigen was not found to be a risk factor. The presence of HBV DNA was not a risk factor for the early-onset of HCC in the overall analysis. However, its presence was an independent factor for the early-onset of HCC in HCV-infected patients with an albumin level of ≥3.5 g/dl. Thus, occult HBV infection may accelerate hepatocarcinogenesis in HCV-infected patients with relatively low carcinogenic potential.

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  • IL-28B polymorphisms and treatment response in hepatitis c virus patients with persistently normal alanine aminotransferase Invited Reviewed

    Tatsuo Miyamura, Tatsuo Kanda, Masato Nakamura, Xia Jiang, Shuang Wu, Shingo Nakamoto, Shigeru Mikami, Nobuo Takada, Fumio Imazeki, Osamu Yokosuka

    World Journal of Hepatology   5 ( 11 )   635 - 641   2013.11

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    AIM: To examine the association between the interleukin 28B (IL-28B) genotype and treatment response in hepatitis C virus (HCV)-infected patients with persistently normal alanine aminotransferase (PNALT). METHODS: We compared the treatment response of HCV-infected patients with PNALT to that of patients with non-PNALT. Between February 2010 and April 2013, 278 patients infected with HCV were enrolled in this study. All of the patients were treated with peginterferon-alpha 2a or 2b plus ribavirin. In addition, 180 μg of peginterferon alpha-2a or 1.5 μg/kg peginterferon alpha-2b per week plus weight-based ribavirin (600-1000 mg/d) were typically administered for 24 wk to HCV genotype 2-infected patients or for 48-72 wk to HCV genotype 1-infected patients. In all of the patients, the IL-28B rs8099917 genotype was determined using a TaqMan single-nucleotide polymorphism assay. HCV RNA was measured using the COBAS TaqMan HCV test. RESULTS: Female patients were dominant in the PNALT group (p &lt
    0.0001). Among 72 HCV genotype 1-infected patients with PNALT, the early virologic response (EVR) rates (p &lt
    0.01) and the sustained virologic response (SVR) rates (p &lt
    0.01) were higher in patients with the IL-28B TT genotype than in those with the IL-28B TG/ GG genotype. In HCV genotype 1-infected patients with PNALT, multivariate logistic-regression analysis showed that SVR was independently predicted by the IL-28B rs8099917 TT type (p &lt
    0.05) and having an EVR (p &lt
    0.01). The IL-28B rs8099917 TT genotype strongly correlated with treatment response in HCV genotype 1-infected Asian patients with PNALT. CONCLUSION: The IL-28B genotype may be useful for selecting HCV genotype 1-infected patients with PNALT who should receive interferon-based treatment. © 2013 Baishideng Publishing Group Co., Limited.

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  • Different effects of three interferons L on Toll-like receptor-related gene expression in HepG2 cells Reviewed

    Tatsuo Kanda, Xia Jiang, Shingo Nakamoto, Masato Nakamura, Tatsuo Miyamura, Shuang Wu, Osamu Yokosuka

    CYTOKINE   64 ( 2 )   577 - 583   2013.11

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    IFNL1 (IL29), IFNL2 (IL28A) and IFNL3 (IL28B) might play important roles in anti-viral defense. IFNL3 genotypes have been shown to be associated with hepatitis C spontaneous and treatment-induced viral clearance.
    The effects of IFNL1, IFNL2 and IFNL3 on innate immunity including Toll-like receptor (TLR)-related pathway in human hepatocytes were examined. After G418 screening, we established the human hepatoma stable cell lines HepG2-IL28A, HepG2-IL28B, and HepG2-IL29, expressing IFNL2, IFNL3, and IFNL1 in conditioned medium, respectively, and a control cell line, HepG2-pcDNA3.1. We performed real-time RT-PCR to investigate 84 Toll-like receptor-related gene expressions in triplicate and, using ddCt methods, compared these gene expressions in each cell line.
    IFNL2, IFNL3 and IFNL1 were respectively detected by ELISA in HepG2-IL28A, HepG2-IL28B and HepG2-IL29. Compared to HepG2-pcDNA3.1 cells, 17(20.2%), 11 (13.0%) and 16 genes (19.0%) were up-regulated 1.5-fold or more (p &lt; 0.05); 10 (11.9%), 2 (2.3%) and 10 genes (11.9%) were 1.5-fold or more downregulated (p &lt; 0.05) in HepG2-IL28A, HepG2-IL28B and HepG2-IL29, respectively. EIF2AK2 and SARM1 were up-regulated among all cells. Of interest, TLR3, TLR4 and related molecules CXCL10 (IP10), IL6, EIF2K2, IFNB1, and IRF1, important genes in the progression of HCV-related pathogenesis and antiviral activities against HCV, in HepG2-IL28B, presented different profiles from those of HepG2-IL28A and HepG2-IL29.
    IFNL3 induces interferon-stimulated genes (ISGs) that are reportedly associated with the progression of HCV-related pathogenesis and antiviral activities against HCV. IFNL is a powerful modulator of innate immune response and it is supposed that the 3 IFNLs may play different roles in the antiviral activity against HBV and HCV. (C) 2013 Elsevier Ltd. All rights reserved.

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  • Prevalence of Hepatitis C Virus Subgenotypes 1a and 1b in Japanese Patients: Ultra-Deep Sequencing Analysis of HCV NS5B Genotype-Specific Region Reviewed

    Shuang Wu, Tatsuo Kanda, Shingo Nakamoto, Xia Jiang, Tatsuo Miyamura, Sueli M. Nakatani, Suzane Kioko Ono, Azusa Takahashi-Nakaguchi, Tohru Gonoi, Osamu Yokosuka

    PLOS ONE   8 ( 9 )   e73615   2013.9

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    Background: Hepatitis C virus (HCV) subgenotypes 1a and 1b have different impacts on the treatment response to peginterferon plus ribavirin with direct-acting antivirals (DAAs) against patients infected with HCV genotype 1, as the emergence rates of resistance mutations are different between these two subgenotypes. In Japan, almost all of HCV genotype 1 belongs to subgenotype 1b.
    Methods and Findings: To determine HCV subgenotype 1a or 1b in Japanese patients infected with HCV genotype 1, real-time PCR-based method and Sanger method were used for the HCV NS5B region. HCV subgenotypes were determined in 90% by real-time PCR-based method. We also analyzed the specific probe regions for HCV subgenotypes 1a and 1b using ultra-deep sequencing, and uncovered mutations that could not be revealed using direct-sequencing by Sanger method. We estimated the prevalence of HCV subgenotype 1a as 1.2-2.5% of HCV genotype 1 patients in Japan.
    Conclusions: Although real-time PCR-based HCV subgenotyping method seems fair for differentiating HCV subgenotypes 1a and 1b, it may not be sufficient for clinical practice. Ultra-deep sequencing is useful for revealing the resistant strain(s) of HCV before DAA treatment as well as mixed infection with different genotypes or subgenotypes of HCV.

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  • Magnitude of contrast-enhanced ultrasonography as a noninvasive predictor for hepatic fibrosis: comparison with liver stiffness measurement and serum-based models Reviewed

    Akinobu Tawada, Hitoshi Maruyama, Hidehiro Kamezaki, Taro Shimada, Hiroyuki Ishibashi, Masanori Takahashi, Tatsuo Kanda, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka

    HEPATOLOGY INTERNATIONAL   7 ( 2 )   749 - 757   2013.6

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    To elucidate the efficiency of contrast-enhanced ultrasonography alone and in combination with other noninvasive models for grading hepatic fibrosis.
    This prospective study included 74 patients with four grades (F1-F4) of chronic liver disease (17, 20, 18, and 19 patients, respectively). Diagnostic performances of the contrast parameter (time to the maximum intensity ratio between the right portal vein and liver parenchyma from the onset of contrast enhancement in the right portal vein) assessed by ultrasonography, liver stiffness measurement (LSM), FIB-4 test, and type IV collagen 7s were compared with histological findings.
    Greatest areas under the receiver operating characteristics curve (Az) with the single model were 0.83 (95 % confidence interval 0.71-0.91) for marked fibrosis (a parts per thousand yenF2) by FIB-4 test; 0.85 (0.73-0.92) for advanced fibrosis (a parts per thousand yenF3) by LSM, and 0.92 (0.83-0.96) by type IV collagen 7s for cirrhosis (F4). When combined, Az for marked fibrosis was a parts per thousand yen0.82; the best Az value was 0.87 (0.74-0.94) for the combination of contrast parameter with FIB-4. Similarly, the Az for advanced fibrosis was a parts per thousand yen0.82, and the best Az value was 0.89 (0.78-0.94) for the combination of contrast parameter with LSM. The Az for cirrhosis was a parts per thousand yen0.95, and the best Az was 0.99 (0.97-1.00) for the combination of contrast parameter with LSM.
    The contrast parameter is a promising predictor for grading hepatic fibrosis when combined with LSM or FIB-4.

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  • Interferons in clinical trials Reviewed

    Tatsuo Kanda, Osamu Yokosuka, Masao Omata

    Emerging Therapeutic Options for Hepatitis C   7 - 17   2013.5

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    ▪ IFN-α2b XL is a sustained-release, hydrogel-coated, human recombinant interferon with Medusa natural amino acids (polyglutamate/vitamin E), which releases unmodified native and fully active protein (strong receptor affinity), possessing the full antiviral activity of native interferon. ▪ Intermediate analysis of a 3-month Phase II study of IFN-α2b XL with ribavirin in naive or nonresponder genotype 1 and 4 hepatitis C patients revealed an improved safety profile with similar or enhanced antiviral activity versus standard of care. ▪ Continuous subcutaneous interferon delivery could induce strong dose-dependent viral suppression. ▪ Albinterferon-α2b could provide the option of less frequent interferon dosing in patients with chronic hepatitis C. ▪ Sustained virologic response rates ranged from 60.0 to 75.9% with peginterferon-λ1a plus ribavirin, versus 53.3% with peginterferon-α2a plus ribavirin. ▪ New interferons may be useful for the improvement of early virologic response and sustained virologic response. Further studies will be needed to develop new interferons with less adverse effects.

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  • Emerging therapeutic options for hepatitis C

    Masao Omata, Tatsuo Kanda

    Emerging Therapeutic Options for Hepatitis C   1 - 113   2013.5

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    First discovered in 1989, hepatitis C virus (HCV) is a leading cause of chronic liver disease, hepatocellular carcinoma and liver failure worldwide. The prevalence of advanced liver disease attributed to chronic HCV infection is projected to rise and efforts to identify treatment candidates will have a greater impact as more effective antiviral therapy becomes available. In the eight chapters of this book, international experts explore the emergent drug classes and specific agents offering hope in HCV therapy and highlight future directions for research in addressing this serious and widespread problem.

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  • Foreword: Hepatitis C virus infection: From discovery to eradication

    Masao Omata, Tatsuo Kanda

    Emerging Therapeutic Options for Hepatitis C   3 - 4   2013.5

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  • Acute liver failure associated with propylthiouracil in a pregnant 26-year-old woman Reviewed

    Tatsuo Miyamura, Tatsuo Kanda, Shoko Minemura, Masato Nakamura, Shingo Nakamoto, Xia Jiang, Shuang Wu, Shin Yasui, Makoto Arai, Osamu Yokosuka

    Case Reports in Gastroenterology   7 ( 2 )   240 - 244   2013.5

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    It seems appropriate to use propylthiouracil to treat maternal hyperthyroidism during the first trimester of pregnancy. We present the case of a 26-year-old woman with acute liver failure associated with propylthiouracil during the first trimester of pregnancy. She was successfully treated without liver transplantation. Attention should be paid to the possible occurrence of propylthiouracil-induced hepatotoxicity even during the first trimester of pregnancy. Copyright © 2013 S. Karger AG, Basel.

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  • Treatment of hepatitis C virus infection in the future. Reviewed International journal

    Kanda T, Yokosuka O, Omata M

    Clinical and translational medicine   2 ( 1 )   9   2013.4

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    Two direct-acting antivirals (DAAs) against hepatitis C virus (HCV): telaprevir and boceprevir, are now available in combination with peginterferon plus ribavirin for the treatment of chronic hepatitis C infection. Although these drugs are potent inhibitors of HCV replication, they occasionally result in severe adverse events. In the present clinical trials, in their stead, several second-generation DAAs are being investigated. Most of them are being viewed with high expectations, but they also require the combination with peginterferon plus ribavirin. In the near future, we might be using all-oral DAAs and interferon-free regimens for the treatment of HCV-infected patients, and these would be potent inhibitors of HCV and have less adverse events.

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  • Lipopolysaccharide blocks induction of unfolded protein response in human hepatoma cell lines Reviewed

    Xia Jiang, Tatsuo Kanda, Takeshi Tanaka, Shuang Wu, Shingo Nakamoto, Fumio Imazeki, Osamu Yokosuka

    Immunology Letters   152 ( 1 )   8 - 15   2013.4

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    In the present study, we examined whether unfolded protein response (UPR) determined the hepatic cell damage induced by an innate immune response including TLR signaling pathways. We observed that lipopolysaccharide (LPS) transcriptionally downregulates 78-kDa glucose-regulated protein/immunoglobulin heavy-chain binding protein (GRP78/Bip), known to confer resistance to apoptosis. We also observed that LPS blocked the induction of UPR and led to poly(ADP-ribose) polymerase (PARP) cleavage in hepatocytes. We also demonstrated that overexpression of GRP78 rescued HepG2 cells treated with LPS from PARP cleavage. These data suggest that UPR downregulation could be a collateral effect of the LPS treatment. We speculate that UPR is an important factor of hepatic cell damage induced by an innate immune response. © 2013 Elsevier B.V.

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  • Platelet count and sustained virological response in hepatitis c treatment Invited Reviewed

    Tatsuo Kanda, Tatsuo Miyamura, Daisuke Maruoka, Shuang Wu, Shingo Nakamoto, Makoto Arai, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka, Keizo Kato, Akihito Tsubota, Nobuo Takada, Takayoshi Nishino, Shigeru Mikami

    World Journal of Hepatology   5 ( 4 )   182 - 188   2013.4

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    Aim: to examine the epidemiological data, hematological safety and treatment responses of peginterferonalpha 2a plus ribavirin therapy for hepatitis c. methods: between march 2008 and february 2011, 196 hepatitis c virus (hcv) genotype 1 infected japanese (127 treatment-naive and 69 treatment-experienced patients) patients treated with peginterferonalpha 2a plus ribavirin were enrolled. we examined the epidemiological data and treatment responses were retrospectively analyzed in terms of hematological safety. hcv rna was measured by the cobas taqman hcv test. results: overall sustained virological response (svr) rates of treatment-naive and treatment-experienced patients were 56% and 39%, respectively. multivariate logistic regression analysis showed that svr was attained independently of early virological response in both treatment-naive and treatment-experienced patients. svr rates did not differ between the pretreatment hemoglobin &lt
    13 g/dl and ≥ 13 g/dl groups. however, in treatment-naive patients, the svr rate of the pretreatment platelet count &lt
    130000/μl group was significantly lower than that of the pretreatment platelet count ≥ 130000/μl group. conclusion: attention should be paid to potential thrombocytopenia in the treatment of chronic hepatitis c patients. © 2013 Baishideng.

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  • Response to peginterferon-alpha 2b and ribavirin in Japanese patients with chronic hepatitis C genotype 1 Reviewed

    Tomoo Miyauchi, Tatsuo Kanda, Fumio Imazeki, Rintaro Mikata, Akinobu Tawada, Makoto Arai, Keiichi Fujiwara, Shingo Nakamoto, Shuang Wu, Takeshi Tanaka, Tatsuo Miyamura, Michio Kimura, Yasuo Hirai, Motohide Takashi, Shigeru Mikami, Nobuyuki Sugiura, Yutaka Natsuki, Ryosaku Azemoto, Noriaki Suzuki, Osamu Yokosuka

    HEPATOLOGY INTERNATIONAL   7 ( 1 )   144 - 152   2013.3

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    Patient age and gender may be associated with response to peginterferon alpha plus ribavirin, the current standard of care (SOC) for chronic hepatitis C genotype 1. We queried whether there was an association between age, gender, and treatment response to SOC in Japanese patients infected with hepatitis C virus (HCV) genotype 1.
    Between 2006 and 2009, HCV-infected Japanese patients treated with peginterferon alpha-2b plus ribavirin for 48 weeks were enrolled. Patients were allocated into four groups according to age and gender, and epidemiological data and treatment outcomes were retrospectively analyzed. HCV RNA was measured with COBAS AMPLICOR HCV Monitor Test v. 2.0.
    The overall sustained virological response (SVR) rate was 49.8%: patients aged a parts per thousand currency sign65 and &gt; 65 years, 50.9 and 44.0%, respectively; male and female, 56.5 and 39.0%. SVR rates of SOC against HCV genotype-1 females aged &gt; 65 years (19.0%) were inferior to those in males aged &gt; 65 years (57.8%) in Japan. Multivariate logistic regression analysis showed that SVR was attained independently of adherence 80/80/80 in all groups.
    Adherence to medication is also a key factor for the eradication of HCV in patients aged &gt; 65 years. As the SVR rate of patients aged a parts per thousand currency sign65 years was similar to that of patients aged &gt; 65 years, SOC could be useful for treating some of the elderly patients.

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  • Hepatitis C virus and hepatocellular carcinoma

    Tatsuo Kanda, Osamu Yokosuka, Masao Omata

    Biology   2 ( 1 )   304 - 316   2013.1

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    Hepatitis C virus (HCV), a hepatotropic virus, is a single stranded-positive RNA virus of ~9,600 nt. length belonging to the Flaviviridae family. HCV infection causes acute hepatitis, chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). It has been reported that HCV-coding proteins interact with host-cell factors that are involved in cell cycle regulation, transcriptional regulation, cell proliferation and apoptosis. Severe inflammation and advanced liver fibrosis in the liver background are also associated with the incidence of HCV-related HCC. In this review, we discuss the mechanism of hepatocarcinogenesis in HCV-related liver diseases. © 2013 by the authors
    licensee MDPI, Basel, Switzerland.

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  • Androgen Receptor and Hepatocellular Carcinoma Invited Reviewed International journal

    Tatsuo Kanda

    Journal of Gastrointestinal & Digestive System   S12   012   2013

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  • Antiviral therapy for "difficult-to-treat" hepatitis C virus-infected patients Invited Reviewed

    Tatsuo Kanda, Osamu Yokosuka, Masao Omata

    Chinese Medical Journal   126 ( 23 )   4568 - 4574   2013

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    Objective To review the updated research on direct antiviral agents (DAAs)-including regimens for hepatitis C virus (HCV), and focus on "difficult-to-treat" HCV-infected patients. Data sources The literature concerning DAAs and hepatitis C cited in this review was collected from PubMed and Google Scholar databases published in English up to July 2013. Study selection Data from published articles regarding HCV and DAAs in clinical trials and in clinical use were identified and reviewed. Results It was recognized that some "difficult-to-treat" patients would still exist, even though stronger treatments using such as DAAs, including telaprevir and boceprevir, which lead to higher sustained virological response rates, are available. Such patients include those with advanced fibrosis/cirrhosis, elderly persons, children, HCV-human immunodeficiency virus co-infected patients, HCV-infected recipients, and so on. Conclusions Certain "difficult-to-treat" patients would still exist, even though stronger treatment is available. Although evidence from clinical trials is still lacking, interferon-sparing regimens could have stronger effects for eradicating HCV in such cases.

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  • Adherence to medication is a more important contributor to viral breakthrough in chronic hepatitis B patients treated with entecavir than in those with lamivudine Reviewed

    Hidehiro Kamezaki, Tatsuo Kanda, Makoto Arai, Shuang Wu, Shingo Nakamoto, Tetsuhiro Chiba, Hitoshi Maruyama, Keiichi Fujiwara, Fumihiko Kanai, Fumio Imazeki, Fumio Nomura, Osamu Yokosuka

    International Journal of Medical Sciences   10 ( 5 )   567 - 574   2013

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    Viral breakthrough is related to poor adherence to medication in some chronic hepatitis B patients treated with nucleos(t)ide analogues (NAs). Our study aimed to examine how adherence to medication is associated with viral breakthrough in patients treated with NAs. A total of 203 patients (135 ETV and 68 LAM) were analyzed in this retrospective analysis. Physical examination, serum liver enzyme tests, and hepatitis B virus marker tests were performed at least every 3 months. We reviewed medical records and performed medical interviews regarding to patients' adherence to medication. Adherence rates &lt
    90% were defined as poor adherence in the present study. Cumulative viral breakthrough rates were lower in the ETV-treated patients than in the LAM-treated patients (P&lt
    0.001). Seven ETV-treated (5.1%) and 6 LAM-treated patients (8.8%) revealed poor adherence to medication (P=0.48). Among ETV-treated patients, 4 (3.1%) of 128 patients without poor adherence experienced viral breakthrough and 3 (42.8%) of 7 patients with poor adherence experienced viral breakthrough (P&lt
    0.001). Only 3 of 38 (7.8%) LAM-treated patients with viral breakthrough had poor adherence, a lower rate than the ETV-treated patients (P=0.039). Nucleoside analogue resistance mutations were observed in 50.0% of ETV- and 94.1% of LAM-treated patients with viral breakthrough (P=0.047). Viral breakthrough associated with poor adherence could be a more important issue in the treatment with especially stronger NAs, such as ETV. © Ivyspring International Publisher.

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  • Natural interferon-beta plus ribavirin therapy led to sustained virological response after seven unsuccessful courses of anti-viral treatment in a chronic hepatitis C patient Reviewed

    Tatsuo Kanda, Shingo Nakamoto, Makoto Arai, Tatsuo Miyamura, Shuang Wu, Keiichi Fujiwara, Osamu Yokosuka

    Clinical Journal of Gastroenterology   6 ( 2 )   160 - 163   2013

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    We describe a patient infected with hepatitis C virus (HCV) genotype 1 who failed to respond to interferon with or without ribavirin seven times but who then achieved sustained virological response by the combination of interferon-beta plus ribavirin treatment for 48 weeks. He did not respond to stronger treatment such as prolonged peginterferon plus ribavirin treatment for 87 weeks. It might be rare to treat a patient with interferon 8 times considering the cost and time, since patients failing interferon treatment several times are regarded to be refractory to interferon. It is possible that the difference in biological effects between interferon-alfa and interferon-beta might have resulted in a different outcome in our patient. Interferon-beta plus ribavirin therapy might be one of the treatment options for certain patients chronically infected with HCV who do not respond to standard care treatment. © Springer 2013.

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  • Acute Liver Failure Occurring during the First Trimester of Pregnancy Successfully Treated with Living Donor Liver Transplantation. Reviewed International journal

    Kanogawa N, Kanda T, Ohtsuka M, Nakamura M, Miyamura T, Yasui S, Arai M, Maruyama H, Fujiwara K, Shozu M, Oda S, Miyazaki M, Yokosuka O.

    Case Rep Transplant.   2013   309545 - 309545   2013

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    Acute liver failure (ALF) during pregnancy remains difficult to treat, and despite advances in treatment, liver transplantation must be selected as treatment option in certain cases. We report a 30-year-old woman with ALF of unknown etiology, occurring during the first trimester of pregnancy. Her condition was complicated by consciousness disturbance and coagulopathy due to ALF, but she was successfully treated with living donor liver transplantation 7 days after dilatation and curettage. At 9-month followup, she was in good medical condition. Liver transplantation has been reported as one of the treatment options for ALF during pregnancy with the prognosis varying depending on the trimester, from living donor or deceased donor liver transplantation. Of importance is that clinicians always think of emergent liver transplantation as a therapeutic option in ALF even in the first trimester of pregnancy.

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  • Alanine Aminotransferase Elevation during Peginterferon Alpha-2a or Alpha-2b plus Ribavirin Treatment Reviewed

    Masato Nakamura, Tatsuo Kanda, Tatsuo Miyamura, Shuang Wu, Shingo Nakamoto, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MEDICAL SCIENCES   10 ( 8 )   1015 - 1021   2013

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    Alanine aminotransferase (ALT) elevation was occassionally observed during the treatment with combination peginterferon alpha plus ribavirin. Two forms of peginterferon are currently available as a standard of care with or without direct-acting antivirals against hepatitis C virus (HCV). Until the appearance of interferon-sparing regimen, peginterferon alpha plus ribavirin will play a central role in the eradication of HCV. In the present study, we compared ALT elevations in response to peginterferon alpha-2a plus ribavirin or peginterferon alpha-2b plus ribavirin in HCV genotype-1-infected patients. There were no significant differences in ALT elevations between treatments with the two peginterferons, but in a comparison of the proportions of patients with transient ALT elevation from baseline between the two groups, transient ALT elevation was observed more in sustained virological response (SVR) patients treated with peginterferon alpha-2a than with peginterferon alpha-2b. However, no patients discontinued treatment due to ALT elevation. Patients with transient ALT elevation from baseline during the treatment had less favorable IL28B rs8099917 genotype in the peginterferon alpha-2b group. Patients achieving SVR tended to have lower ALT levels, although some had persistent ALT elevation during treatment. In conclusion, clinicians should pay attention to possible ALT elevation during the treatment of chronic hepatitis C patients.

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  • Efficacy of Lamivudine or Entecavir against Virological Rebound after Achieving HBV DNA Negativity in Chronic Hepatitis B Patients Reviewed

    Tomoo Miyauchi, Tatsuo Kanda, Masami Shinozaki, Hidehiro Kamezaki, Shuang Wu, Shingo Nakamoto, Kazuki Kato, Makoto Arai, Shigeru Mikami, Nobuyuki Sugiura, Michio Kimura, Nobuaki Goto, Fumio Imazeki, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MEDICAL SCIENCES   10 ( 6 )   647 - 652   2013

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    Nucleos(t)ide analogues (NAs) lead to viral suppression and undetectable hepatitis B virus (HBV) DNA in some individuals infected with HBV, but the rate of virological rebound has been unknown in such patients. We examined the prevalence of virological rebound of HBV DNA among NA-treated patients with undetectable HBV DNA. We retrospectively analyzed 303 consecutive patients [158 entecavir (ETV)- and 145 lamivudine (LAM)-treated] who achieved HBV DNA negativity, defined as HBV DNA &lt; 3.7 log IU/mL for at least 3 months. They were followed up and their features, including their rates of viral breakthrough, were determined. Viral rebound after HBV DNA negativity was not observed in the ETV-group. Viral rebound after HBV DNA negativity occurred in 38.7% of 62 HBe antigen-positive patients in the LAM-group. On multivariate analysis, age was an independent factor for viral breakthrough among these patients (P = 0.035). Viral rebound after HBV DNA negativity occurred in 29.1% of 79 HBe antigen-negative patients in the LAM-group. Differently from LAM, ETV could inhibit HBV replication once HBV DNA negativity was achieved. In contrast, LAM could not inhibit HBV replication even if HBV negativity was achieved in the early phase. Attention should be paid to these features in clinical practice.

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  • A Semi-Supervised Ensemble Learning Method for Finding Discriminative Motifs and its Application Reviewed

    Thi Nhan Le, Tu Bao Ho, Saori Kawasaki, Tatsuo Kanda, Katsuhiko Takabayashi, Shuang Wu, Osamu Yokosuka

    JOURNAL OF UNIVERSAL COMPUTER SCIENCE   19 ( 4 )   563 - 580   2013

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    Finding discriminative motifs has recently received much attention in biomedicine as such motifs allow us to characterize in distinguishing two different classes of sequences. It is common in biomedical applications that the quantity of labeled sequences is very limited while a large number of unlabeled sequences is usually available. The current methods of discriminative motif finding are powerful and effective with large labeled datasets, but they do not function well on small labeled datasets. In this paper, we present a semi-supervised ensemble method for finding discriminative motifs which is based on the SLUPC algorithm, a separate-and-conquer searching method to discover motifs of type 'discriminative one occurrence per sequence'. The proposed method, named E-SLUPC (Ensemble SLUPC), uses SLUPC to search discriminative motifs from an extended labeled dataset that contains labeled data and unlabeled data with predicted labels. Strong discriminative and frequent motifs characterizing two outcome classes of hepatitis C virus treatment (sustained viral response and non-sustained viral response) were detected and analyzed. Furthermore, the experimental evaluation shows that our method can function considerably well in the common context of medical research when the labeled data is usually difficult to obtain.

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  • Peginterferon alfa-2a plus ribavirin in Japanese patients infected with hepatitis C virus genotype 2 who failed previous interferon therapy Reviewed

    Tatsuo Kanda, Shingo Nakamoto, Takayoshi Nishino, Nobuo Takada, Akihito Tsubota, Keizo Kato, Tatsuo Miyamura, Daisuke Maruoka, Shuang Wu, Takeshi Tanaka, Makoto Arai, Shigeru Mikami, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka

    International Journal of Medical Sciences   10 ( 1 )   43 - 49   2012.12

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    Some patients infected with hepatitis C virus (HCV) genotype 2 could be cured with treatment shorter than 24 weeks using peginterferon plus ribavirin, but there are still treatment- refractory patients. Direct-acting antivirals (DAAs) are not currently available for HCV genotype 2 patients, different from genotype 1 patients, in clinical practice. We investigated 29 HCV genotype 2-infected Japanese patients who had been previously treated and failed to clear HCV. We retreated them with peginterferon alfa-2a plus ribavirin and measured HCV RNA level to assess the efficacy and safety of this treatment in patients who had failed previous therapy. We found that retreatment of HCV genotype 2-infected Japanese patients with peginterferon alfa-2a plus ribavirin for 24-48 weeks led to 60 to 66.6% sustained virological response (SVR) in patients previously treated with (peg-)interferon monotherapy and to 69.9% SVR in relapsers previously treated with peginterferon plus ribavirin. Attention should be paid to certain patients with unique features. Selection of patients according to their previous treatment could lead to optimal therapy in HCV genotype 2 treatment-experienced patients. © Ivyspring International Publisher.

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  • Interleukin-29 suppresses hepatitis A and C viral internal ribosomal entry site-mediated translation Reviewed

    Tatsuo Kanda, Shuang Wu, Tomoko Kiyohara, Shingo Nakamoto, Xia Jiang, Tatsuo Miyamura, Fumio Imazeki, Koji Ishii, Takaji Wakita, Osamu Yokosuka

    Viral Immunology   25 ( 5 )   379 - 386   2012.10

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    Our aim was to investigate the effects of interferons (IFNs)-λ (interleukin-29 [IL-29], IL-28A, and IL-28B) on hepatitis C virus (HCV) and hepatitis A virus (HAV) internal ribosomal entry site (IRES)-mediated translation. The effects of these IFNs on HCV/HAV translation from HAV/HCV IRES were investigated using bicistronic reporter constructs. We transfected HCV/HAV IRES constructs into these IFN-expressing cell lines. IL-29 showed stronger inhibition of their IRES-mediated translation. Combining IL-29 with IFN-α or amantadine resulted in stronger inhibition of HAV IRES activity. Our findings demonstrated a novel antiviral effect of IFNs-λ against HAV and HCV through the suppression of IRES-mediated translation. © 2012 Mary Ann Liebert, Inc.

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  • Hepatitis A, B, C and E virus markers in Chinese residing in Tokyo, Japan Reviewed

    Jun Yan, Tatsuo Kanda, Shuang Wu, Fumio Imazeki, Osamu Yokosuka

    Hepatology Research   42 ( 10 )   974 - 981   2012.10

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    Aim: Recently, the number of foreigners living in Japan has been increasing, with the majority originating from China. It is important for us to know the prevalence of hepatitis virus markers among them, as proper medical practices and vaccinations should be prepared when seeing them and their offspring. Methods: We examined the relationship between the prevalence of hepatitis virus markers: hepatitis B surface antigen (HBsAg), anti-HBs, anti-hepatitis C virus (HCV), anti-hepatitis A virus (HAV) and anti-hepatitis E virus immunoglobulin (Ig)G, and background such as age, birthplace and length of stay in Japan, of 568 Chinese residing in Tokyo, and also of 55 indigenous Japanese. Results: The prevalence of HBV and HAV markers in Chinese staying in Tokyo is higher than in indigenous Japanese (HBsAg, 10% vs 1.8%
    anti-HBs, 45% vs 9.0%
    anti-HAV, 90% vs 14%). There were no differences in anti-HCV and anti-HEV IgG between the two groups. Conclusion: Indigenous Japanese subjects have less immunity against HAV and HBV. The HBV carrier rate is higher in Chinese subjects, and attention should be paid to this issue in clinical practice. It might be important to control hepatitis viruses in Chinese subjects when doctors see them in Japan. © 2012 The Japan Society of Hepatology.

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  • Knockdown of Receptor-Interacting Serine/Threonine Protein Kinase-2 (RIPK2) Affects EMT-associated Gene Expression in Human Hepatoma Cells Reviewed

    Shuang Wu, Tatsuo Kanda, Shingo Nakamoto, Fumio Imazeki, Osamu Yokosuka

    ANTICANCER RESEARCH   32 ( 9 )   3775 - 3783   2012.9

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    Background: Receptor-interacting serinel threonine protein kinase-2 (RIPK2) has been reported to be an important regulator of tumor proliferation, differentiation and wound repair. We investigated the effects of RIPK2 knockdown in human hepatoma cells on epithelial-to-mesenchymal transition (EMT)-associated gene expression. Materials and Methods: HepG2 cells stably expressing RIPK2-shRNA (HepG2-shRIPK2) were generated after puromycin selection. Total RNAs from HepG2-shRIPK2 and from HepG2-shcontrol cells were isolated and PER-based arrays were performed to compare the 84 EMT-associated gene expressions. Results: We observed that knockdown of RIPK2 down-regulated mRNA expression of jagged 1 (JAG1); plasminogen activator inhibitor-1 (PAI1); regulator of G-protein signalling 2, 24 kDa (RGS2); E-cadherin (CDH1); fibroblast growth factor binding protein 1 (FGFBP1); snail homolog 2 (SNAI2); protein tyrosine phosphatase type IVA, member 1 (PTP4A1); keratin 19 (KRT19); vimentin (VIM); and survival of motor neuron protein-interacting protein 1 (SIP1). Conclusion: We found that knockdown of RIPK2 down-regulated nuclear factor kappa B (NE-kappa B)-dependent PAH and VIM gene expressions. RIPK2 might play an important role in hepatic cell migration. These findings could shed new light on carcinogenesis and on liver regeneration.

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  • Knockdown of receptor-interacting serine/threonine protein kinase-2 (RIPK2) affects EMT-associated gene expression in human hepatoma cells.

    Wu S, Kanda T, Nakamoto S, Imazeki F, Yokosuka O

    Anticancer research   32 ( 9 )   3775 - 83   2012.9

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  • Roles of ITPA and IL28B Genotypes in Chronic Hepatitis C Patients Treated with Peginterferon Plus Ribavirin Reviewed

    Tatsuo Miyamura, Tatsuo Kanda, Shingo Nakamoto, Shuang Wu, Xia Jiang, Makoto Arai, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka

    VIRUSES-BASEL   4 ( 8 )   1264 - 1278   2012.8

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    It has been reported that inosine triphosphatase (ITPA) gene variants protect against ribavirin-induced anemia in patients treated for chronic hepatitis C. IL28B variants also influence the treatment response of peginterferon plus ribavirin treatment in these patients. In the present study, we examined how ITPA and IL28B genotypes have clinical impacts on treatment-induced hematotoxicities and treatment response in HCV-infected patients treated with peginterferon plus ribavirin. ITPA genotypes (rs1127354 and rs6051702) and IL28B genotype (rs8099917) were determined by TaqMan SNP assay. We compared clinical background, treatment course and treatment response in terms of these genotypes. Only IL28B rs8099917 major type could predict sustained virological response. ITPA rs1127354 major type leads to significantly greater ribavirin-induced anemia than ITPA rs1127354 minor type between days 0 and 84. We noticed that IL28B rs8099917 minor genotype was associated with higher reduction of neutrophils and platelets. ITPA rs1127354 is useful for the prediction of ribavirin-induced anemia in the early phase after the commencement of peginterferon plus ribavirin treatment and IL28B rs8099917 is useful for the prediction of sustained virological response. Use of the combination of these two genotypes could lead to safe and effective treatment of chronic hepatitis C patients.

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  • Hepatitis B virus e antigen physically associates with receptor-interacting serine/threonine protein kinase 2 and regulates IL-6 gene expression. Reviewed

    Wu S, Kanda T, Imazeki F, Nakamoto S, Tanaka T, Arai M, Roger T, Shirasawa H, Nomura F, Yokosuka O

    The Journal of infectious diseases   206 ( 3 )   415 - 20   2012.8

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  • Hepatitis A outbreak associated with a revolving sushi bar in Chiba, Japan: Application of molecular epidemiology Reviewed

    Atsuko Tominaga, Tatsuo Kanda, Taro Akiike, Hiroshi Komoda, Kenji Ito, Asami Abe, Akiko Aruga, Satoru Kaneda, Masaaki Saito, Tomoko Kiyohara, Takaji Wakita, Koji Ishii, Osamu Yokosuka, Nobuyuki Sugiura

    HEPATOLOGY RESEARCH   42 ( 8 )   828 - 834   2012.8

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    Aim: The number of hepatitis A cases in Japan as well as in other developed countries has been progressively decreasing during the last several years. There is no universal hepatitis A vaccination program in Japan, and a hepatitis A virus (HAV) epidemic in Japan is not unlikely. In 2011, a hepatitis A outbreak associated with a revolving sushi bar occurred in Chiba, Japan. We aimed to analyze this outbreak. Methods: Twenty-seven patients associated with this outbreak were admitted to the National Hospital Organization Chiba Medical Center. Molecular epidemiologic investigations were conducted. Results: Twenty-six of the 27 patients had gone to the same revolving sushi bar, and then clinical symptoms appeared. HAV RNA was detected by reverse transcription polymerase chain reaction in 23 of the 27 (85.1%) patients whose sera had tested positive for anti-HAV immunoglobulin M. All isolates from this outbreak were clustered within subgenotype IA, displaying 100% sequence homology with each other in 232 bp from all 23 patients. All isolates belong to the IA-1 sublineage, which is endemic to Japan. Conclusion: A revolving sushi bar was associated with a hepatitis A outbreak, and molecular epidemiological investigations proved useful.

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  • Inhibition of cell viability by human IFN-beta is mediated by microRNA-431 Reviewed

    Takeshi Tanaka, Shigeru Sugaya, Kazuko Kita, Makoto Arai, Tatsuo Kanda, Katsunori Fujii, Fumio Imazeki, Katsuo Sugita, Osamu Yokosuka, Nobuo Suzuki

    INTERNATIONAL JOURNAL OF ONCOLOGY   40 ( 5 )   1470 - 1476   2012.5

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    MicroRNAs (miRNAs) are small non-coding RNAs that inhibit gene expression by cleaving or hindering the translation of target mRNAs. We used microarray-based comparative transcriptome analysis to identify changes in miRNA expression and function between a human cell line, RSa, which is highly sensitive to HuIFN-beta-mediated inhibition of cell viability, and its variant, the F-IFr cell line, which is relatively resistant to the cytokine. miR-431 expression was significantly higher in RSa cells compared with F-IFr cells. The addition of HuIFN-beta to RSa cultures reduced cell viability, down-regulated expression of IGFIR and IRS2 (putative miR-431 target genes), and inhibited the PI3K-Akt and MAPK pathways. The survival of F-IFr cells was not reduced by HuIFN-beta, but transient transfection with miR-431 precursors significantly decreased viability and concomitantly down-regulated IGFIR and IRS2 expression. In addition, the MAPK pathway, but not the PI3K-Akt pathway, was suppressed in F-IPr cells. Based on these results, we propose that, in RSa cells, HuIFN-beta-induced miR-431 expression may down-regulate IGFIR and IRS2 expression, and consequently inhibit cell proliferation by suppressing the MAPK pathway.

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  • Acute liver failure in an antimitochondrial antibody-positive 63-year-old man. Reviewed International journal

    Toru Wakamatsu, Tatsuo Kanda, Akinobu Tawada, Tatsuo Miyamura, Masanori Takahashi, Tetsuhiro Chiba, Makoto Arai, Hitoshi Maruyama, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka

    Case reports in gastroenterology   6 ( 2 )   394 - 9   2012.5

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    Antimitochondrial antibody (AMA) is one of the representative features of primary biliary cirrhosis (PBC). PBC is a female-dominant disease usually presenting intrahepatic bile duct destruction, cholestasis and fibrosis with or without chronic nonsuppurative destructive cholangitis. We presented the case of a 63-year-old man with acute liver failure who had AMA, pronounced alanine aminotransferase elevation and high bilirubinemia. We administered corticosteroids and rescued this patient without liver transplantation. It is well known that some patients within the spectrum of autoimmune liver disease present with characteristics of both PBC and autoimmune hepatitis. Although corticosteroids may be associated with a significant worsening of adverse events in patients with PBC, if acute liver failure in AMA-positive cases is progressive, the administration of corticosteroids has to be considered, as well as the preparation of urgent liver transplantation.

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  • Quantification of hepatitis B surface antigen can help predict spontaneous hepatitis B surface antigen seroclearance Reviewed

    Makoto Arai, Seiko Togo, Tatsuo Kanda, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka

    EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY   24 ( 4 )   414 - 418   2012.4

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    Background and aim The clinical outcomes of hepatitis B virus (HBV) carriers are favorable following hepatitis B surface antigen (HBsAg) seroclearance. The aim of this study was to investigate the clinical course of spontaneous HBsAg seroclearance and the factors predicting it.
    Methods A total of 423 patients who tested positive for HBsAg and were referred to Chiba University Hospital between January 1985 and April 2008 were included in the study and the following characteristics were analyzed: age, sex, status of hepatitis B e antigen, alanine aminotransferase level, HBV DNA level, number of platelets, HBV genotype, past treatment with interferon, and HBsAg level. When a nucleotide analog was used for treatment, we stopped follow-up. Measurement of HBsAg was performed using the chemiluminescent enzyme immunoassay method and less than 0.03 IU/ml of HBsAg was designated as HBsAg seroclearance.
    Results The study group included 239 men and 184 women and their average age was 40.5 +/- 13.8 years. Twenty-five patients achieved HBsAg seroclearance during the follow-up period with an incidence rate of 0.97% per year. Multivariate analysis revealed that HBsAg titer (compared with patients with a low HBsAg level: odds ratio = 0.45, 95% confidence interval: 0.29-0.70) at baseline was the only predictive factor for HBsAg seroclearance.
    Conclusion HBsAg seroclearance occurred at a frequency of 0.97% per year without the use of a nucleotide analog. HBsAg titer at baseline was the only predictive factor for HBsAg seroclearance. Eur J Gastroenterol Hepatol 24: 414-418 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

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  • APASL consensus statements and management algorithms for hepatitis C virus infection Reviewed

    Masao Omata, Tatsuo Kanda, Ming-Lung Yu, Osamu Yokosuka, Seng-Gee Lim, Wasim Jafri, Ryosuke Tateishi, Saeed S. Hamid, Wan-Long Chuang, Anuchit Chutaputti, Lai Wei, Jose Sollano, Shiv Kumar Sarin, Jia-Horng Kao, Geoffrey W. McCaughan

    HEPATOLOGY INTERNATIONAL   6 ( 2 )   409 - 435   2012.4

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    The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the "APASL Consensus Statements and Management Algorithms for Hepatitis C Virus Infection" in December, 2010, in order to revise "Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis, management and treatment of hepatitis C virus infection (J Gastroenterol Hepatol 22:615-633, 2007)". The working party consisted of expert hepatologists from the Asian-Pacific region gathered at Makuhari, Chiba, Japan on 19 December 2010. New data were presented, discussed and debated to draft a revision. Participants of the consensus meeting assessed the quality of cited studies. Finalized recommendations are presented in this review.

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  • Possible widespread presence of hepatitis A virus subgenotype IIIA in Japan: Recent trend of hepatitis A causing acute liver failure Reviewed

    Tatsuo Miyamura, Koji Ishii, Tatsuo Kanda, Akinobu Tawada, Tadashi Sekimoto, Shuang Wu, Shingo Nakamoto, Makoto Arai, Keiichi Fujiwara, Fumio Imazeki, Tomoko Kiyohara, Takaji Wakita, Osamu Yokosuka

    Hepatology Research   42 ( 3 )   248 - 253   2012.3

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    Aim: Recently, the number of acute hepatitis A cases has decreased in Japan. However, six patients with acute liver failure caused by hepatitis A virus (HAV) have been admitted to Chiba University Hospital, Japan, in the last 18months, between 2010 and June 2011. The aim of this study is to characterize the recent HAV genotypes from an urban hospital in Japan and to compare the clinical differences. Methods: Hepatitis A virus RNA was detected by strand-specific reverse transcription. Then, HAV VP1/2A regions were amplified by nested polymerase chain reaction (PCR). Sequences were directly determined and phylogenetic trees were constructed for determining HAV subgenotypes. Results: Analysis of these HAV genomes revealed that 4 and 2 belonged to subgenotypes IA and IIIA, respectively. Conclusions: Fujiwara etal. reported a frequency of HAV subgenotype IIIA of only 2.1% in Japan. We conclude that HAV subgenotype IIIA might be widespread in our country. © 2011 The Japan Society of Hepatology.

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  • 【経口感染ウイルス肝炎の現状と展望】韓国流行株の解析からみた本邦におけるA型肝炎対策

    神田 達郎, 太和田 暁之, 宮村 達雄, 呉 霜, 中本 晋吾, 藤原 慶一, 今関 文夫, 横須賀 收

    消化器内科   54 ( 2 )   239 - 243   2012.2

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  • Long-term cohort study of chronic hepatitis C according to interferon efficacy Reviewed

    Daisuke Maruoka, Fumio Imazeki, Makoto Arai, Tatsuo Kanda, Keiichi Fujiwara, Osamu Yokosuka

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   27 ( 2 )   291 - 299   2012.2

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    Background and Aim: We investigated the prognosis of patients with C-viral chronic liver disease (C-CLD) according to the efficacy of interferon (IFN) therapy in a long-term retrospective cohort study. Methods: Of 721 patients with C-CLD who underwent liver biopsy between January 1986 and December 2005, 577 were treated with IFN, and 221 of these patients achieved sustained virological response (SVR) with a follow-up period of 9.9 +/- 5.3 years. Results: The annual rate of HCC development was 2.71%/year, 2.31%/year, and 0.24%/year in untreated, non-SVR, and SVR patients, respectively. Multivariate Cox proportional regression analysis showed that the risk of HCC development was significantly lower in SVR patients than in untreated or non-SVR patients; moreover, this risk was similar in non-SVR patients and untreated patients. The annual mortality rate in overall death was 3.19%/year, 1.98%/year, and 0.44%/year in untreated, non-SVR, and SVR patients, respectively. Multivariate Cox proportional hazards regression analysis showed that the SVR status reduced the risk ratio for overall death to 0.173, whereas the non-SVR status did not significantly reduce the risk ratio. Conclusions: The risk ratio of overall death and HCC development was significantly reduced in SVR patients, whereas no significant reduction was found in non-SVR patients in a long-term cohort study.

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  • Longitudinal changes of the laboratory data of chronic hepatitis C patients with sustained virological response on long-term follow-up Reviewed

    D. Maruoka, F. Imazeki, M. Arai, T. Kanda, K. Fujiwara, O. Yokosuka

    JOURNAL OF VIRAL HEPATITIS   19 ( 2 )   E97 - E104   2012.2

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    . There is no study that follows up longitudinal changes in laboratory data of patients with C-viral chronic liver disease (C-CLD) who achieved sustained virological esponse (SVR) with interferon treatment in a long-term study. We investigated the laboratory data in a long-term retrospective cohort study of 581 patients with C-CLD who underwent liver biopsy between January 1986 and December 2005. 467 were treated with interferon and 207 of these patients achieved SVR with follow-up periods of 8.36 +/- 5.13 years. Alanine aminotransferase (ALT) levels, albumin levels, platelet counts, and the aspartate aminotransferase (AST)-to-platelet ratio index (APRI) values were serially examined during the follow-up period. None of the 207 patients with SVR exhibited hepatitis C virus (HCV) RNA positivity more than 6 months after the end of IFN treatment. Platelet counts and albumin levels increased only in those with eradication of HCV. APRI values decreased more in patients with SVR than in those with nonsustained virological responses (non-SVR). Patients who achieved SVR and had fibrosis stage 01 and 24 at enrolment had platelet counts that longitudinally increased by 2.81 +/- 3.95 and 5.49 +/- 4.53 x 103/mu L during the 10-year follow-up period, respectively. Albumin levels continuously increased during the first 2 years by 0.15 +/- 0.31 and 0.33 +/- 0.37 in fibrosis stage 01 and 24, respectively and then plateaued. ALT levels decreased rapidly one year after the start of treatment by 110.3 +/- 140.0 and 100.5 +/- 123.4 in fibrosis 01 and 24, respectively. HCV RNA negativity persisted in all patients with SVR, and laboratory data including APRI longitudinally improved during the long-term follow-up period.

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  • Hepatic sarcoidosis with an increased serum level of immunoglobulin G4 Reviewed

    Masanori Inoue, Tetsuhiro Chiba, Yoh Zen, Hajime Yokota, Tatsuo Kanda, Sadahisa Ogasawara, Harutoshi Sugiyama, Makoto Arai, Fumihiko Kanai, Makoto Ogawa, Fumio Imazeki, Osamu Yokosuka

    Internal Medicine   51 ( 21 )   3095 - 3098   2012

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    A 70-year-old woman with an increased uptake of 18-Fluorodeoxyglucose (FDG) in whole liver on positron emission tomography (PET) was referred to our hospital. Laboratory examinations showed increased serum levels of total immunoglobulin G (IgG) and IgG4. Gallium scintigraphy showed a remarkable uptake in the liver but not in any other organs. On computed tomography (CT) and magnetic resonance imaging (MRI), multiple foci of abnormal density were observed in the liver, but the pancreas and bile duct lacked any indications of IgG4-related sclerosing disease. A liver biopsy specimen revealed multiple non-necrotizing granulomas. This is the first report of hepatic sarocidosis in a patient with an elevated serum level of IgG4. © 2012 The Japanese Society of Internal Medicine.

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  • Signaling pathways involved in molecular carcinogenesis of hepatocellular carcinoma Reviewed

    Tatsuo Kanda, Fumio Imazeki, Fumihiko Kanai, Motohisa Tada, Osamu Yokosuka, Masao Omata

    Molecular Aspects of Hepatocellular Carcinoma   39 - 55   2012

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    Hepatocellular carcinoma (HCC) is one of the major health problems worldwide. It was recently reported that systemic treatment with sorafenib, a multiple kinase inhibitor, for advanced HCC patients with mild hepatic impairment (Child-Pugh class A) significantly extends overall survival. These results highlight the importance of understanding the molecular pathways to hepatocarcinogenesis that can lead to improvement in treatment for unresectable HCC. In this article, we provide an update on the molecular pathways to hepatocarcinogenesis, focusing on the extracellular signal-regulated kinase [Erk: mitogen activated protein kinase (MAPK)], Wnt/β-catenin, apoptosis, transforming growth factor-beta (TGF-β), phosphoinositide-3-kinase (PI3K)/Akt, mammalian target of rapamycin (mTOR), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-βB), Hedgehog, p53, cytokine and sex steroid pathways. Molecular targeted therapy against these pathways will shed new light on the treatment of advanced HCC patients. © 2012 Bentham Science Publishers. All rights reserved.

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  • Efficacy of Lamivudine or Entecavir on Acute Exacerbation of Chronic Hepatitis B Reviewed

    Tatsuo Kanda, Masami Shinozaki, Hidehiro Kamezaki, Shuang Wu, Shingo Nakamoto, Makoto Arai, Keiichi Fujiwara, Nobuaki Goto, Fumio Imazeki, Osamu Yokosuka

    INTERNATIONAL JOURNAL OF MEDICAL SCIENCES   9 ( 1 )   27 - 32   2012

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    Background/Aims: Spontaneous acute exacerbation of chronic hepatitis B virus (HBV) infection occasionally occurs in its natural history, sometimes leading rapidly to fatal hepatic failure. We compared the effects of lamivudine (LAM) with those of entecavir (ETV) treatments in acute exacerbation of chronic hepatitis B with 500 IU/L or higher alanine aminotransferase (ALT) levels.
    Methods: Thirty-four patients with acute exacerbation were consecutively treated with LAM /ETV. Their clinical improvements were compared.
    Results: Among LAM-treated and ETV-treated patients, none showed a reduction of &lt;1 log IU/mL in HBV DNA after 1 or 3 months of treatment. Initial virological response, defined as a reduction of 4 log IU/mL in HBV DNA at 6 months, with LAM and ETV, respectively, was 83.3% and 100%. One LAM patient developed hepatic encephalopathy, but all patients in both groups survived. Twelve months after treatment, 41.6% of 24 LAM group patients switched to another drug or added adefovir to their treatment due to the emergence of LAM-resistant mutants. On the other hand, patients receiving ETV did not need to change drugs.
    Conclusions: ETV appears to be as effective as LAM in the treatment of patients with acute exacerbation of chronic hepatitis B. Clinicians should carefully start to treat these patients as soon as possible.

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  • Hepatic STAT1-Nuclear Translocation and Interleukin 28B Polymorphisms Predict Treatment Outcomes in Hepatitis C Virus Genotype 1-Infected Patients Reviewed

    Tatsuo Miyamura, Tatsuo Kanda, Shingo Nakamoto, Shuang Wu, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka

    PLOS ONE   6 ( 12 )   e28617   2011.12

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    Background: We investigated associations between signal transducer and activator of transcription (STAT) 1 in pretreated liver tissues, interleukin (IL) 28B polymorphism and treatment response in hepatitis C virus (HCV)-infected patients treated with peginterferon and ribavirin.
    Methods and Findings: We performed immunostaining analysis of STAT1 in liver tissues and determined IL28B polymorphism at rs8099917. We then compared the results with treatment outcomes in HCV genotype 1 patients with high viral load who were receiving peginterferon plus ribavirin. In univariate analysis, younger age, white blood cell counts, virological responder, early virological responder (EVR), mild activity (A1) of liver inflammation grading, and lower STAT1 nuclear-stain of hepatocytes in zone 1, zone 2 and total zones of liver were associated with sustained virological responder (SVR). Multivariate analysis showed that EVR, age and hepatic STAT1 nuclear-stain in zone 2 of liver were independent predictors of SVR. It was also revealed that IL28B and STAT1-nuclear translocation in hepatocytes are independent predictors of response to treatment with peginterferon and ribavirin in chronic hepatitis C patients.
    Conclusions: Concomitant assessment of lower STAT1 nuclear-stain of hepatocytes and IL28B polymorphism is useful for prediction of SVR in HCV genotype 1 patients.

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  • Nuclear receptor mRNA expression by HBV in human hepatoblastoma cell lines Reviewed

    Shuang Wu, Tatsuo Kanda, Fumio Imazeki, Shingo Nakamoto, Hiroshi Shirasawa, Osamu Yokosuka

    CANCER LETTERS   312 ( 1 )   33 - 42   2011.12

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    Recent studies have implicated nuclear receptors (NRs) in the development of hepatocarcinogenesis. We assumed that hepatitis B virus (HBV) alters the expression of NRs and coregulators, and compared the gene expression profiling for 84 NRs and related genes between HpeG2.2.15, which secretes complete HBV virion, and HepG2 by real-time RT-PCR with SyBr green. Forty (47.6%) genes were upregulated 2-fold or greater, and only 5(5.9%) were down-regulated 2-fold or more, in HepG2.2.15 compared to HepG2. These results suggest that HBV affects NRs and their related signal transduction, and that they play important roles in viral replication and HBV-related hepatocarcinogenesis. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

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  • Epigenetic silencing of microRNA-373 plays an important role in regulating cell proliferation in colon cancer Reviewed

    Takeshi Tanaka, Makoto Arai, Shuang Wu, Tatsuo Kanda, Hideaki Miyauchi, Fumio Imazeki, Hisahiro Matsubara, Osamu Yokosuka

    Oncology Reports   26 ( 5 )   1329 - 1335   2011.11

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    microRNAs (miRNA) are non-coding RNAs that negatively control gene expression by cleaving or inhibiting the translation of target gene mRNAs. We used a microarray-based transcriptomic analysis to identify miRNA expression levels that changed in response to epigenetic factors. Specifically, we searched for increased expression of miRNAs prepared from colon cancer cell line DLD-1 after a 96-h treatment with 5 μM of 5-aza-2′-deoxycytidine (DAC). Among those identified, transient transfection of miRNA hsa-miR-373 resulted in cytostasis. In addition, bisulfate sequence analysis of the promoter regions of these miRNAs showed aberrant methylation in the cancer cells. In clinical colon samples, hsa-miR-373 was down-regulated in colon cancers (29/40, 72.5%) relative to control samples, whereas the purported oncogene RAB22A (a target gene of hsa-miR-373) was up-regulated (24/40, 60%). Using methylation-specific PCR, we also observed aberrant methylation of hsa-miR-373 in colon cancers (35/40, 87.5%) relative to controls (8/40, 20%). Based on these results, we conclude that expression of hsa-miR-373 is down-regulated by aberrant methylation in colon cancer and that this miRNA may function by regulating expression of the oncogene RAB22A.

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  • Response to Peginterferon-alfa 2b and Ribavirin in Japanese Patients with Chronic Hepatitis C Genotype 2 Reviewed

    Tatsuo Kanda, Fumio Imazeki, Ryosaku Azemoto, Yutaka Yonemitsu, Shigeru Mikami, Kazuhiko Kita, Motohide Takashi, Masahiko Sunaga, Shuang Wu, Shingo Nakamoto, Akinobu Tawada, Makoto Arai, Keizo Kato, Yu Yoshida, Yoshihiro Koma, Keiichi Fujiwara, Kenichi Fukai, Noriaki Suzuki, Osamu Yokosuka

    DIGESTIVE DISEASES AND SCIENCES   56 ( 11 )   3335 - 3342   2011.11

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    Background The current standard treatment for patients infected with hepatitis C virus (HCV) of genotype 2 is the combination of peginterferon (PEG-IFN) plus ribavirin (RBV) for 24 weeks.
    Aims We assessed the sustained virological response (SVR) rates in HCV genotype 2-infected Japanese patients in relation to the duration of treatment.
    Methods Between 2006 and 2009, among 147 patients with HCV genotype 2-infection in Chiba Prefecture, 138 consecutive patients were finally enrolled. Twenty-one, 97 and 20 patients were treated with PEG-IFN-alfa 2b plus RBV for 16, 24 and 48 weeks, respectively. Epidemiological data and treatment outcomes were retrospectively evaluated. HCV RNA was measured with COBAS AMPLICOR HCV Monitor Test v. 2.0.
    Results The overall SVR rate was 82.6% (114 of 138): treatment-na &lt; ve patients, 86.4% (89 of 103); patients with history of previous treatment, 71.4% (25 of 35). Patients treated for 16, 24 and 48 weeks obtained SVR rates of 66.6% (14 of 21), 86.5% (84 of 97) and 80.0 (16 of 20), respectively.
    Conclusions The SVR rates of PEG-IFN-alfa 2b plus RBV in Japanese patients were similar to those in previous studies. Combination treatment for 24 weeks for some patients infected with HCV genotype 2 may be superior to that for 16 weeks. More precise patient selection will be needed to shorten the combination treatment.

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  • Clinical importance of serum hepatitis B surface antigen levels in chronic hepatitis B Reviewed

    S. Togo, M. Arai, A. Tawada, T. Chiba, T. Kanda, K. Fujiwara, F. Imazeki, O. Yokosuka

    Journal of Viral Hepatitis   18 ( 10 )   e508 - e515   2011.10

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    Quantitative serology for hepatitis B surface antigen (HBsAg) is a new candidate marker for prediction of clinical outcome. The aim of this study was to investigate the clinical significance of quantifying HBsAg in patients with hepatitis B virus (HBV) infection. A total of 424 patients who tested positive for HBsAg and were referred to Chiba University Hospital between January 1985 and April 2008 were included in the study, and the following characteristics were analyzed: age, gender, status of hepatitis B e antigen (HBeAg), alanine aminotransferase level (ALT), HBV DNA level, number of platelets and development of hepatocellular carcinoma. Measurement of HBsAg was performed using the chemiluminescent enzyme immunoassay method. The study group consisted of 239 men and 185 women, and their average age was 40.6 ± 14.0 years. HBsAg showed a positive correlation with HBV DNA level (Pearson's product moment correlation, r = 0.586, P &lt
    0.001) and a weak inverse correlation with age (r = 0.3325, P &lt
    0.001). A control study, matched with age and sex, was performed between two groups with and without HBeAg seroconversion during follow-up period. Compared with the age and sex-matched controls, the change in HBsAg levels per year showed a significant decrease 2 years before seroconversion (paired t-test, P &lt
    0.05). The serial measurement of quantitative HBsAg level has the possibility of predicting the occurrence of HBeAg seroconversion. © 2011 Blackwell Publishing Ltd.

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  • The Assessment of Serum Hepatitis C Virus RNA 12 Weeks After the End of Treatment Using TaqMan Polymerase Chain Reaction Is Less Relevant Than After 24 Weeks for Predicting Sustained Virological Response Reviewed

    Tatsuo Kanda, Fumio Imazeki, Shuang wu, Shingo Nakamoto, Osamu Yokosuka

    HEPATOLOGY   54 ( 4 )   1482 - 1482   2011.10

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    Owner : NLM<br />
    Status : MEDLINE<br />
    PubModel : Print-Electronic<br />
    Language : eng<br />
    Pagination : 1482; author reply 1482-3

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  • Emergence of entecavir-resistant mutations in nucleos(t)ide-naive Japanese patients infected with hepatitis B virus: Virological breakthrough is also dependent on adherence to medication Reviewed

    Hidehiro Kamezaki, Tatsuo Kanda, Shuang Wu, Shingo Nakamoto, Makoto Arai, Hitoshi Maruyama, Keiichi Fujiwara, Fumio Imazeki, Osamu Yokosuka

    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY   46 ( 9 )   1111 - 1117   2011.9

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    Objective. Currently, five nucleos(t)ide analogues (NUCs) are available for the treatment of chronic hepatitis B in the world. We examined the prevalence of hepatitis B virus (HBV) DNA and alanine aminotransferase normalization in patients receiving entecavir (ETV) and the frequency of ETV-resistant mutations during an approximately 27-month use of ETV in chronic hepatitis B patients in an urban hospital in Japan. Materials and methods. A retrospective analysis of 81 NUC-naive chronic hepatitis B patients who received 0.5 mg of ETV daily was performed. HBV DNA was measured and sequence analysis of HBV DNA was performed in virological breakthrough patients. Results. Hepatitis B e antigen (HBeAg)-positive patients with HBV DNA 5.0-7.0 log IU/mL group and all HBeAg-negative patients achieved serum HBV DNA negativity by 12 months. Four patients experienced virological breakthrough during ETV therapy. Two patients had no genotypic mutations, and medical interviews revealed that they had poor adherence to ETV. Conclusions. We found that some of the HBV virological breakthroughs during ETV treatment were related to poor adherence to medication, highlighting that clinicians should pay attention to the emergence of resistant mutants as well as adherence to ETV.

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  • Hepatitis C Virus Nonstructural 5A Protein Inhibits Lipopolysaccharide-Mediated Apoptosis of Hepatocytes by Decreasing Expression of Toll-Like Receptor 4 Reviewed

    Ryo Tamura, Tatsuo Kanda, Fumio Imazeki, Shuang Wu, Shingo Nakamoto, Takeshi Tanaka, Makoto Arai, Keiichi Fujiwara, Kengo Saito, Thierry Roger, Takaji Wakita, Hiroshi Shirasawa, Osamu Yokosuka

    JOURNAL OF INFECTIOUS DISEASES   204 ( 5 )   793 - 801   2011.9

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    Background. Hepatitis C virus (HCV) nonstructural protein 5A (NS5A) has been shown to modulate multiple cellular processes, including apoptosis. The aim of this study was to assess the effects of HCV NS5A on apoptosis induced by Toll- like receptor (TLR) 4 ligand, lipopolysaccharide (LPS).
    Methods. Apoptotic responses to TLR4 ligands and the expression of molecules involved in TLR signaling pathways in human hepatocytes were examined with or without expression of HCV NS5A.
    Results. HCV NS5A protected HepG2 hepatocytes against LPS-induced apoptosis, an effect linked to reduced TLR4 expression. A similar downregulation of TLR4 expression was observed in Huh-7-expressing genotype 1b and 2a. In agreement with these findings, NS5A inhibited the expression of numerous genes encoding for molecules involved in TLR4 signaling, such as CD14, MD-2, myeloid differentiation primary response gene 88, interferon regulatory factor 3, and nuclear factor-kappa B2. Consistent with a conferred prosurvival advantage, NS5A diminished the poly(adenosine diphosphate-ribose) polymerase cleavage and the activation of caspases 3, 7, 8, and 9 and increased the expression of anti-apoptotic molecules Bcl-2 and c-FLIP.
    Conclusions. HCV NS5A downregulates TLR4 signaling and LPS-induced apoptotic pathways in human hepatocytes, suggesting that disruption of TLR4-mediated apoptosis may play a role in the pathogenesis of HCV infection.

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  • Simple assay based on restriction fragment length polymorphism associated with IL28B in chronic hepatitis C patients Reviewed

    Shingo Nakamoto, Tatsuo Kanda, Fumio Imazeki, Shuang Wu, Makoto Arai, Keiichi Fujiwara, Osamu Yokosuka

    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY   46 ( 7-8 )   955 - 961   2011.7

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    Objective. Several studies recently revealed that single nucleotide polymorphisms (SNPs) in the interleukin28B (IL28B) region are associated with the response to pegylated interferon-alfa (PEG-IFN-alfa) and ribavirin (RBV) treatment among hepatitis C virus (HCV)-infected individuals of European, African and Asian ancestry. The purpose of the study was to establish methods for determining the SNP rs8099917 associated with IL28B, which might be useful for further research of the treatment of HCV. Material and methods. Blood samples obtained from 93 consecutive patients with chronic hepatitis C were examined. On the basis of the sequence data, a new simple genotyping assay based on a PCR-restriction fragment length polymorphism (RFLP) with two enzymes, BsrDI and Tsp45I, was developed. Results. The proportion of null virological responders in the combined TG/GG group was higher than that in the TT group (p = 0.015), suggesting that minor allele is one of the important factors playing crucial roles in IFN-resistance. Genotyping of rs8099917 by our new method showed results identical to PCR and sequence in 98.9% and 98.9% by BsrDI and Tsp45I, respectively. Using two enzymes, BsrDI and Tsp45I, it was possible to distinguish IL28B SNP rs8099917. Conclusion. This simple method using RFLP will provide the framework for further studies of HCV.

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  • Quantification of hepatitis C virus in patients treated with peginterferon-alfa 2a plus ribavirin treatment by COBAS TaqMan HCV test Reviewed

    T. Kanda, F. Imazeki, Y. Yonemitsu, S. Mikami, N. Takada, T. Nishino, M. Takashi, A. Tsubota, K. Kato, N. Sugiura, A. Tawada, S. Wu, T. Tanaka, S. Nakamoto, R. Mikata, M. Tada, T. Chiba, T. Kurihara, M. Arai, K. Fujiwara, F. Kanai, O. Yokosuka

    JOURNAL OF VIRAL HEPATITIS   18 ( 7 )   E292 - E297   2011.7

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    Extremely low levels of serum hepatitis C virus (HCV) RNA can be detected by COBAS TaqMan HCV test. To investigate whether the COBAS TaqMan HCV test is useful for measuring rapid virological response (RVR) and early virological response (EVR) to predict sustained virological response (SVR), we compared the virological response to PEG-IFN-alfa 2a plus RBV in 76 patients infected with HCV genotype 1 when undetectable HCV RNA by the COBAS TaqMan HCV test was used, with those when below 1.7 log IU/mL HCV RNA by COBAS TaqMan HCV test was used, which corresponded to the use of traditional methods. Among the 76 patients, 28 (36.8%) had SVR, 13 (17.1%) relapsed, 19 (25.0%) did not respond, and 16 (21.0%) discontinued the treatment due to side effects. The positive predictive values for SVR based on undetectable HCV RNA by COBAS TaqMan HCV test at 24 weeks after the end of treatment [10/10 (100%) at week 4, 21/23 (91.3%) at week 8 and 26/33 (78.7%) at week 12] were superior to those based on &lt;1.7 log IU/mL HCV RNA [17/19 (89.4%) at week 4, 27/38 (71.0%) at week 8, and 27/43 (62.7%) at week 12]. The negative predictive values for SVR based on &lt;1.7 log IU/mL HCV RNA by COBAS TaqMan HCV test [46/57 (80.7%) at week 4, 37/38 (97.3%) at week 8, and 32/33 (96.9%) at week 12] were superior to those based on undetectable HCV RNA [48/66 (72.7%) at week 4, 46/53 (86.7%) at week 8, and 41/43 (95.3%) at week 12]. The utilization of both undetectable RNA and &lt;1.7 log IU/mL HCV RNA by COBAS TaqMan HCV test is useful and could predict SVR and non-SVR patients with greater accuracy.

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  • Initial Virological Response and Viral Mutation with Adefovir Dipivoxil Added to Ongoing Lamivudine Therapy in Lamivudine-Resistant Chronic Hepatitis B Reviewed

    Shuang Wu, Kenichi Fukai, Fumio Imazeki, Makoto Arai, Tatsuo Kanda, Yutaka Yonemitsu, Osamu Yokosuka

    DIGESTIVE DISEASES AND SCIENCES   56 ( 4 )   1207 - 1214   2011.4

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    Although adefovir dipivoxil (ADV) has been used for antiviral treatment of lamivudine (LAM)-resistant chronic hepatitis B (CHB) patients, the long-term efficacy of this treatment is not well understood. Initial virological response (IVR) has been reported to be an important factor in relation to the development of ADV-resistance.
    We therefore examined the factors associated with IVR and ADV mutation in these patients.
    Forty-nine LAM-resistant CHB patients with ADV add-on LAM therapy, 47% of whom were hepatitis B e-antigen (HBeAg)-positive with median treatment duration of 23 months, were enrolled in this study. Patients were classified into IVR and non-IVR groups on the basis of viral suppression status. Mutational analysis of the HBV polymerase/reverse transcriptase (rt) domain was performed by PCR-direct sequencing.
    Serum HBV DNA was undetectable (&lt; 2.6 log(10) copies/mL) in 67, 82, and 84% of patients at 24, 48, and 96 weeks, respectively, after ADV add-on LAM therapy. IVR was achieved in 82% of patients, and ALT normalized at week 24 in 90% of IVR and 78% of non-IVR patients. The lower pretreatment HBV DNA level and virus-containing mutations other than double mutation of rtL180M + rtM204V were significantly associated with IVR (P = 0.002 and P = 0.014, respectively). ADV-resistant mutations in the RT motif, reported previously, were not detected.
    IVR is useful for predicting the antiviral efficacy of ADV and LAM combination therapy in LAM-resistant CHB.

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  • Autoimmune fulminant liver failure in adults: Experience in a Japanese center Reviewed

    Keiichi Fujiwara, Shin Yasui, Akinobu Tawada, Koichiro Okitsu, Yutaka Yonemitsu, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Fumio Imazeki, Masayuki Nakano, Shigeto Oda, Osamu Yokosuka

    HEPATOLOGY RESEARCH   41 ( 2 )   133 - 141   2011.2

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    Aim:
    After the establishment of the international criteria of autoimmune hepatitis (AIH) in 1999 and the recognition of acute onset AIH, the diagnosis of patients with fulminant type of AIH came to be made. We diagnosed autoimmune fulminant liver failure based on the criteria, and discussed the etiology of fulminant hepatitis (FH) and late onset hepatic failure (LOHF), and the characteristics of autoimmune fulminant liver failure.
    Methods:
    We investigated the etiology of 95 consecutive adult patients with FH or LOHF admitted to our liver unit between 1990 and 2009. Clinical and biochemical features, therapies and outcomes were examined in patients with AIH after 2000.
    Results:
    Of 95 patients, 85 were FH and 10 LOHF. The etiology was due to viral infections in 51.6% (hepatitis A virus in 7.4%, hepatitis B virus in 43.2% and hepatitis E virus in 1.1%), AIH in 15.8%, drug allergy-induced in 12.6%, and unknown causes in 20.0%. The rate of patients with AIH increased significantly between 2000 and 2009 compared to the rate between 1990 and 1999 (P = 0.002). In recovered patients with AIH without transplantation after 2000, coma grade was lower, alanine aminotransferase level, prothrombin time activity and alfa-fetoprotein level were higher than in the others with statistical significance.
    Conclusion:
    AIH is not a rare cause of FH and LOHF, and the number of patients with unknown causes would surely decrease in concert with the precise diagnosis of AIH.

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  • Evolution of hepatitis B genotype C viral quasi-species during hepatitis B e antigen seroconversion. Reviewed

    Wu S, Imazeki F, Kurbanov F, Fukai K, Arai M, Kanda T, Yonemitsu Y, Tanaka Y, Mizokami M, Yokosuka O

    Journal of hepatology   54 ( 1 )   19 - 25   2011.1

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  • Pegylated interferon-alfa plus ribavirin therapies for chronic hepatitis C Reviewed

    T. Kanda, O. Yokosuka

    JOURNAL OF NEPAL MEDICAL ASSOCIATION   50 ( 1 )   41 - 48   2011.1

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    Until HCV NS3/4A protease inhibitors become available at the end of 2011, the combination pegylated-interferon (PEG-IFN)-alfa and ribavirin (RBV) will remain the standard treatment for chronic hepatitis C patients. In some hepatitis C virus-infected patients, PEG-IFN plus RBV treatment against HCV should continue to be used because of side effects of new drugs such as anemia. Our Japanese experiences should provide new information for the treatment of chronic hepatitis C.

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  • Long-term follow-up of patients with hepatitis B e antigen negative chronic hepatitis B Reviewed

    Dan Bekku, Makoto Arai, Fumio Imazeki, Yutaka Yonemitsu, Tatsuo Kanda, Keiichi Fujiwara, Kenichi Fukai, Kenichi Sato, Sakae Itoga, Fumio Nomura, Osamu Yokosuka

    Journal of Gastroenterology and Hepatology (Australia)   26 ( 1 )   122 - 128   2011

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    Background and Aim: After hepatitis B virus (HBV) e antigen (HBeAg) seroconversion, HBV-DNA continues to replicate, and HBeAg-negative patients still face the risk of liver disease progression. We investigated the predictive factors for alanine aminotransferase (ALT) elevation, antiviral drug use, and hepatocellular carcinoma (HCC) occurrence in HBeAg-negative patients.Methods: Age, sex, ALT, platelet counts, HBV-DNA levels, genotype, antidiabetic drug use, body mass index, smoking, and alcohol consumption were analyzed for a total of 244 HBV carriers who were HBeAg-negative.Results: Of 244 HBeAg-negative patients, 158 (64.8%) showed normal ALT levels at baseline. Multivariate Cox hazard regression analysis identified high HBV-DNA levels and high ALT at baseline as independent risk factors for ALT elevation in the patients with normal ALT at baseline. The threshold ALT and HBV-DNA levels were determined to be 31 IU/L and 5.3 logcopies/mL, respectively. Seventeen (7.0%) patients used antiviral drugs. Multivariate Cox hazard regression analysis identified high HBV-DNA levels (threshold, 5.7 log copies/mL), the use of antidiabetic drugs, and daily alcohol consumption at baseline as an independent risk factor for the use of antiviral drugs in HBeAg-negative patients. In 10 patients (4.1%), HCC was detected, and a low platelet count (threshold, 10.0 × 104/mm3) was associated with the occurrence of HCC.Conclusion: This study identified predictors of future active liver disease in HBeAg-negative patients, i.e. ALT elevation, unavoidable use of antiviral drugs, and occurrence of HCC. © 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

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  • Occurrence of Hepatocellular Carcinoma Was Not a Rare Event during and Immediately after Antiviral Treatment in Japanese HCV-Positive Patients Reviewed

    Tatsuo Kanda, Fumio Imazeki, Shigeru Mikami, Keizo Kato, Noritomo Shimada, Yutaka Yonemitsu, Tomoo Miyauchi, Makoto Arai, Keiichi Fujiwara, Akihito Tsubota, Nobuo Takada, Takayoshi Nishino, Motohide Takashi, Nobuyuki Sugiura, Michio Kimura, Kenichi Fukai, Osamu Yokosuka

    ONCOLOGY   80 ( 5-6 )   366 - 372   2011

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    Advanced chronic hepatitis C patients with sustained virolological response by antivirals remain at risk for hepatocellular carcinoma (HCC). We investigated the incidence of HCC during and immediately after peginterferon-alfa-2a and ribavirin (RBV) treatment in patients with chronic hepatitis C in Japan. HCC was detected in 8 of 238 patients during and after these treatments (mean follow-up period: 572 8 252 days). In conclusion, occurrence of HCC is not a rare event during and immediately after peginterferon-alfa-2a plus RBV treatment. In cases with cirrhosis, higher alpha-fetoprotein levels, old age, or a previous history of HCC treatment, clinicians should be especially alert for the possible development of HCC during and immediately after peginterferon-alfa-2a and RBV treatment. Clinicians should regularly check for the possible development of HCC even in chronic hepatitis C patients under treatment. Copyright (C) 2011 S. Karger AG, Basel

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  • Pegylated interferon-alfa-2a monotherapy in patients infected with HCV genotype 2 and importance of rapid virological response Reviewed

    Reiko Etoh, Fumio Imazeki, Tomoko Kurihara, Kenichi Fukai, Keiichi Fujiwara, Makoto Arai, Tatsuo Kanda, Rintaro Mikata, Yutaka Yonemitsu, Osamu Yokosuka

    BMC Research Notes   4   316   2011

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    Background: Pegylated (PEG)-interferon (IFN)-alfa-2a plus ribavirin (RBV) therapy for 24 weeks is now a standard treatment protocol for patients with hepatitis C virus (HCV) genotype 2. As RBV cannot be used in certain situations, we examined whether PEG-IFN-alfa-2a monotherapy for 24 weeks or less would be sufficient to obtain a sustained virological response (SVR) in patients infected with HCV genotype 2. Methods. Forty-nine consecutive patients with HCV genotype 2 received PEG-IFN-alfa-2a (180 g/week) subcutaneously without oral RBV for 8-64 weeks. HCV RNA level was determined by COBAS AMPLICOR HCV Test, v2.0. Results: HCV RNA was equal to or less than 100 KIU/mL (defined as low viral load) in 15 of 49 patients, and the remaining 34 had HCV RNA above 100 KIU/mL (defined as high viral load). All 15 patients with low viral load achieved rapid virological response (RVR
    HCV RNA negative at week 4), and also achieved SVR with an average treatment duration of 17.1 weeks. The 34 patients with high viral load were treated for 33.7 weeks on average, and 19 of them (55.9%) achieved RVR. The SVR rates of these patients were significantly higher in those with RVR than without RVR (16/19 vs. 6/15 p = 0.0074). Conclusion: PEG-IFN-alfa-2a monotherapy for 24 weeks or less might be sufficient to treat selected patients with HCV genotype 2, especially those with low viral load and becoming negative for HCV RNA by week 4 of treatment. © 2011 Imazeki et al
    licensee BioMed Central Ltd.

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  • Discovering relationship between hepatitis C virus NS5A protein and interferon/ribavirin therapy Reviewed

    Saori Kawasaki, Tu Bao Ho, Tatsuo Kanda, Osamu Yokosuka, Katsuhiro Takabayashi, Nhan Le

    Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)   6746   79 - 90   2011

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    Less than a half of hepatitis C patients respond to the current therapy by peg-interferon combined with ribavirin, and the genomic basis of those drug resistance remains unknown. It is recognized that the emerging challenge in the development of therapies for hepatitis C is new functions and mysteries of hepatitis C virus (HCV) non structural 5A (NS5A) protein. Different from current studies using small experimental samples to analyze relations between the HCV NS5A region and the response to interferon/ribavirin therapy, we introduce a data mining-based framework that exploits the largest available HCV database. This paper focuses on the methodology and early results of analyzing NS5A data. © 2011 Springer-Verlag.

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  • Analysis of 5' nontranslated region of hepatitis A viral RNA genotype I from South Korea: comparison with disease severities Reviewed

    Tatsuo Kanda, Sook-Hyang Jeong, Fumio Imazeki, Keiichi Fujiwara, Osamu Yokosuka

    PLOS ONE   5 ( 12 )   e15139   2010.12

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    The aim of the study was to analyze genotype I hepatitis A virus (HAV) 5&apos; nontranslated region (NTR) sequences from a recent outbreak in South Korea and compare them with reported sequences from Japan. We collected a total of 54 acute hepatitis A patients&apos; sera from HAV genotype I [27 severe disease (prothrombin time INR &gt;= 1.50) and 27 mild hepatitis (prothrombin time INR &lt;1.00)], performed nested RT-PCR of 5&apos; NTR of HAV directly sequenced from PCR products (similar to 300 bp), and compared them with each other. We could detect HAV 5&apos;NTR sequences in 19 of the 54 (35.1%) cases [12 of 27 severe cases (44.4%) and 7 of 27 self-limited cases (25.9%)], all of which were subgenotype IA. Sequence analysis revealed that sequences of severe disease had 93.6%-99.0% homology and of self-limited disease 94.3%-98.6% homology, compared to subgenotype IA HAV GBM wild-type IA sequence. In this study, confirmation of the 5&apos;NTR sequence differences between severe disease and mild disease was not carried out. Comparison with Japanese HAV A10 revealed (222)C to G or T substitution in 8/12 cases of severe disease and (222)C to G or T and (392)G to A substitutions in 5/7 and 4/7 cases of mild disease, respectively, although the nucleotide sequences in this study showed high homology (93.6%-100%). In conclusion, HAV 5&apos;NTR subgenotype IA from Korea had relatively high homology to Japanese sequences previously reported from Japan, and this region would be considered one of the antiviral targets. Further studies will be needed.

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  • Hepatitis C Virus Infection Impairs IRF-7 Translocation and Alpha Interferon Synthesis in Immortalized Human Hepatocytes Reviewed

    Amit Raychoudhuri, Shubham Shrivastava, Robert Steele, Srikanta Dash, Tatsuo Kanda, Ranjit Ray, Ratna B. Ray

    JOURNAL OF VIROLOGY   84 ( 21 )   10991 - 10998   2010.11

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    Hepatitis C virus (HCV) establishes chronic infection in a significant number of infected humans, although the mechanisms for chronicity remain largely unknown. We have previously shown that HCV infection in immortalized human hepatocytes (IHH) induces beta interferon (IFN-beta) expression (T. Kanda, R. Steele, R. Ray, and R. B. Ray, J. Virol. 81:12375-12381, 2007). However, the regulation of the downstream signaling pathway for IFN-alpha production by HCV is not clearly understood. In this study, the regulation of the IFN signaling pathway following HCV genotype 1a (clone H77) or genotype 2a (clone JFH1) infection of IHH was examined. HCV infection upregulated expression of total STAT1 but failed to induce phosphorylation and efficient nuclear translocation. Subsequent study revealed that HCV infection induces IFN-stimulated response element activation, as evidenced by upregulation of 2&apos;,5&apos;-oligoadenylate synthetase 1. However, nuclear translocation of IRF-7 was impaired following HCV infection. In HCV-infected IHH, IFN-alpha expression initially increased (up to 24 h) and then decreased at later time points, and IFN-alpha-inducible protein 27 was not induced. Interestingly, HCV infection blocked IRF-7 nuclear translocation upon poly(I-C) or IFN-alpha treatment of IHH. Together, our data suggest that HCV infection enhances STAT1 expression but impairs nuclear translocation of IRF-7 and its downstream molecules. These impairments in the IFN-alpha signaling pathway may, in part, be responsible for establishment of chronic HCV infection.

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  • Hepatitis B Virus e Antigen Downregulates Cytokine Production in Human Hepatoma Cell Lines Reviewed

    Shuang Wu, Tatsuo Kanda, Fumio Imazeki, Makoto Arai, Yutaka Yonemitsu, Shingo Nakamoto, Keiichi Fujiwara, Kenichi Fukai, Fumio Nomura, Osamu Yokosuka

    VIRAL IMMUNOLOGY   23 ( 5 )   467 - 476   2010.10

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    Disease activities of hepatitis B are affected by the status of hepatitis B e antigen (HBeAg). The function of the hepatitis B virus (HBV) precore or HBeAg is unknown. We assumed that HBeAg blocks aberrant immune responses, although HBeAg is not required for viral assembly, infection, or replication. We examined the interaction of HBeAg and the immune system, including cytokine production. The inflammatory cytokine TNF, IL-6, IL-8, IL-12A, IFN-alpha 1, and IFN-beta mRNA were downregulated in HBeAg-positive HepG2, which stably expresses HBeAg, compared to HBeAg-negative HepG2 cells. The results of real-time RT-PCR-based cytokine-related gene arrays showed the downregulation of cytokine and IFN production. We also observed inhibition of the activation of NF-kappa B-and IFN-beta-promoter in HBeAg-positive HepG2, as well as inhibition of IFN and IL-6 production in HBeAg-positive HepG2 cell culture fluids. HBeAg might modify disease progression by inhibiting inflammatory cytokine and IFN gene expression, while simultaneously suppressing NF-kappa B-signaling- and IFNb-beta promoter activation.

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  • Inhibitory effects on HAV IRES-mediated translation and replication by a combination of amantadine and interferon-alpha Reviewed

    Lingli Yang, Tomoko Kiyohara, Tatsuo Kanda, Fumio Imazeki, Keiichi Fujiwara, Verena Gauss-Mueller, Koji Ishii, Takaji Wakita, Osamu Yokosuka

    VIROLOGY JOURNAL   7   212   2010.9

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    Hepatitis A virus (HAV) causes acute hepatitis and sometimes leads to fulminant hepatitis. Amantadine is a tricyclic symmetric amine that inhibits the replication of many DNA and RNA viruses. Amantadine was reported to suppress HAV replication, and the efficacy of amantadine was exhibited in its inhibition of the internal ribosomal entry site (IRES) activities of HAV. Interferon (IFN) also has an antiviral effect through the induction of IFN stimulated genes (ISG) and the degradation of viral RNA. To explore the mechanism of the suppression of HAV replication, we examined the effects of the combination of amantadine and IFN-alpha on HAV IRES-mediated translation, HAV replicon replication in human hepatoma cell lines, and HAV KRM003 genotype IIIB strain replication in African green monkey kidney cell GL37. IFN-alpha seems to have no additive effect on HAV IRES-mediated translation inhibition by amantadine. However, suppressions of HAV replicon and HAV replication were stronger with the combination than with amantadine alone. In conclusion, amantadine, in combination of IFN-alpha, might have a beneficial effect in some patients with acute hepatitis A.

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  • Hepatitis A virus (HAV) proteinase 3C inhibits HAV IRES-dependent translation and cleaves the polypyrimidine tract-binding protein Reviewed

    T. Kanda, V. Gauss-Mueller, S. Cordes, R. Tamura, K. Okitsu, W. Shuang, S. Nakamoto, K. Fujiwara, F. Imazeki, O. Yokosuka

    JOURNAL OF VIRAL HEPATITIS   17 ( 9 )   618 - 623   2010.9

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    Hepatitis A virus (HAV) infection is still an important issue worldwide. A distinct set of viruses encode proteins that enhance viral cap-independent translation initiation driven by an internal ribosome entry site (IRES) and suppress cap-dependent host translation. Unlike cytolytic picornaviruses, replication of HAV does not cause host cell shut off, and it has been questioned whether HAV proteins interfere with its own and/or host translation. HAV proteins were coexpressed in Huh-7 cells with reporter genes whose translation was initiated by either cap-dependent or cap-independent mechanisms. Among the proteins tested, HAV proteinase 3C suppressed viral IRES-dependent translation. Furthermore, 3C cleaved the polypyrimidine tract-binding protein (PTB) whose interaction with the HAV IRES had been demonstrated previously. The combined results suggest that 3C-mediated cleavage of PTB might be involved in down-regulation of viral translation to give way to subsequent viral genome replication.

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  • Internal ribosomal entry-site activities of clinical isolate-derived hepatitis A virus and inhibitory effects of amantadine Reviewed

    Tatsuo Kanda, Fumio Imazeki, Shingo Nakamoto, Kohichiroh Okitsu, Keiichi Fujiwara, Osamu Yokosuka

    HEPATOLOGY RESEARCH   40 ( 4 )   415 - 423   2010.4

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    Aim:
    Little is known about specific naturally-occurring internal ribosomal entry site (IRES) activities of hepatitis A virus (HAV). We examined these activities using the bicistronic reporter assay and the effects of antiviral amantadine against their activities.
    Methods:
    Six HAV IRES clones from three patients with fulminant hepatitis and three with self-limited acute hepatitis were obtained. The activities of their IRES were analyzed using bicistronic reporter assay in hepatocyte- and non-hepatocyte-derived cell lines, and the potential efficaciousness of the amantadine was examined.
    Results:
    One clone from fulminant hepatitis had a deletion in domains III-IV of HAV IRES had higher IRES activities than HM175 in HLE and Huh-7 cells. In Huh-7 cells, amantadine is effective for inhibiting HAV IRES activities, and especially fulminant hepatitis-derived ones.
    Conclusion:
    HAV IRES derived from clinical isolates have various activities. Bicistronic reporter assay using clinical isolates may be another useful tool for testing antiviral activities like those of amantadine and the new acridines and hydrazones recently reported.

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  • Corrigendum to: "Association between mutations in the core region of hepatitis C virus genotype 1 and hepatocellular carcinoma development" [J Hepatol 2010;52:72-78] (DOI:10.1016/j.jhep.2009.10.001) Reviewed

    Shingo Nakamoto, Fumio Imazeki, Kenichi Fukai, Keiichi Fujiwara, Makoto Arai, Tatsuo Kanda, Yutaka Yonemitsu, Osamu Yokosuka

    Journal of Hepatology   52 ( 4 )   620   2010.4

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  • Association between mutations in the core region of hepatitis C virus genotype 1 and hepatocellular carcinoma development Reviewed

    Shingo Nakamoto, Fumio Imazeki, Kenichi Fukai, Keiichi Fujiwara, Makoto Arai, Tatsuo Kanda, Yutaka Yonemitsu, Osamu Yokosuka

    JOURNAL OF HEPATOLOGY   52 ( 1 )   72 - 78   2010.1

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    Background & Aims: To determine whether amino acid mutations in the core region of hepatitis C virus (HCV) genotype I are associated with response to interferon (IFN) therapy and development of hepatocellular carcinoma (HCC).
    Methods:We followed up 361 patients (median duration, 121 months), and IFN monotherapy was administered to 275 (76%) [sustained virological response (SVR) rate, 26.5%]. Using pretreatment sera, mutations at core residues 70 and 91 were analyzed [double wild (DW)-type amino acid pattern: arginine, residue 70: leucine, residue 91].
    Results: A low aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio and low HCV load were independently associated with SVR, but core mutations were not. During follow-up, 12 of 81 (14.8%) patients with the DW-type pattern and 52 of 216 (24.1%) patients with non-DW-type pattern developed HCC (p = 0.06, Breslow-Gehan-Wilcoxon test). Multivariate analysis with the Cox proportional-hazards model revealed the following independent risk factors for HCC: male gender [p &lt; 0.0001; risk ratio (RR), 3.97], older age (p &lt; 0.05; RR, 2.08), advanced fibrosis (p &lt; 0.0001; RR, 5.75), absence of SVR (p&lt;0.01; RR, 10.0), high AST level (p&lt;0.01; RR, 2.08), high AST/ALT ratio (p&lt;0.01; RR, 2.21), and non-DW-type pattern (p&lt;0.05: RR, 1.96). In patients with F0-F2 fibrosis at entry, non-DW-type was likely to lead to cirrhosis (p = 0.051).
    Conclusions: In HCV genotype 1 patients, HCC risk could be predicted by studying core mutations, response to IFN, and host factors like age, gender, and liver fibrosis. (C) 2009 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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  • New antiviral therapies for chronic hepatitis C. Reviewed

    Kanda T, Imazeki F, Yokosuka O

    Hepatology international   4 ( 3 )   548 - 61   2010.1

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    Owner : NLM<br />
    Status : PubMed-not-MEDLINE<br />
    PubModel : Electronic<br />
    Language : eng<br />
    Pagination : 548-61

    DOI: 10.1007/s12072-010-9193-3

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  • Involvement of interleukin-6 and androgen receptor signaling in pancreatic cancer Reviewed

    Kohichiroh Okitsu, Tatsuo Kanda, Fumio Imazeki, Yutaka Yonemitsu, Ratna B. Ray, Chawnshang Chang, Osamu Yokosuka

    Genes and Cancer   1 ( 8 )   859 - 867   2010

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    Pancreatic cancer remains one of the "difficult-to-treat" cancers. Signaling of androgen receptor (AR), one of the nuclear receptors, in the pancreas may be related to carcinogenesis. Higher interleukin-6 (IL-6) levels have been observed in pancreatic cancer patients. It is also well known that IL-6 affects the AR signaling pathway and that AR is important for cell migration activities. We demonstrated that IL-6 enhances the phosphorylation of STAT3 and MAPK, which in turn enhances AR-mediated transcription in pancreatic cancer cell lines. This activity was blocked by a pharmacological inhibitor of the JAK/STAT signaling pathway, AG490, and one of the MAPK signaling pathways, U0126. IL-6 also enhances pancreatic cancer cell migration in the presence of AR. This activity is blocked by AR-siRNA. IL-6 acts as a positive regulator in AR signaling, providing further insight into the progression of pancreatic carcinogenesis. © The Author(s) 2010.

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  • Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Virus Infection Reviewed

    Kenichi Ito, Makoto Arai, Fumio Imazeki, Yutaka Yonemitsu, Dan Bekku, Tatsuo Kanda, Keiichi Fujiwara, Kenichi Fukai, Kenichi Sato, Sakae Itoga, Fumio Nomura, Osamu Yokosuka

    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY   45 ( 2 )   243 - 249   2010

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    Objective. To determine the risk factors for the occurrence of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV) infection. Material and methods. A total of 620 patients who tested positive for hepatitis B surface antigen and were referred to Chiba University Hospital between February 1985 and March 2008 were included in the study and the following characteristics were analyzed: age, gender, status of hepatitis B e antigen, alanine aminotransferase level, HBV DNA level, and number of platelets (PLTs). Results. HCC was detected in 30 cases during the follow-up period (5.4 +/- 5.1 years). Multivariate analysis revealed that age &gt; 40 years [compared with patients aged &lt; 40 years; odds ratio (OR) = 4.28; 95% confidence interval (CI) = 1.68-10.9] and PLT level &lt; 206, 000/mu l (compared with patients with a higher PLT level; OR = 8.50; 95% CI = 1.98-36.2) were predictive factors for HCC occurrence. In patients aged &gt; 40 years, the HBV DNA level (compared with &lt; 5.0 log copies/ml; OR = 4.22, 95% CI = 1.13-15.8) and PLT level (compared with patients with &gt; 196,000/mu l PLTs; OR = 15.6, 95% CI = 2.06-118.3) were predictive factors for HCC occurrence. Conclusions. Advanced age and low PLT level were risk factors for HCC occurrence in patients with HBV infection. In patients aged &gt; 40 years, viral load was also a risk factor for HCC.

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  • Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Virus Infection Reviewed

    Kenichi Ito, Makoto Arai, Fumio Imazeki, Yutaka Yonemitsu, Dan Bekku, Tatsuo Kanda, Keiichi Fujiwara, Kenichi Fukai, Kenichi Sato, Sakae Itoga, Fumio Nomura, Osamu Yokosuka

    Scandinavian Journal of Gastroenterology   45 ( 2 )   243 - 249   2010

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    Objective. To determine the risk factors for the occurrence of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV) infection. Material and methods. A total of 620 patients who tested positive for hepatitis B surface antigen and were referred to Chiba University Hospital between February 1985 and March 2008 were included in the study and the following characteristics were analyzed: age, gender, status of hepatitis B e antigen, alanine aminotransferase level, HBV DNA level, and number of platelets (PLTs). Results. HCC was detected in 30 cases during the follow-up period (5.4 ± 5.1 years). Multivariate analysis revealed that age &gt
    40 years [compared with patients aged &lt
    40 years
    odds ratio (OR) 4.28
    95% confidence interval (CI) 1.68-10.9] and PLT level &lt
    206,000/μl (compared with patients with a higher PLT level
    OR 8.50
    95% CI 1.98-36.2) were predictive factors for HCC occurrence. In patients aged &gt
    40 years, the HBV DNA level (compared with &lt
    5.0 log copies/ml
    OR 4.22, 95% CI 1.13-15.8) and PLT level (compared with patients with &gt
    196,000/μl PLTs
    OR 15.6, 95% CI 2.06-118.3) were predictive factors for HCC occurrence. Conclusions. Advanced age and low PLT level were risk factors for HCC occurrence in patients with HBV infection. In patients aged &gt
    40 years, viral load was also a risk factor for HCC.

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  • MBP-1 Inhibits Breast Cancer Growth and Metastasis in Immunocompetent Mice Reviewed

    Tatsuo Kanda, Amit Raychoudhuri, Robert Steele, John E. Sagartz, Cheri West, Ratna B. Ray

    CANCER RESEARCH   69 ( 24 )   9354 - 9359   2009.12

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    Breast cancer is the leading cause of cancer death among women. We have shown previously an antiproliferative effect of MBP-1 on several human cancer cells. In this study, we have examined the potential of MBP-1 as a gene therapeutic candidate in regression of breast cancer growth and metastasis in an immunocompetent mouse model. For this, we have used a mouse breast cancer cell line (EO771) and syngeneic C57BL/6 mice. EO771 cells were implanted into the mammary fat pad of C57BL/6 mice. Replication-deficient recombinant adenovirus expressing MBP-1 was administered intratumorally to determine gene therapeutic potential. The results showed a significant regression of primary and distant (lung) tumor growth. Animals exhibited prolonged survival on treatment with MBPA compared with the control group (dl312). Subsequent studies suggested that MBP-1 inhibits matrix metalloproteinase expression in human breast cancer cells. Cells transduced with MBP-1 displayed inhibition of migration in a wound-healing assay. The conditioned medium from MBP-1-transduced cells blocked in vitro tube formation assay and inhibited expression of several angiogenic molecules. Taken together, our study shows that MBP-1 acts as a double-edged sword by inhibiting primary and metastatic tumor growth and modulating matrix metalloproteinase expression with a therapeutic potential against breast cancer progression. [Cancer Res 2009;69(24):9354-9]

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  • Opportunistic infection in the patients with acute liver failure: A report of three cases with one fatality Reviewed

    Makoto Arai, Fumio Imazeki, Yutaka Yonemitsu, Tatsuo Kanda, Keiichi Fujiwara, Kenichi Fukai, Akira Watanabe, Takeyuki Sato, Shigeto Oda, Osamu Yokosuka

    Clinical Journal of Gastroenterology   2 ( 6 )   420 - 424   2009.12

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    We report three cases of severe opportunistic infection in patients with acute liver failure (ALF). These cases included a 56-year-old man infected with Cryptococcus neoformans, cytomegarovirus (CMV), Candida albicans and Aspergillus fumigates, as well as a 62-year-old man and a 54-year-old woman infected with pneumocystis pneumonia, CMV and Aspergillus fumigatus. One patient died as a result of the infection rather than liver failure. We stress the importance of opportunistic infection as a consideration in the use of immunosuppressive agents for the treatment of ALF. © 2009 Springer.

    DOI: 10.1007/s12328-009-0108-6

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  • Inhibition of Intrahepatic Gamma Interferon Production by Hepatitis C Virus Nonstructural Protein 5A in Transgenic Mice Reviewed

    Tatsuo Kanda, Robert Steele, Ranjit Ray, Ratna B. Ray

    JOURNAL OF VIROLOGY   83 ( 17 )   8463 - 8469   2009.9

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    Hepatitis C virus (HCV) utilizes strategies to suppress or evade the host immune response for establishment of persistent infection. We have shown previously that HCV nonstructural protein 5A (NS5A) impairs tumor necrosis factor alpha (TNF-alpha)-mediated apoptosis. In this study, we have examined the immunomodulatory role of HCV NS5A protein in transgenic mouse (NS5A-Tg) liver when mice were challenged with an unrelated hepatotropic adenovirus as a nonspecific stimulus. Hepatotropic adenovirus was introduced intravenously into NS5A-Tg mice and control mice, and virus clearance from liver was compared over a time course of 3 weeks. The differential mRNA expression levels of 84 cytokine-related genes, signal pathway molecules, transcription factors, and cell surface molecules were determined using real-time reverse transcription-PCR array. NS5A-Tg mice failed to clear adenovirus from liver up to 3 weeks postinfection while control mice cleared virus within 1 to 2 weeks. Subsequent study revealed that gamma interferon (IFN-gamma) expression is inhibited at both the mRNA and protein levels in NS5A-Tg mice, and an inverse expression of transcription factors Gata-3 and Tbx21 is observed. However, TNF-alpha mRNA and protein expression were elevated in both NS5A-Tg and control mice. Together, our results suggested that HCV NS5A acts as an immunomodulator by inhibiting IFN-gamma production and may play an important role toward establishment of chronic HCV infection.

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  • Memories of studying life in Saint Louis

    Tatsuo Kanda

    Chiba medical journal   2009.8

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  • Quantification of hepatitis C amino acid substitutions 70 and 91 in the core coding region by real-time amplification refractory mutation system reverse transcription-polymerase chain reaction Reviewed

    Shingo Nakamoto, Tatsuo Kanda, Yutaka Yonemitsu, Makoto Arai, Keiichi Fujiwara, Kenichi Fukai, Fumihiko Kanai, Fumio Imazeki, Osamu Yokosuka

    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY   44 ( 7 )   872 - 877   2009.7

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    Objective. The effects of hepatitis C virus (HCV) sequence variations on the success of antiviral therapy or the development of hepatocellular carcinoma (HCC) are complex for many reasons. Recently, there have been several reports on the effects of genotype 1b HCV core amino acid substitutions 70 and/or 91 on the outcome of antiviral therapies and the clinical course. The purpose of this study was to establish real-time amplification refractory mutation system (ARMS) reverse transcription (RT)-polymerase chain reaction (PCR) assays for easy detection of these HCV mutations. Material and methods. Plasmids p-core-W, including the wild-type HCV core coding region (70R and 91L), and p-core-M, including the mutant-type HCV core (70Q and 91M), were constructed by cloning and PCR-based mutagenesis for control vector of the wild-type core and that of the mutant core, respectively. Using serially diluted forms of these vectors, SyBr Green-based real-time ARMS RT-PCR detection with each of the specific primer pairs was performed. Results. Each primer could clearly distinguish the difference between p-core-W and p-core-M at the same copy numbers. Concerning substitution 70, the ratios 100:1, 10:1, 1:1, 1:10, and 1:100 of p-core-W versus p-core-M could be distinguished, while for substitution 9 1, the ratios 100:1, 10:1, 1:1, 1:10, 1:100, and 1:1000 could be distinguished, confirming the sensitivity and specificity of the assay. Conclusions. This method could be a useful alternative for the detection of genotype 1b HCV core amino acid substitutions 70 and 91 and be reliably applied for rapid screening.

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  • Inhibition of HCV replication by small interfering RNA. Reviewed International coauthorship

    Ray RB, Kanda T

    Methods in molecular biology (Clifton, N.J.)   510   251 - 62   2009.1

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    Small interfering RNAs (siRNAs) and short hairpin RNAs (shRNAs) have been reported to suppress gene expression significantly. HCV seems a suitable candidate for targets of siRNAs, as HCV is a positive single-strand RNA virus and replicates in the cytoplasm. Efficient inhibition by siRNAs requires access to target RNAs, which usually possess secondary structure. We have shown that shRNAs suppressing the HCV internal ribosomal entry site (IRES) can inhibit different HCV genotypes grown in cell culture and replicon replication, suggesting the potential of siRNA as an additional therapeutic option against HCV infection.

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  • Hepatitis C Virus Core Protein Augments Androgen Receptor-Mediated Signaling Reviewed

    Tatsuo Kanda, Robert Steele, Ranjit Ray, Ratna B. Ray

    JOURNAL OF VIROLOGY   82 ( 22 )   11066 - 11072   2008.11

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    Hepatitis C virus (HCV) infection is frequently associated with the development of hepatocellular carcinoma (HCC), which is one of the male-dominant diseases. Androgen signaling in liver may be related to carcinogenesis. In this study, we investigated whether HCV proteins cross talk with the androgen receptor (AR) signaling pathway for promotion of carcinogenesis. We have demonstrated that HCV core protein alone or in context with other HCV proteins enhances AR-mediated transcriptional activity and further augments in the presence of androgen. Subsequent study suggested that HCV core protein activates STAT3, which in turn enhances AR-mediated transcription. This activity was blocked by a pharmacological inhibitor of the Jak/Stat signaling pathway, AG490. Vascular endothelial growth factor (VEGF) is a target gene of AR in liver and plays an important role in angiogenesis. Therefore, we examined whether HCV infection modulates VEGF expression in hepatocytes. Our results demonstrated that HCV enhances VEGF expression and facilitates tube formation in human coronary microvascular endothelial cells in the presence of AR. Together, our results suggest that HCV core protein acts as a positive regulator in AR signaling, providing further insight into oncogenic potential in the development of HCC in HCV-infected individuals.

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  • Knockdown of MBP-1 in Human Foreskin Fibroblasts Induces p53-p21 Dependent Senescence Reviewed

    Asish K. Ghosh, Tatsuo Kanda, Robert Steele, Ratna B. Ray

    PLOS ONE   3 ( 10 )   e3384   2008.10

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    MBP-1 acts as a general transcriptional repressor. Overexpression of MBP-1 induces cell death in a number of cancer cells and regresses tumor growth. However, the function of endogenous MBP-1 in normal cell growth regulation remains unknown. To unravel the role of endogenous MBP-1, we knocked down MBP-1 expression in primary human foreskin fibroblasts (HFF) by RNA interference. Knockdown of MBP-1 in HFF (HFF-MBPsi-4) resulted in an induction of premature senescence, displayed flattened cell morphology, and increased senescence-associated beta-galactosidase activity. FACS analysis of HFF-MBPsi-4 revealed accumulation of a high number of cells in the G1-phase. A significant upregulation of cyclin D1 and reduction of cyclin A was detected in HFF-MBPsi-4 as compared to control HFF. Senescent fibroblasts exhibited enhanced expression of phosphorylated and acetylated p53, and cyclin-dependent kinase inhibitor, p21. Further analysis suggested that promyolocytic leukemia protein (PML) bodies are dramatically increased in HFF-MBPsi-4. Together, these results demonstrated that knockdown of endogenous MBP-1 is involved in cellular senescence of HFF through p53-p21 pathway.

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  • Prevalence of diabetes mellitus and insulin resistance in patients with chronic hepatitis C: Comparison with hepatitis B virus-infected and hepatitis C virus-cleared patients Reviewed

    Fumio Imazeki, Osamu Yokosuka, Kenichi Fukai, Tatsuo Kanda, Hiroshige Kojima, Hiromitsu Saisho

    LIVER INTERNATIONAL   28 ( 3 )   355 - 362   2008.3

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    Background/Aims: Our aim was to evaluate the relationship between hepatitis C virus (HCV) infection and development of diabetes mellitus (DM) or insulin resistance (IR) in comparison with hepatitis B virus (HBV) infection and eradication of HCV infection by interferon treatment. Methods: This study consisted of 952 outpatients, including 544 HCV-infected (HCV + chronic), 286 HBV-infected (HBV + chronic) and 122 patients whose HCV was cleared by interferon treatment (HCV + cleared) (diabetes study). Among 849 without overt DM, IR was assessed in 423 patients, including 232 HCV-infected (HCV + chronic), 135 HBV-infected (HBV + chronic) and 56 HCV-eradicated patients (HCV + cleared) (IR substudy). Results: The prevalence of DM in the HBV + chronic, HCV + chronic and HCV + cleared groups was 6.3, 13.6 and 9.0%, respectively (HBV + chronic vs HCV + chronic, P &lt; 0.005), in the diabetes study, and the prevalence of IR in the HCV + chronic group (54.3%) was also higher than that in the HBV + chronic (36.3%) (P &lt; 0.005) and HCV + cleared groups (35.7%) (P &lt; 0.05) in the IR substudy. However, HCV infection was not shown to be independently associated with DM development [odds ratio (OR) 1.669; P = 0.0936] and with IR (OR 1.531; P = 0.2154) by multivariate analysis in comparison with HBV infection as control. Conclusions: HCV-infected patients showed a higher prevalence of DM and IR than those with HBV infection. However, in Japan, other confounding factors appeared to be more important risk factors for the development of disturbance in glucose metabolism.

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  • Hepatitis C virus genotype 1a growth and induction of autophagy Reviewed

    Malika Ait-Goughoulte, Tatsuo Kanda, Keith Meyer, Jan S. Ryerse, Ratna B. Ray, Ranjit Ray

    JOURNAL OF VIROLOGY   82 ( 5 )   2241 - 2249   2008.3

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    We have previously reported that immortalized human hepatocytes (IHH) support the generation of infectious hepatitis C virus (HCV) genotype la (clone H77). In the present study, we have investigated the growth of HCV genotype la (clone H77) through serial passages and accompanying changes in IHH in response to infection. Eleven serial passages of HCV genotype la (clone H77) in IHH were completed. Virus replication was ascertained from the presence of HCV-specific sequences, the detection of core antigen, the virus genome copy number, and the virus titer in IHH culture fluid. Electron microscopy suggested that HCV infection induces autophagic vacuole formation in IHH. Fluorescence microscopy displayed localization of autophagic markers, microtubule-associated protein-1 light chain-3 and Apg5, on the vacuoles of HCV-infected hepatocytes. Taken together, our results suggested that HCV genotype la (clone H77) can be serially passaged in IHH and that HCV infection induces an autophagic response in hepatocytes.

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  • Analysis of the complete hepatitis B virus genome in patients with genotype C chronic hepatitis and hepatocellular carcinoma Reviewed

    Kai Yu Zhang, Fumio Imazeki, Kenichi Fukai, Makoto Arai, Tatsuo Kanda, Rintaro Mikata, Osamu Yokosuka

    CANCER SCIENCE   98 ( 12 )   1921 - 1929   2007.12

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    Hepatitis B virus (HBV) genotype C and the basic core promoter (BCP) mutations were reported to be associated with the development of hepatocellular carcinoma (HCC). In this study the full sequences of HBV genomes were analyzed in order to find the other predictors of HCC development. We determined the full sequences of HBV genomes in 24 genotype C carriers who developed HCC (HCC group) at the beginning of follow-up and at the time of HCC diagnosis, and 20 patients who did not develop HCC (non-HCC group) served as a control. The number of nucleotide and amino acid substitutions in most regions was higher in the HCC group than in the non-HCC group, and the following substitutions and deletions were found more frequently in the HCC group than in the non-HCC group: G1317A and T1341C/A/G in the X promoter region were detected in 13 and six of the HCC cases, four and none of the non-HCC cases, respectively; and pre-S2 deletion was detected in eight HCC and none of the non-HCC cases. Compared with the wild type X promoter, the mutant type X promoters, M1 (G1317A), M2 (T1341C), and M4 (T1341G) showed increases in activity of 2.3, 3.8, and 1.4 times, respectively, in HepG2 cells. Substitutions and deletion of nucleotides of the HBV genome, especially the pre-S2 deletion and G1317A and T1341C/A/G mutations may be useful markers for predicting the development of HCC.

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  • Hepatitis C virus infection induces the beta interferon signaling pathway in immortalized human Hepatocytes Reviewed

    Tatsuo Kanda, Robert Steele, Ranjit Ray, Ratna B. Ray

    JOURNAL OF VIROLOGY   81 ( 22 )   12375 - 12381   2007.11

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    Beta interferon (IFN-beta) expression is triggered by double-stranded RNA, a common intermediate in the replication of many viruses including hepatitis C virus (HCV). The recent development of cell culture-grown HCV allowed us to analyze the IFN signaling pathway following virus infection. In this study, we have examined the IFN-beta signaling pathway following infection of immortalized human hepatocytes (IHH) with HCV genotype la (clone 1177) or 2a (clone JFH1). We observed that IHH possesses a functional Toll-like receptor 3 pathway. HCV infection in IHH enhanced IFN-beta and IFN-stimulated gene 56 (ISG56) promoter activities; however, poly(I-C) -induced IFN-beta and ISG56 expression levels were modestly inhibited upon HCV infection. IHH infected with HCV (genotype la or 2a) exhibited various levels of translocation of IRF-3 into the nucleus. The upregulation of endogenous IFN-beta and 2',5'-oligoadenylate synthetase 1 mRNA expression was also observed in HCV-infected IHH. Subsequent studies suggested that HCV infection in IHH enhanced STAT1. and ISG56 protein expression. A functional antiviral response of HCV-infected IHH was observed by the growth-inhibitory role in vesicular stomatitis virus. Together, our results suggested that HCV infection in IHH induces the IFN signaling pathway, which corroborates observations from natural HCV infection in humans.

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  • Body mass index in Japanese patients with autoimmune liver disease: Overweight patients with primary biliary cirrhosis tend to be asymptomatic Reviewed

    Tatsuo Kanda, Osamu Yokosuka, Fumio Imazeki, Yuichi Hirasawa, Tetsu Ikeuchi, Rintaro Mikata, Kai Yu Zhang, Tomoko Kurihara, Makoto Arai, Kenichi Fukai, Hiromitsu Saisho, Shigeru Mikami, Ryosaku Azemoto, Yoshimi Ito

    HEPATO-GASTROENTEROLOGY   54 ( 78 )   1758 - 1760   2007.9

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    Background/Aims: The aim of this study was to investigate the effects of being overweight on autoinumme hepatitis (AIH) and primary biliary cirrhosis (PBC) patients.
    Methodology/Results: 44 AIH and 95 PBC patients were enrolled in this study. Body weight and. body mass index (BMI) of AIH (57.6 +/- 10.4kg and 23.8 +/- 2.9kgrn -2, respectively) were higher than those of PBC (51.6 +/- 7.Okg and 22.0 +/- 2.6kgm(-2), respectively) (P&lt;0.601). The prevalence of overweight patients in AIH was also higher than those in PBC (P&lt; 0. 005). Being overweight and having 25 &lt;= BMI &lt; 30 did not affect the progression of hepatic fibrosis in AIH and PBC. In comparison with the non-overweight with PBC, overweight patients with PBC tended not to be symptomatic, such as having itching or fatigue (P=0.027).
    Conclusions: Clinicians should be aware that not only non-alcoholic fatty liver disease but also PBC patients might be included among the overweight hepatic disease patients with unknown etiology.

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  • Analysis of the complete hepatitis B virus genome in patients with genotype C chronic hepatitis in relation to HBeAg and anti-HBe Reviewed

    KaiYu Zhang, Fumio Imazeki, Kenichi Fukai, Makoto Arai, Tatsuo Kanda, Rintaro Mikata, Osamu Yokosuka

    JOURNAL OF MEDICAL VIROLOGY   79 ( 6 )   683 - 693   2007.6

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    To investigate the relationship between viral factors and the development of chronic hepatitis B, the entire hepatitis B virus (HBV) genome of chronic carriers at different disease stages were analyzed. Eighty genotype C HBV carriers including 12 hepatitis B e antigen (HBeAg) positive asymptomatic carriers (Group A), 49 HBeAg positive patients with chronic liver diseases (Group B) and 19 anti-HBe positive patients with chronic liver diseases (Group C) were studied. HBV nucleic acid from serum samples was sequenced directly and compared with GenBank reference sequences HBV X01587 and M12906. On phylogenetic analysis, 76 cases were genotype C2. Of the 76 genotype C2 cases, the nucleotide and amino acid substitution rates in the precore/core region were significantly higher in Groups B and C than in Group A, also in Group C than in Group B. The nucleotide substitution rates in the full genome and the core promoter region were significantly higher in Group C than in Group A, also in group C than in Group B. The nucleotide and amino acid substitution rates in the X region were significantly higher in Group C than in Group A. The amino acid substitution rate in the pre-S2 region was significantly higher in Group C than in Group B. Deletion mutations were found mainly in Groups B and C. This whole genome analysis of HBV chronic carriers suggested that the nucleotide substitutions and deletions in HBV were closely associated with the pathogenesis of chronic HBV infection. J. Med. Virol. 79:683-693, 2007. (C) 2007 Wiley-Liss, Inc.

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  • Sulfated homologues of heparin inhibit hepatitis C virus entry into mammalian cells Reviewed

    Arnab Basu, Tatsuo Kanda, Aster Beyene, Kousuke Saito, Keith Meyer, Ranjit Ray

    JOURNAL OF VIROLOGY   81 ( 8 )   3933 - 3941   2007.4

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    The mechanism of entry of hepatitis C virus (HCV) through interactions between the envelope glycoproteins and specific cell surface receptors remains unclear at this time. We have previously shown with the vesicular stomatitis virus (VSV)/HCV pseudotype model that the hypervariable region I of the HCV E2 envelope glycoprotein helps in binding with glycosaminoglycans present on the cell surface. In this study, we have examined the binding of HCV envelope glycoproteins with chemically modified derivatives of heparin. Furthermore, we have determined the functional relevance of the interaction of heparin derivatives with HCV envelope glycoproteins for infectivity by using a human immunodeficiency virus (HIV)/HCV pseudotype, a VSV/HCV pseudotype, and cell culture-grown HCV genotype 1a. Taken together, our results suggest that the HCV envelope glycoproteins rely upon O-sulfated esters of a heparin homologue to facilitate entry into mammalian cells.

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  • Small interfering RNA targeted to hepatitis C virus 5 ' nontranslated region exerts potent antiviral effect Reviewed

    Tatsuo Kanda, Robert Steele, Ranjit Ray, Ratna B. Ray

    JOURNAL OF VIROLOGY   81 ( 2 )   669 - 676   2007.1

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    Hepatitis C virus (HCV) is a major cause of cirrhosis and hepatocellular carcinoma. Interferon alone or together with ribavirin is the only therapy for HCV infection; however, a significant number of HCV-infected individuals do not respond to this treatment. Therefore, the development of new therapeutic options against HCV is a matter of urgency. In the present study, we have examined vectors carrying short hairpin RNA (shRNA) targeting the 5' nontranslated conserved region of the HCV genome for inhibition of virus replication. Initially, three sequences were selected, and all three shRNAs (psh-53, psh-274, and psh-375) suppressed HCV internal ribosome entry site (IRES)-mediated translation to different degrees in Huh-7 cells. Next, we introduced siRNA into Huh-7.5 cells persistently infected with HCV genotype 2a (JFH1). The most efficient inhibition of JFH1 replication was observed with psh-274, targeted to the portion from subdomain IIId to IIIe of the IRES. Subsequently, Huh-7.5 cells stably expressing psh-274 further displayed a significant reduction in HCV JFH1 replication. The effect of psh-274 on cell-culture-grown HCV genotype 1a (H77) was also evaluated, and inhibition of virus replication and infectivity titers was observed. In the absence of a cell-culture-grown HCV genotype 1b, the effects of psh-274 on subgenomic and full-length replicons were examined, and efficient inhibition of genome replication was observed. Therefore, we have identified a conserved sequence targeted to the HCV genome that can inhibit replication of different genotypes, suggesting the potential of siRNA as an additional therapeutic modality against HCV infection.

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  • Inhibition of subgenomic hepatitis C virus RNA replication in HeLa cells Reviewed

    Tatsuo Kanda, Osamu Yokosuka, Rintaro Mikata, Kai Yu Zhang, Masamichi Tanaka, Motohisa Tada, Kenichi Fukai, Fumio Imazeki, Hiromitsu Saisho

    HEPATO-GASTROENTEROLOGY   54 ( 73 )   32 - 35   2007.1

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    Background/Aims: Antiviral therapy such as combination interferon and ribavirin can eradicate hepatitis C virus (HCV) RNA by up to 40-50%. However, many patients still remain non-responders to this treatment for various reasons. The aim of this study was to evaluate the effect of interferon or ribavirin treatment on subgenomic HCV RNA replication in, 'non-hepatic' HeLa cells.
    Methodology: Huh-7 or HeLa cells harboring HCV replicon were constructed by using cellular RNA of Huh-7 harboring HCV replicon RNAs, named as C13-3 cells. We also tested whether interferon or ribavirin can suppress HCV RNA in HeLa cells.
    Results: Huh-7 or HeLa cells harboring HCV replicon RNAs were constructed by using cellular RNA of C13-3 cells than using in vitro-transcribed RNA. Ribavirin at 1 mu g/mL or 10 mu g/mL did not suppress colony formation in HeLa cells, but at 100 mu g/ml, suppression was observed. Interferon-alpha 2b suppressed HCV replication even at 1 U/mL.
    Conclusions: HeLa cells harboring HCV replicon RNAs also might be useful for the development of antiviral drugs.

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  • Analysis of genes upregulated by the demethylating agent 5-aza-2 '-deoxycytidine in gastric cancer cell lines Reviewed

    Rintaro Mikata, Osamu Yokosuka, Kenichi Fukai, Fumio Imazeki, Makoto Arai, Motohisa Tada, Tomoko Kurihara, Kaiyu Zhang, Tatsuo Kanda, Hiromitsu Saisho

    INTERNATIONAL JOURNAL OF CANCER   119 ( 7 )   1616 - 1622   2006.10

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    In gastric cancer, increasing numbers of genes have been reported to be silenced by aberrant methylation. However, global analysis of epigenetic inactivation in cancer cells has rarely been performed. For screening the genes upregulated by the demethylating agent 5-aza-2'-deoxycytidine (DAC), cDNA microarray analysis (AceGene (R), containing 30,000 genes) was performed using gastric cancer cell lines (AGS, MKN74, MKN1, MKN45 and Kato3) treated with DAC. The candidate upregulated genes were confirmed by real-time PCR, and the methylation status of 5'CpG islands was determined by bisulfite DNA sequencing or methylation-specific PCR. Among the upregulated genes considered to have CpG island in their promoter regions, we selected 5 genes (BCL2L10, DKK1, DNAJD1, GAGED2 and NMU) that exhibited a greater than 3-fold increase in at least 2 cell lines. Of these, we could determine the methylation status of 5'CpG islands of BCL2L10, DKK1 and DNAJD1. 5'CpG of BCL2L10 and DNAJD1 was hypermethylated in 4 of 5 gastric cancer cell lines, whereas 5'CpG of DKK1 was hypermethylated in only 1 cell line. MSP analysis for BCL2L10 revealed that the CpG island was demethylated after DAC treatment. In addition, we observed that overexpression of BCL2L10 could promote apoptosis and growth-inhibitory effect in gastric cancer cell lines. In conclusion, some of the genes upregulated by DAC treatment may be transcriptionally repressed by promoter hypermethylation. These genes might be related to gastric carcinogenesis. In particular, the suppression of BCL2L10, which could induce apoptosis and inhibit proliferation of cancer cells, might be one of the underlying mechanisms for gastric carcinogenesis. (c) 2006 Wiley-Liss, Inc.

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  • Silencing of Hepatitis A virus infection by small interfering RNAs Reviewed

    Y Kusov, T Kanda, A Palmenberg, JY Sgro, Gauss-Muller, V

    JOURNAL OF VIROLOGY   80 ( 11 )   5599 - 5610   2006.6

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    Infection by hepatitis A virus (HAV) can cause acute hepatitis and, rarely, fulminant liver failure, in particular in patients chronically infected with hepatitis C virus. Based on our previous observation that small interfering RNAs (siRNAs) can silence translation and replication of the firefly luciferase-encoding HAV replicon, we now exploited this technology to demonstrate the effect of siRNAs on viral infection in Huh-7 cells. Freshly and persistently infected cells were transfected with siRNAs targeting various sites in the HAV nonstructural genes. Compared to a single application, consecutive siRNA transfections targeting multiple sequences in the viral genome resulted in a more efficient and sustained silencing effect than a single transfection. In most instances, multiple applications of a single siRNA led to the emergence of viral escape mutants with mutated target sites that rendered these genomes resistant to RNA interference (RNAi). Efficient and sustained suppression of the viral infectivity was achieved after consecutive applications of an siRNA targeting a computer-predicted hairpin structure. This siRNA holds promise as a therapeutic tool for severe courses of HAV infection. In addition, the results provide new insight into the structural bases for sequence-specific RNAi.

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  • Sequential gene expression changes in cancer cell lines after treatment with the demethylation agent 5-aza-2 '-deoxycytidine Reviewed

    M Arai, O Yokosuka, Y Hirasawa, K Fukai, T Chiba, F Imazeki, T Kanda, M Yatomi, Y Takiguchi, N Seki, H Saisho, T Ochiai

    CANCER   106 ( 11 )   2514 - 2525   2006.6

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    BACKGROUND. 5-Aza-2'-deoxycytidine (5-AzaC) is known well for its demethylation effect and is a promising anticancer agent. However, to the authors' knowledge, serial changes in gene expression over time after 5-AzaC treatment have not been studied to date. To clarify the categories of genes that are up-regulated or downregulated after 5-AzaC treatment, the authors surveyed the genes that had expression levels changed by 5-AzaC treatment in 6 hepatoma cell lines (Hep3B, HLE, Huh7, HepG2, PLC/PRF/5, and Huh6).
    METHODS. Cell lines were grown in medium that contained 1 mu M of 5-AzaC. Changes in messenger RNA levels were monitored from 24 hours up to 120 hours after 5-AzaC treatment using an in-house microarray that consisted of 4608 combinational DNAs. Using clustering analysis to identify the genes that had gradually changed expression levels and to exclude the substantial experimental noise by microarray analysis, the authors focused on 206 up-regulated genes and 248 down-regulated genes.
    RESULTS. According to their functional characterization, genes that were involved in the cytoskeleton and the extracellular matrix were enriched significantly in the up-regulated genes. Conversely, genes that were involved in metabolism were enriched significantly in the down-regulated genes.
    CONCLUSIONS. The current results demonstrated that 5-AzaC can regulate the expression of groups of genes with characteristic functions.

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  • Generation of infectious hepatitis C virus in immortalized human hepatocytes Reviewed

    T Kanda, A Basu, R Steele, T Wakita, JS Ryerse, R Ray, RB Ray

    JOURNAL OF VIROLOGY   80 ( 9 )   4633 - 4639   2006.5

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    Progress in understanding hepatitis C virus (HCV) biology has remained a challenge due to the lack of an efficient cell culture system for virus growth. In this study, we examined HCV core protein-mediated immortalized human hepatocytes (IHH) for growth of HCV. In vitro-transcribed full-length RNA from HCV genotype la (clone H77) was introduced into IHH by electroporation. Reverse transcription-PCR of cellular RNA isolated from HCV genome-transfected IHH suggested that viral RNA replication occurred. IHH transfected with the full-length HCV genome also displayed viral protein expression by indirect immunofluorescence. In contrast, cells transfected with polymerase-defective HCV (H77/GND) RNA as a negative control did not exhibit expression of the viral genome. Immunogold labeling demonstrated localization of El protein in the rough endoplasmic reticulum of RNA-transfected IHH. Virus-like particles of similar to 50 nm were observed in the cytoplasm. After being inoculated with culture media of cells transfected with the full-length HCV genome, naive IHH displayed NS5a protein expression in a dilution-dependent manner, but expression of NS5a was inhibited by prior incubation of culture medium with HCV-infected patient sera. NS5a-positive immunofluorescence of cell culture media of IHH transfected with full-length H77 RNA yielded similar to 4.5 X 10(4) to 1 X 10(5) focus-forming units/ml. A similar level of virus growth was observed upon transfection of RNA from HCV genotype 2a (JFH1) into IHH. Taken together, our results suggest that IHH support HCV genome replication and virus assembly.

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  • State of hepatitis C viral replication enhances activation of NF-kB- and AP-1-signaling induced by hepatitis B virus X Reviewed

    T Kanda, O Yokosuka, K Nagao, H Saisho

    CANCER LETTERS   234 ( 2 )   143 - 148   2006.3

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    We examined the effect of hepatitis B virus X (HBx) on NF-kB- and AP-1-mediated transcription in human hepatocellular carcinoma cell lines, Huh-7 with or without SUbgenomic hepatitis C virus (HCV) RNA. Expression of HBx in Huh-7 cells with HCV resulted in 4.9 times increased NF-kB-activation and 3.8 times AP-1-activation whereas that without HCV resulted in 2.4 times increased NF-kB-activation and 2.3 times AP-1-activation. Interestingly, the expression of the matured form of HCV core protein, Core 173, did not activate NF-kB- or AP-1-transcription in either Huh7 with or without HCV replicon. HBx protein might play an important role in HCV-related hepatocarcinogenesis. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

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  • Hepatitis A protein VP1-2A reduced cell viability in Huh-7 cells with hepatitis C virus subgenomic RNA replication Reviewed

    T Kanda, O Yokosuka, F Imazeki, K Fujiwara, H Saisho

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   21 ( 3 )   625 - 626   2006.3

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  • Occurrence of autoimmune hepatitis during the course of primary biliary cirrhosis: Report of two cases Reviewed

    T Kanda, O Yokosuka, Y Hirasawa, F Imazeki, K Nagao, H Saisho

    DIGESTIVE DISEASES AND SCIENCES   51 ( 1 )   45 - 46   2006.1

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  • Serum osteopontin levels in patients with acute liver dysfunction Reviewed

    M Arai, O Yokosuka, T Kanda, K Fukai, F Imazeki, M Muramatsu, N Seki, M Miyazaki, T Ochiai, H Hirasawa, H Saisho

    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY   41 ( 1 )   102 - 110   2006.1

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    Objective. Fulminant hepatic failure (FHF) is a clinical syndrome of sudden and severe liver dysfunction accompanied by encephalopathy in a previously healthy person. In FHF, hepatocytes are severely damaged and ordinary liver regeneration is impaired. We demonstrated that the expression of osteopontin (OPN), a multifunctional cytokine, was up-regulated in mouse oval cell (a stem-cell progenitor) induction models. Material and methods. Based on this finding, serum OPN levels were examined in 43 patients with FHF and in 45 patients with acute self-limited hepatitis (AH). To determine the cellular source of OPN, the expression of OPN was studied in a liver specimen derived from an FHF patient. Results. The mean OPN level of patients with FHF was 2.809 +/- 0.48 ng/ml (log(10), +/- SD), which was significantly higher than that of the patients with AH (2.429 +/- 0.39 ng/ml) (p=0.003, unpaired t-test). Patients with elevated serum OPN levels had a significantly poorer prognosis than patients whose serum OPN levels were not elevated. In the FHF patient's liver, OPN protein was expressed not only in inflammatory cells but also in regenerating hepatocytes and bile ductular structures. Conclusions. Our current study indicates that serum OPN levels increased in patients with FHF and that OPN might play an important role in liver regeneration due to activation of hepatic stem cells.

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  • Enhanced sensitivity of human hepatoma cells to 5-fluorouracil by small interfering RNA targeting Bcl-2 Reviewed

    T Kanda, O Yokosuka, F Imazeki, M Arai, H Saisho

    DNA AND CELL BIOLOGY   24 ( 12 )   805 - 809   2005.12

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    This study was designed to reveal whether the apoptosis induced in human hepatocellular carcinoma (HCC) cell lines by 5-fluorouracil (5-FU) could be enhanced by transfecting Bcl-2 small interfering RNA (siRNA). Bcl-2 siRNA and control siRNA were transfected into cells following treatment with or without 5-FU. Suppression of Bcl-2 expression was confirmed by Western blotting; cell viability was evaluated by MTS assay, and the occurrence of apoptosis in cells was evaluated by apoptosis assay. Expression of Bcl-2 protein after transfection of 20 nM Bcl-2 siRNA was significantly lower than that of control. Incubation of all cell lines with Bcl-2 siRNA reduced cell viability 96 h after 5-FU treatment compared with all other controls: Huh-7 (P &lt; 0.01), Huh-7 with hepatitis C replicon (P &lt; 0.01), HepG2 (P &lt; 0.01), HLE (P &lt; 0.05). Moreover, the proportion of apoptosis in control siRNA, Bcl-2 siRNA, control siRNA prior to 5-FU treatment, and Bcl-2 siRNA prior to 5-FU treatment groups were (4.6 +/- 2.3)%, (7.5 +/- 0.5)%, (6.0 +/- 2.1)%, and (19.5 +/- 0.86)%, respectively. The Bcl-2 siRNA prior to 5-FU treatment group showed the strongest effect of inducing apoptosis. In conclusion, the combination Bcl-2 siRNA and 5-FU might represent a new therapeutic option for HCC.

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  • Evaluation of clinical usefulness of second-generation HCV core antigen assay: comparison with COBAS AMPLICOR HCV MONITOR assay version 2.0 Reviewed

    O Yokosuka, S Kawai, Y Suzuki, K Fukai, F Imazeki, T Kanda, M Tada, R Mikata, A Hata, H Saisho

    LIVER INTERNATIONAL   25 ( 6 )   1136 - 1141   2005.12

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    Background: Hepatitis C virus (HCV) is an important etiologic agent for chronic liver diseases. Methods: The aim of this study was to evaluate the clinical usefulness of second-generation HCV core antigen assay by comparing the results of the assay with those of the COBAS AMPLICOR HCV MONITOR version 2.0 (COBAS v2.0). Results: HCV core antigen was detectable by this assay in 142/149 (95.3%) of serotype 1 (3821 +/- 322 fmol/l; mean +/- SD), in 56/58 (96.6%) of serotype 2 (2589 +/- 449 fmol/l), and in 6/6 (100%) of serotypes 1+2 (1240 +/- 548 fmol/l). The HCV core antigen levels measured by this assay correlated well with the HCV RNA levels by COBAS v2.0 (r=0.848, P &lt; 0.0001). In relation to the outcome of interferon monotherapy, the pretreatment HCV core antigen levels of sustained and non-sustained virological responders were 659 +/- 189 and 4904 +/- 376 fmol/l in serotype 1, 1993 +/- 740 and 3145 +/- 519 fmol/l in serotype 2. The cutoff values with the best accuracy for HCV core Ag levels to discriminate between sustained and non-sustained virological response were 699 fmol/l for serotype 1 and 292 fmol/l for serotype 2, respectively, by receiver operating characteristic curve analysis. Conclusions: This new assay was considered to be useful in evaluating the HCV levels in patients with chronic hepatitis C.

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  • Introduction of the Department of Medicine and Clinical Oncology (No. 2).(INTRODUCTION OF THE PROJECTS OF CHIBA UNIVERSITY GRADUATE SCHOOL OF MEDICINE)

    Yokosuka Osamu, Imazeki Fumio, Fukai Kenichi, Kanda Tatsuo, Saisho Hiromitsu

    Chiba medical journal   81 ( 5 )   247 - 251   2005.10

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  • 5-aza-2 '-deoxycytidine sensitizes hepatoma and pancreatic cancer cell lines Reviewed

    T Kanda, M Tada, F Imazeki, O Yokosuka, K Nagao, H Saisho

    ONCOLOGY REPORTS   14 ( 4 )   975 - 979   2005.10

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    Hepatocellular carcinoma (HCC) and pancreatic cancer are at the forefront of chemotherapy-resistant tumors with poor prognosis. Even with innovative treatment regimens, response rates remain low and the duration of response is short. We examined whether the suppression of DNA methylation was capable of enhancing the sensitivity of hepatoma and pancreatic cancer cell lines to 5-fluorouracil (5-FU). 5-aza-2'-deoxycytidine (5-aza-dC) at 2 mu M, a specific DNA methylation inhibitor, did not induce cell death in Huh-7 with or without HCV, HLE, HepG2 and MIA PaCa-2 cells. However, a combination of 5-aza-dC with 5-FU showed a reduction in cell viability and induction of apoptosis in these cell lines to a greater degree than with 5-FU only. These findings underline the fact that DNA methylation plays a key role in conferring chemoresistance to hepatoma and pancreatic cancer, and the combination of DNA methylation inhibitor with chemotherapy could be a novel and highly effective tool for future targeted therapy of chemoresistant tumors.

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  • Lower incidence of hepatic failure than hepatocellular carcinoma in Japanese patients with chronic Hepatitis C Reviewed

    F Imazeki, O Yokosuka, K Fukai, S Kawai, T Kanda, H Kojima, H Saisho

    LIVER INTERNATIONAL   25 ( 4 )   772 - 778   2005.8

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    Background: Previous studies have shown that the development of hepatic failure was found more frequently than that of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C in the United States and European countries. We investigated the status in Japan in a retrospective cohort study. Methods: The incidences of HCC and hepatic failure were accessed in 459 patients with biopsy-proven C-viral chronic liver disease with a mean follow-up period of 8.9 +/- 3.2 years and the cause of death was also analyzed in the cohort. Results: HCC developed in 63 patients, 46 of 355 interferon (IFN)-treated and 17 of 104 untreated patients. In contrast, the development of hepatic failure was found in 18 patients, 12 of 355 IFN-treated and six of 104 untreated patients. HCC developed in four of 116 with sustained virological response (SVR), and hepatic failure developed in one of them. Thirty-two of 63 patients developing HCC and eight of 18 patients developing hepatic failure died. Conclusions: Development of hepatic failure was less frequent than that of HCC in Japan. It is important for a favorable prognosis of patients with C viral chronic liver disease to achieve a higher SVR and thus inhibit the development of HCC in Japan.

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  • Acute-onset autoimmune hepatitis resembling acute hepatitis: A case report and review of reported cases Reviewed

    T Kanda, O Yokosuka, Y Hirasawa, F Imazeki, K Nagao, Y Suzuki, H Saisho

    HEPATO-GASTROENTEROLOGY   52 ( 64 )   1233 - 1235   2005.7

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    We report a 54-year-old Japanese man, whose ALT level was 1689 IU/L, without increased gamma-globulin level or autoantibodies. He could not be diagnosed as autoimmune hepatitis (AIH) using scoring systems, and his liver function became normalized after steroid treatment.
    Recently, AIH with acute presentation of disease and acute-onset AIH without bridging fibrosis have been increasingly reported but cases without the character of increasing gamma-globulin level or autoantibodies before immunosuppressive treatment are extremely rare. This is the third such case report in the literature.

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  • Amantadine inhibits hepatitis A virus internal ribosomal entry site-mediated translation in human hepatoma cells Reviewed

    T Kanda, O Yokosuka, F Imazeki, K Fujiwara, K Nagao, H Saisho

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   331 ( 2 )   621 - 629   2005.6

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    The effect of six drugs (amantadine, glycyrrhizin, ribavirin, ursodeoxycholic acid, alcohol, and IFN) on HAV RNA translation from the HAV internal ribosomal entry site (IRES) was investigated using a bicistronic reporter construct containing HAV IRES as intragenic spacer. Huh-7 cells and derivatives were transfected with in vitro transcripts, and the reporter gene activity was determined. IFN suppressed both cap-dependent and HAV IRES-dependent translation, while amantadine specifically inhibited HAV IRES-dependent translation. In contrast to IFN, by reporter assay, amantadine did not activate the interferon-stimulated response element (ISRE) or interferon g-activated sequence (GAS)-associated pathways. Immunoblot analysis revealed that amantadine had no effect on PKR and on IFN-regulatory factor-1 (IRF-1) expression. These findings demonstrated a novel antiviral effect of amantadine against HAV with or without HCV infection. 2005 Elsevier Inc. All rights reserved.

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  • Lamivudine treatment in a patient with hepatitis B virus reactivation after allogenic peripheral bone marrow transplantation Reviewed

    T Imamura, O Yokosuka, T Chiba, T Kanda, H Kojima, K Fukai, F Imazeki, M Nishimura, Y Saito, H Saisho

    LEUKEMIA & LYMPHOMA   46 ( 6 )   915 - 917   2005.6

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    We report the case of a 52-year-old woman with hepatitis B virus (HBV) reactivation during treatment for chronic graft vs. host disease (GVHD) after peripheral bone marrow transplantation (PBSCT) to treat chronic myelocytic leukemia. She was given cyclosporine and prednisolone orally to treat chronic GVHD after PBSCT. Liver dysfunction. first developed 25 months after transplantation with the appearance of hepatitis B s antigen ( HBsAg), hepatitis B e antigen ( HBeAg), and elevation of HBV-DNA up to 4.5 log copies/ml. Retrospective examination of her serum before PBSCT proved negative for HBsAg and HBeAg, and positive for anti-HBsAg, anti-HBeAg, anti-hepatitis B core antigen, and HBV-DNA ( 2.7 log copies/ml), showing that she was in a state of occult HBV infection. Nucleotide sequences of the HBV genome obtained from her serum showed no core promoter mutations at nt 1762 and 1764 and no pre-core mutation at nt 1896. Polymerase chain reaction-restriction fragment length polymorphism showed that she was infected with HBV genotype B. The administration of lamivudine, a nucleoside analog, improved her liver function and reduced HBV-DNA replication. We conclude that antiviral agents, such as lamivudine, are effective for treating hepatitis B reactivation during immunosuppressive treatment, such as for GVHD. The administration of a nucleoside analog before transplantation should also be considered in the light of HBV genotypes and mutations, even if HBsAg was negative and the viral load was low before transplantation.

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  • Fas polymorphisms influence susceptibility to autoimmune hepatitis Reviewed

    A Hiraide, F Imazeki, O Yokosuka, T Kanda, H Kojima, K Fukai, Y Suzuki, A Hata, H Saisho

    AMERICAN JOURNAL OF GASTROENTEROLOGY   100 ( 6 )   1322 - 1329   2005.6

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    BACKGROUND AND AIMS: Genetic factors associated with autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC), immune-mediated chronic inflammatory liver diseases of unknown etiology, remain to be elucidated. Polymorphisms of the gene encoding Fas have been linked to a variety of autoimmune diseases. We hypothesized that Fas gene polymorphisms might be genetic markers for AIH and PBC.
    METHODS: To determine the frequency and significance of Fas polymorphisms in patients with AIH and PBC, 74 Japanese AIH patients, 98 Japanese PBC patients, and 132 ethnically matched control subjects were investigated by the use of the Taqman assay.
    RESULTS: We found significant differences between AIH patients and controls in allele frequencies of Fas-670 (p= 0.009), Fas IVS (intervening sequence) 2nt176 (p= 0.018), Fas IVS3nt46 (p= 0.031), and Fas IVS5nt82 (p= 0.013) polymorphisms. Haplotype analysis revealed that one of the haplotypes, GATGC, was associated with increased AIH prevalence. On the other hand, we found no statistically significant differences between PBC patients and controls in allele frequencies of the Fas polymorphisms genotyped in this study.
    CONCLUSIONS: These results indicate a genetic link of Fas polymorphisms to the development of AIH. Further studies are needed to determine the genetic factors contributing to the development of AIH.

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  • Effect of lamivudine in HBeAg-positive chronic hepatitis B: Discordant effect on HBeAg and HBV DNA according to pretreatment ALT level Reviewed

    Tomoko Kurihara, Fumio Imazeki, Osamu Yokosuka, Kenichi Fukai, Tatsuo Kanda, Shigenobu Kawai, Hiromitsu Saisho

    WORLD JOURNAL OF GASTROENTEROLOGY   11 ( 22 )   3346 - 3350   2005.6

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    AIM: To clarify differences in antiviral effect of the drug in patients with different ALT levels, we examined the changes in HBV markers in patients with high or low ALT levels with or without lamivudine treatment.
    METHODS: Thirty-seven HBeAg-positive patients were studied. Ten patients with ALT levels higher than 200 IU/L (group 1) and 8 patients with ALT below 200 IU/L (group 2) were treated orally with 100 mg/d of lamivudine. As untreated control, 9 patients with ALT above 200 IU/L (group 3) and 10 patients with ALT below 200 IU/L (group 4) were examined. ALT level, HBeAg/HBeAb status, and HBV DNA level were examined monthly for 11.9 +/- 0.4 mo.
    RESULTS: The ALT level normalized in all 10 patients of group 1, 7/8 of group 2, 4/9 of group 3, and 1/10 of group 4 within 6 mo (groups 1 vs 2, P = NS; groups 1 vs 3, P = 0.002; groups 1 vs 4, P&lt;0.0001). HBV DNA fell below the detection limit in all 10 patients of group 1, 7/8 of group 2, 0/9 of group 3, and 0/10 of group 4 within 6 mo (groups 1 vs 2, P = NS). HBeAg became seronegative in 7/10 patients of group 1, 1/8 of group 2, 3/9 of group 3, and 0/10 of group 4 within 12 mo (groups 1 vs 2, P = 0.02; groups 1 vs 3, P = NS).
    CONCLUSION: Our data suggest that HBeAg-positive patients with higher ALT levels can be considered good candidates for lamivudine therapy, probably because lamivudine accelerates the natural seroconversion of HBeAg, accompanied by HBV DNA loss, in these patients. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.

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  • Prolonged acute hepatitis A mimicking autoimmune hepatitis Reviewed

    Rintaro Mikata, Osamu Yokosuka, Fumio Imazeki, Kenichi Fukai, Tatsuo Kanda, Hiromitsu Saisho

    WORLD JOURNAL OF GASTROENTEROLOGY   11 ( 24 )   3791 - 3793   2005.6

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    AIM: We report a case with a prolonged course of hepatitis A, with alanine aminotransferase (ALT) higher than 500 IU/L for more than 2 mo.
    METHODS: A middle-aged woman had an elevated IgG level of more than 2 000 mg/dL, positive anti-nuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.
    RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained.
    CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCA proved to be effective.(C) 2005 The WJG Press and Elsevier Inc. All rights reserved.

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  • Suppression of hepatitis A virus genome translation and replication by siRNAs targeting the internal ribosonial entry site Reviewed

    T Kanda, B Zhang, Y Kusov, O Yokosuka, Gauss-Muller, V

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   330 ( 4 )   1217 - 1223   2005.5

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    Small interfering RN As (siRNAs) targeting the coding region of hepatitis A virus (HAV) were shown to specifically inhibit viral genome replication. Compared to the coding region, the HAV internal ribosomal entry site (IRES) in the 5' non-coding region is highly sequence-conserved and folds into stable secondary structures. Here, we report efficient and sustained RNA interference mediated by both RNase III-prepared siRNA (esiRNA) and vector-derived short hairpin RNAs (shRNAs) that are targeted to various domains of the HAV IRES. Using reporter constructs, and the DNA-based HAV replicon system, we found that shRNAs targeting the HAV IRES domains IIIc and V sustainably suppressed genome translation and replication whereas the IRES domains IIIa and IV were resistant to RNA interference. Our study suggests that some HAV IRES domains might be used as a universal and effective target for specific inhibition of HAV infection. (c) 2005 Elsevier Inc. All rights reserved.

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  • Prolonged hepatitis caused by cytomegalovirus and non-alcoholic steatohepatitis in 16-year-old obese boy Reviewed

    T Kanda, O Yokosuka, Y Suzuki

    EUROPEAN JOURNAL OF PEDIATRICS   164 ( 4 )   212 - 215   2005.4

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    Recently, the prevalence of non-alcoholic steatohepatitis (NASH) has been increasingly reported in patients with type 2 diabetes and obesity. NASH exists not only in adults but also in children. We report on an 16-year-old boy with prolonged hepatitis associated with NASH after cytomegalovirus hepatitis. Increased transaminase levels recovered in parallel to his weight reduction. Conclusion: Clinicians should be aware of the possibility that prolonged acute hepatitis might be associated with non-alcoholic steatohepatitis in adolescents.

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  • Importance of adequate immunosuppressive therapy for the recovery of patients with "life-threatening" severe exacerbation of chronic hepatitis B Reviewed

    Keiichi Fujiwara, Osamu Yokosuka, Hiroshige Kojima, Tatsuo Kanda, Hiromitsu Saisho, Hiroyuki Hirasawa, Hiroshi Suzuki

    WORLD JOURNAL OF GASTROENTEROLOGY   11 ( 8 )   1109 - 1114   2005.2

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    AIM: Hepatitis B virus (HBV) re-activation often occurs spontaneously or after withdrawal of immunosuppressive therapy in patients with chronic hepatitis B. Severe exacerbation, sometimes developing into fulminant hepatic failure, is at high risk of mortality. The efficacy of corticosteroid therapy in "clinically severe" exacerbation of chronic hepatitis B has not been well demonstrated. In this study we evaluated the efficacy of early introduction of high-dose corticosteroid therapy in patients with life-threatening severe exacerbation of chronic hepatitis B.
    METHODS: Twenty-two patients, 14 men and 8 women, were defined as "severe" exacerbation of chronic hepatitis B using uniform criteria and enrolled in this study. Eleven patients were treated with corticosteroids at 60 mg or more daily with or without anti-viral drugs within 10 d after the diagnosis of severe disease ("early high-dose" group) and 11 patients were either treated more than 10 d or untreated with corticosteroids ("non-early high-dose" group).
    RESULTS: Mean age, male-to-female ratio, mean prothrombin time (PT) activity, alanine transaminase (ALT) level, total bilirubin level, positivity of HBeAg, mean IgM-HBc titer, and mean HBV DNA polymerase activity did not differ between the two groups. Ten of 11 patients of the "early high-dose" group survived, while only 2 of 11 patients of the "non-early high-dose" group survived (P&lt;0.001). During the first 2 wk after the introduction of corticosteroids, improvements in PT activities and total bilirubin levels were observed in the "early high-dose" group. Both ALT levels and HBV DNA polymerase levels fell in both groups.
    CONCLUSION: The introduction of high-dose corticosteroid can reverse deterioration in patients with "clinically life-threatening" severe exacerbation of chronic hepatitis B, when used in the early stage of illness. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.

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  • Prevalence of obesity in patients with acute hepatitis; Is severe obesity a risk factor for fulminant hepatitis in Japan? Reviewed

    T Kanda, O Yokosuka, A Hiraide, H Kojima, A Honda, K Fukai, F Imazeki, K Nagao, H Saisho

    HEPATO-GASTROENTEROLOGY   52 ( 61 )   180 - 182   2005.1

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    Background/Aims: The prevalence of obesity in acute convalescent hepatitis and fulminant hepatitis has not been reported. The aim of this study was to investigate whether obesity affected the disease severity in Japanese patients with acute hepatitis.
    Methodology: 31 non-severe acute hepatitis (NS-AH) and 24 severe acute hepatitis and 14 fulminant hepatitis patients (S-AH) between January 1995 and December 2001 were analyzed retrospectively. Height and weight were used to calculate the body mass index (BMI) in these 69 patients.
    Results: Mean height, weight and BMI were not significantly different between S-AH and NS-AH patients. Two severely obese (BMI greater than 35kg/m(2)) patients had developed S-AH.
    Conclusions: Severe obesity may be one of the prognostic factors in acute hepatitis. Further studies are needed.

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  • Inhibition of subgenomic hepatitis C virus RNA in Huh-7 cells: ribavirin induces mutagenesis in HCV RNA Reviewed

    T Kanda, O Yokosuka, F Imazeki, M Tanaka, Y Shino, H Shimada, T Tomonaga, F Nomura, K Nagao, T Ochiai, H Saisho

    JOURNAL OF VIRAL HEPATITIS   11 ( 6 )   479 - 487   2004.11

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    Hepatitis C virus (HCV) infection is a major problem throughout the world. Combination therapy of interferon (IFN) and ribavirin is the best treatment for eradication at present, but the mechanism is not completely understood. We used the HCV replicon system to investigate this mechanism. The effects of six drugs (UDCA, glycyrrhizin, TJ-9, bezafibrate, ribavirin, and alpha-IFN 2b) on HCV subgenomic RNA (genotype 1b, NS5B 415Y) were examined by reverse transcription polymerase chain reaction, cloning and sequencing. The HCV replication was inhibited by alpha-IFN 2b (7.39-13.2% at 10 U/mL, 3.29-6.12% at 100 U/mL, 1.3-4.86% at 1000 U/mL) and by ribavirin (4.36-13.9% at 100 mug/mL), but not by the other drugs at 24-72 h after treatment. Furthermore, the combination treatment was superior to IFN monotherapy and to ribavirin monotherapy at 72 h post-treatment. Sequence analyses of the double-stranded RNA-activated protein kinase (PKR)-binding domain and flanking regions within the HCV NS5A region revealed that the total numbers of substitutions caused by ribavirin (n = 36) or combination treatment (n = 57) were more than those of IFN alone (n = 5) and controls (n = 6). The HCV replicon system is the most efficient system for HCV replication and is an excellent choice for testing anti-HCV drugs and disinfectants. Our results further suggested that the combination of alpha-IFN 2b and ribavirin might induce mutations, and inhibit HCV RNA synthesis in hepatocytes to a greater extent than ribavirin monotherapy.

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  • Severe hypercholesterolemia associated with primary biliary cirrhosis in a 44-year-old Japanese woman Reviewed

    Tatsuo Kanda, Osamu Yokosuka, Hiroshige Kojima, Fumio Imazeki, Keiich Nagao, Ichiro Tatsuno, Yasushi Saito, Hiromitsu Saisho

    WORLD JOURNAL OF GASTROENTEROLOGY   10 ( 17 )   2607 - 2608   2004.9

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    A 44-year-old woman developed jaundice and was diagnosed as stage II of primary biliary cirrhosis (PBC). She showed a severely high total cholesterol level. This article focuses on atypical presentations of PBC and the need to test the total cholesterol level of PBC patients.

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  • Hepatitis C infection with history of tuberculosis in Japan: No association with progression of liver fibrosis Reviewed

    T Kanda, O Yokosuka, F Imazeki, H Saisho, K Nagao

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   19 ( 6 )   717 - 719   2004.6

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  • Hepatitis B virus X protein (HBx)-induced apoptosis in HuH-7 cells: Influence of HBV genotype and basal core promoter mutations Reviewed

    T Kanda, O Yokosuka, F Imazeki, Y Yamada, T Imamura, K Fukai, K Nagao, H Saisho

    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY   39 ( 5 )   478 - 485   2004.5

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    Background: Hepatitis B virus (HBV) infection is a serious, world-wide problem. HBV genotype and basal core promoter (BCP) mutations affect the clinical course of HBV-infected patients. BCP mutations also lead to mutations at HBV X protein (HBx) codons 130/131. The functional significance of naturally occurring variants of human HBx remains largely unknown. The purpose of the study was to investigate whether HBV genotypes or double mutations affect HBx-induced apoptosis. Methods: We constructed genotype A, B, C, and D HBx expression vectors and HBx expression vectors with double mutations at HBx codons 130K and 131V or positions 130M and 131I using site-directed mutagenesis. A transient expression system in HuH-7 cells was established and this model was utilized to address the effect of HBx on cell viability. Results: HBx-transfected cells showed a dose-dependent decrease in cell viability by MTS assay. A subset of cells expressing HBx underwent apoptosis according to terminal transferase enzyme-mediated end labeling of DNA and caspase-3 activity. This study demonstrated that HBx can induce cell death by apoptosis in a dose-dependent manner and that HBV genotypes and double mutations did not affect HBx-induced apoptosis. Conclusions: HBV genotypes and mutation of two amino acids directly adjacent to the conserved Kunitz domain essential for transcription activating activity of HBx did not change the pro-apoptotic activity of HBx. Further study is needed to determine whether HBV genotypes and double mutations have any effect on the function of HBx.

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  • Interference of hepatitis A virus replication by small interfering RNAs Reviewed

    T Kanda, Y Kusov, O Yokosuka, Gauss-Muller, V

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   318 ( 2 )   341 - 345   2004.5

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    The rate of acute liver failure due to hepatitis A virus (HAV) has not decreased [Hepatology 39 (2004) 572], and therapy of severe infections is still of major interest. Using a DNA-based HAV replicon Cell Culture system, we demonstrate that small interfering RNAs (siRNAs) targeted against viral sequences or a reporter gene contained in the vital genome specifically inhibit HAV RNA replication in HuhT7 cells. Combinations of siRNAs were more effective suppressors of HAV RNA replication. Also, siRNAs targeted against HAV 2C and 3D inhibited the expression of the respective protein. Expressions of endogenous beta-actin and double-stranded-specific RNA-activated serin/threonine kinase (PKR) were unaltered, demonstrating that the siRNA inhibitory effect was not connected to interferon inhibition, but rather was specifically targeted against HAV RNA. These results Suggest that RNA interference might ultimately be useful in treatment of severe HAV infection with or without chronic liver diseases. (C) 2004 Elsevier Inc. All rights reserved.

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  • Acute hepatitis C virus infection, 1986-2001: A rare cause of fulminant hepatitis in Chiba, Japan Reviewed

    T Kanda, O Yokosuka, F Imazeki, H Saisho

    HEPATO-GASTROENTEROLOGY   51 ( 56 )   556 - 558   2004.3

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    Background/Aims: Hepatitis C virus (HCV) is the most common cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. It is controversial whether HCV causes fulminant hepatitis.
    Methodology: To determine the clinical features and etiology of acute hepatitis and fulminant hepatitis in Japan, an endemic area of hepatitis C, between 1986 and 2001 inclusively, a retrospective study of consecutively referred patients was performed. Two hundred and sixty-three patients admitted to a liver clinic after diagnosis of acute hepatitis or fulminant hepatitis, were evaluated.
    Results: We found 181 cases of acute hepatitis and 82 cases of fulminant hepatitis/late onset hepatic failure. No cases of fulminant hepatitis were positive for HCV RNA. Only three cases had positive anti-HCV antibody, and they were thought to indicate past HCV infection. The main cause of infection in these three patients was hepatitis A virus in one, hepatitis B virus in one, and drugs in the remaining one. HCV did not seem to be the major cause. The three cases died without receiving liver transplantation.
    Conclusions: It was revealed that fulminant hepatitis C rarely occurs in Japan, as well as in the USA and European countries. Investigators should search for other causes in fulminant cases presenting an HCV marker.

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  • A case of severe acute hepatitis of unknown etiology treated with the Chinese herbal medicine Inchinko-to Reviewed

    M Arai, O Yokosuka, K Fukai, T Kanda, H Kojima, S Kawai, F Imazeki, H Hirasawa, H Saisho

    HEPATOLOGY RESEARCH   28 ( 3 )   161 - 165   2004.3

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    A prolonged severe hepatitis of unknown etiology was treated with Inchinko-to, a Chinese herbal medicine, and this case is herein described. Inchinko-to was given with ursodeoxycholic acid (UDCA) and glycyrrhizin. The improvement in the patient's liver function seemed to be accelerated after the treatment, especially after stopping the administration of kanamycin sulfate which might possibly inhibit the conversion of geniposide, one of the constituents of Inchinko-to, to an active ingredient through the suppression of the bacterial growth in intestinal flora, suggesting the usefulness of Inchinko-to for treatment of severe hepatitis. (C) 2003 Elsevier B.V. All rights reserved.

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  • Corticosteroids and lamivudine combined to treat acute severe flare-up in a chronic hepatitis B and C patient Reviewed

    T Kanda, O Yokosuka, F Imazeki, S Yoshida, Y Suzuki, K Nagao, H Saisho

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   19 ( 2 )   238 - 239   2004.2

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  • High sustained virologic response rate after interferon monotherapy in Japanese hepatitis C patients with a low HCV RNA titer and/or HCV genotype 2 - A prospective study Reviewed

    O Yokosuka, S Iwama, N Suzuki, M Takashi, Y Hirai, K Uchiumi, M Kimura, N Gotou, S Hino, A Hayasaka, T Kanda, S Kawai, K Fukai, F Imazeki, H Saisho

    INTERVIROLOGY   47 ( 6 )   328 - 334   2004

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    Objective: Hepatitis C virus (HCV) RNA titer and HCV genotype are considered to be major determinants of the outcome of interferon monotherapy. To clarify whether interferon monotherapy is really effective in patients with the appropriate viral parameters, we prospectively examined these parameters and treated the patients with interferon monotherapy. Methods: Sixty-four patients with an HCV RNA titer &lt;100 kIU/ml and/or HCV genotype 2 were enrolled in the study. Eighteen patients with an HCV RNA titer &gt;100 kIU/ml and genotype 1 were also enrolled as controls. All patients were treated with 10 megaunits of interferon-alpha2b every day for 2 weeks and then 3 times a week for 24 weeks. Results: Of the 64 patients with either HCV RNA &lt;100 kIU/ml and/or genotype 2, seven dropped out from the study. Of the remaining 57 who completed the treatment, 48 (84%) showed a virologic sustained response. In contrast, only 4 of the 18 patients (22%) with HCV RNA &gt;100 kIU/ml and genotype 1 were virologic sustained responders (p&lt;0.001). Conclusion: Our current study showed that the patients with HCV RNA &lt;100 kIU/ml and/or HCV genotype 2 are good candidates for interferon monotherapy. Copyright (C) 2004 S. Karger AG, Basel.

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  • Distribution of hepatitis B viral genotypes and mutations in the core promoter and precore regions in acute forms of liver disease in patients from Chiba, Japan Reviewed

    T. Imamura, O. Yokosuka, T. Kurihara, T. Kanda, K. Fukai, F. Imazeki, H. Saisho

    Gut   52 ( 11 )   1630 - 1637   2003.11

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    Background: Although it has been reported that different hepatitis B virus (HBV) genotypes induce different clinical characteristics in patients with chronic liver diseases (CLD), there have been few reports that have detailed the distribution of HBV genotypes in acute forms of liver disease. Methods: HBV genotypes were determined in 61 patients who had acute forms of liver disease (45 had acute self limited hepatitis (AH) and 16 had fulminant hepatitis (FH)) and in 531 patients with CLD, including 19 patients with severe acute exacerbation of CLD. We also analysed the enhancer II, core promoter, and precore region sequences for the presence of mutations. Results: Expression of genotype B in patients with acute forms of liver disease was significantly greater than in those with CLD (39.3% v 11.7%, respectively
    p&lt
    0.001). Furthermore, expression of genotype B was significantly greater in patients with FH than in those with AH (62.5% v 31.1%, respectively
    p = 0.027). The precore mutation A1896 and the core promoter mutation at nt 1753 and 1754 were found more frequently in FH than in AH, and genotype B was predominant in FH regardless of the presence of these mutations. Conclusions: HBV genotype B was found more frequently in patients with acute forms of liver disease than in patients with CLD, and more frequently in patients with FH than in those with AH. These results suggest that this HBV genotype may induce more severe liver damage than other viral genotypes, at least in patients from Chiba, Japan.

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  • N-nitroso-fenfluramine hepatotoxicity resembling chronic hepatitis Reviewed

    T Kanda, O Yokosuka, M Tada, T Kurihara, S Yoshida, Y Suzuki, K Nagao, H Saisho

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   18 ( 8 )   999 - U1   2003.8

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  • Severe hepatotoxicity associated with Chinese diet product 'Onshidou-Genbi-Kounou' Reviewed

    T Kanda, O Yokosuka, O Okada, Y Suzuki, H Saisho

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   18 ( 3 )   354 - 355   2003.3

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  • Hepatitis A virus VP3 may activate serum response element associated transcription Reviewed

    T Kanda, O Yokosuka, N Kato, F Imazeki, K Fujiwara, S Kawai, H Saisho, M Omata

    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY   38 ( 3 )   307 - 313   2003.3

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    Background: Hepatitis A virus (HAV) infection is a major public health problem worldwide. The infection does not induce any visible cytopathic effects or interfere with macromolecular synthesis in host cells. However, the hepatitis B and C viruses have recently been reported to activate intracellular signals. To clarify the effects of HAV infection on intracellular signalling, we examined the influence of 9 FLAG-tagged HAV proteins (VP2, VP3, VP1-2A, 2B, 2C, 3A, 3BC, 3C and 3D) on signal transduction pathways. Methods: Viral protein expression vectors were co-transfected into HeLa cells with reporter plasmids controlled by a synthetic promoter containing direct repeats of the cyclic AMP response element (CRE), serum response factor (SRF), activator protein 1 (AP-1), nuclear factor kB (NF-kB) or serum response element (SRE). Cells were harvested 42 h after transfection and luciferase assays were performed. Viral protein activation twice that of the control was defined as significant. Results: VP3 induced an SRE-associated signal 2.2 +/- 0.3 times higher than that of control. VP3 did not activate CRE-, SRF-, AP-1- or NF-kB-associated signalling. The other HAV proteins tested also failed to induce these pathways. Conclusions: HAV interacts with the host signalling mechanism, and HAV VP3, different from HBX and hepatitis C core protein, may activate only SRE-associated intracellular signalling, a pathway associated with cell proliferation and differentiation.

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  • Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease Reviewed

    H Sumi, O Yokosuka, N Seki, M Arai, F Imazeki, T Kurihara, T Kanda, K Fukai, M Kato, H Saisho

    HEPATOLOGY   37 ( 1 )   19 - 26   2003.1

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    To investigate the hepatitis B virus (HBV) genotype-related differences in the progression of liver disease, 585 patients with chronic HBV infection including 258 with histologically verified chronic liver disease (CLD) and 74 with hepatocellular carcinoma (HCC) were examined. The mean ages of both patients with advanced fibrosis (F3 or F4) and with HCC were significantly older in genotype B than in genotype C patients (P =.018, P =.024, respectively). Both the hepatitis B e antigen (HBeAg) negativity rate at biopsy and the cumulative HBe seroconversion rate in patients with CLD were significantly higher in genotype B patients than genotype C patients (P &lt;.01, P =.022, respectively). Multivariate analysis revealed that genotype B, presence of precore mutation, high ALT levels, and severe histologic activity were independent factors for HBe seroconversion. Among all the biopsy-proven CLD patients, the ratio of patients with advanced fibrosis in genotype B was significantly lower than that in genotype C (4/30 vs. 74/224, respectively; P =.034). This difference was more remarkable in younger patients (&LE;45 years; 1/25 vs. 47/180, respectively; P =.020), and there was no difference in older patients (&gt; 45 years). The distribution of each genotype between CLD and HCC was very similar (B and C: 11.2% and 87.0% vs. 10.8% and 89.2%, respectively). In conclusion, our results suggest that, although the patients with genotype B experience earlier HBe seroconversion, slower progression of liver fibrosis, and slower development of HCC, the life-long risk of progression to advanced fibrosis and development of HCC may not differ among genotypes B- and C-related chronic liver disease.

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  • Bezafibrate treatment: a new medical approach for PBC patients? Reviewed

    T Kanda, O Yokosuka, F Imazeki, H Saisho

    JOURNAL OF GASTROENTEROLOGY   38 ( 6 )   573 - 578   2003

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    Background. A new medical approach to primary biliary cirrhosis (PBC) has been desired. We investigated the feasibility of using combination ursodeoxycholic acid (UDCA)-bezafibrate therapy in patients with PBC nonresponsive to UDCA monotherapy. Methods. During a 6-month period, 22 PBC patients with elevated serum alkaline phosphatase (ALP) despite UDCA monotherapy received either UDCA at 600 mg/day (control group) or UDCA at 600 mg/day plus bezafibrate at 400 mg/day (bezafibrate group). Each patient underwent detailed clinical and biochemical evaluation. Results. During treatment, changes in ALP level were greater in the bezafibrate group than in the control group (P &lt; 0.01). During and at the end of treatment, serum ALP levels were significantly lower than those before treatment in patients receiving UDCA plus bezafibrate (P &lt; 0.05). At the end of the 6 months, normalization of serum ALP was observed in 5 of 11 (45.4%) patients given bezafibrate and in 2 of 11 (18.1%) patients not given bezafibrate (P &lt; 0.16). Bile acid proportions during the combination therapy did not change. Pruritus disappeared in 1 of 7 bezafibrate-group patients with this symptom. Conclusions. UDCA at 600 mg/day plus bezafibrate at 400 mg/day may be considered as a new therapeutic option for patients with PBC.

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  • Hepatic graft-versus-host disease resembling acute hepatitis: additional treatment with ursodeoxycholic acid Reviewed

    T Chiba, O Yokosuka, T Kanda, K Fukai, F Imazeki, H Saisho, M Nishimura, Y Saito

    LIVER   22 ( 6 )   514 - 517   2002.12

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    Hepatic graft-versus-host disease (GVHD) is a frequent complication after bone-marrow transplantation (BMT). The disease is often refractory to immunosuppressive therapy. We present a 30-year-old Japanese male, who developed an abrupt elevation of aminotransferases, on day 135 after allogeneic BMT. A liver biopsy specimen revealed degeneration of the small bile ducts and portal fibrosis, and the diagnosis of chronic hepatic GVHD was confirmed. No manifestation of chronic GVHD was observed except liver dysfunction. The administration of prednisolone (PSL) and cyclosporin (CsA) ameliorated laboratory data to a degree, but they did not return to normal. Treatment with ursodeoxycholic acid (UDCA), subsequently added to the immunosuppressive therapy, apparently normalized the levels of biliary tract enzyme and total bilirubin. His liver function test completely returned to normal on day 260. We believe that it is worthwhile to administer UDCA as an additional treatment for not only common hepatic GVHD but also atypical cases presenting as acute hepatitis.

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  • Fulminant hepatic failure associated with benzbromarone treatment: A case report Reviewed

    M Arai, O Yokosuka, K Fujiwara, H Kojima, T Kanda, H Hirasawa, H Saisho

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   17 ( 5 )   625 - 626   2002.5

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  • Fulminant hepatic failure associated with triazolam Reviewed

    T Kanda, O Yokosuka, K Fujiwara, H Saisho, H Shiga, S Oda, K Okuda, Y Sugawara, M Makuuchi, H Hirasawa

    DIGESTIVE DISEASES AND SCIENCES   47 ( 5 )   1111 - 1114   2002.5

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  • Roles of TT virus infection in various types of chronic hepatitis

    T Ikeuchi, O Yokosuka, T Kanda, F Imazeki, T Seta, H Saisho

    INTERVIROLOGY   44 ( 4 )   219 - 223   2001.7

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    An unenveloped single-stranded virus, which might be a causative agent for posttransfusion non-A-G hepatitis, was recently found and named 'TT virus' (TTV). There is still controversy over the role of TTV in chronic hepatitis. Therefore, we have examined the prevalence of TTV in various types of chronic hepatitis in Japan. TTV DNA was detected in 11 of 40 patients (27.5%) with non-B, non-C chronic hepatitis, 13 of 46 patients (28.3%) with type B chronic hepatitis, 21 of 55 patients (38.2%) with type C chronic hepatitis, and 41 of 131 subjects (31.3%) with normal liver function tests. The positivity rate for TTV DNA tended to increase with age. The detection rate did not differ statistically between non-B, non-C chronic hepatitis and type B or type C chronic hepatitis, or normal subjects. The distribution of TTV genotypes was not significantly different among them. Clinical characteristics of the chronic illness were similar for patients with or without TTV in all hepatitis groups. The etiologic role of TTV in chronic hepatitis is not confirmed from the statistical and clinical standpoint. Copyright (C) 2001 S. Karger AG, Basel.

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  • The prevalence of TT virus infection in renal transplant recipients in Brazil Reviewed

    O Yokosuka, T Ikeuchi, T Kanda, S Kawai, F Imazeki, H Saisho, M Mazzalli, G Alves, NF Nishimura, EC Soares

    TRANSPLANTATION   70 ( 8 )   1194 - 1197   2000.10

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    Background, Recently, rr virus (TTV) was discovered as a potential causative agent for non-A-E hepatitis. Little is known about the prevalence of TTV infection in renal transplant recipients.
    Methods. One hundred and seventeen Brazilian renal transplant recipients and 100 normal subjects were examined to determine the prevalence of ITV infection. The TTV DNA in serum and its genotype were examined using polymerase chain reaction and restriction enzyme length polymorphism, respectively.
    Results. TTV DNA was detected in 63/117 (53.8%) renal transplant recipients in contrast to its detection in 10/100 (10%) normal subjects (P&lt;0.001). There was no statistical difference in the distribution of TTV genotypes between these groups. There was no significant difference in clinical backgrounds between TTV positive and negative patients.
    Conclusions. These results indicate a risk for Tm infection in renal transplant recipients in Brazil. They also indicate that TTV itself might not have a strong correlation with the pathogenicity of liver diseases.

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  • Sequence-motif analysis of 5 '-untranslated region of GB virus-C in Japanese patients Reviewed

    T Kanda, O Yokosuka, S Kawal, F Imazeki, H Saisho

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   15 ( 9 )   1048 - 1053   2000.9

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    Background: GB Virus C (GBV-C) is considered to belong to the Flaviviridae; however, the structures of the N-terminal end of its putative polyprotein are not well known. The internal ribosomal entry site (IRES) at the 5'-untranslated region of GBV-C and an initiating codon at nucleotides (nt) 552-554 have been proposed. We investigated the validity of this proposal.
    Methods: The 5'-untranslated region of GBV-C was amplified from serum samples of 17 Japanese patients. Polymerase chain reaction-amplified products were directly sequenced and the obtained sequences were analysed by comparing them with the IRES structure of other viruses.
    Results: Fifteen of the 17 (88%) GBV-C strains in our patients were classified as being Asian type. The box-A-like sequence (UUUC) and box-B-like sequence (AUCAUGG) observed in the IRES of picornaviruses were highly conserved in all the strains. Based on pair-wise comparisons with the multiple alignment data, overall sequence divergence for the 5'-terminus was 2.9-12%. When compared with the proposed secondary structure of the IRES model, the sequence divergences of the Asian-type GBV-C were higher at the regions of loop structures and lower at the regions of double-stranded RNA. The AUG codons, except for the one located at nt 552-554, produced truncated polyproteins or were not in-frame with the putative protein.
    Conclusions: Our examination of the sequence motif of GBV-C supports the proposal that the GBV-C has common structural motifs for IRES at its 5'-untranslated region and the AUG codon at nt 552-554 may be an initiating codon. (C) 2000 Blackwell Science Asia Pty Ltd.

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  • Superinfection of TT virus and hepatitis C virus among chronic haemodialysis patients Reviewed

    T Ikeuchi, K Okuda, O Yokosuka, T Kanda, S Kobayashi, M Murata, H Hayashi, K Yokozeki, Y Ohtake, T Kashima, Y Irie

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   14 ( 8 )   796 - 800   1999.8

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    Background: The TT virus (TTV), a new DNA virus found in Japan from a patient with posttransfusion hepatitis non-A-non-G, is frequently positive in the sera of patients with liver disease. It is not established whether this virus causes liver damage. We studied the frequency of superinfection of this virus and hepatitis C virus (HCV) known to be endemic among haemodialysis patients, and the possible deleterious effect of TTV on HCV-induced chronic liver disease.
    Methods: We used primers from a conservative region in the TTV genome (Okamoto, 1998) to detect TTV. Sera from 163 dialysis patients positive for anti-HCV and 77 dialysis patients negative for anti-HCV (control) were tested.
    Results: TT Virus positivity was 35% among HCV antibody (anti-HCV)-positive patients and 45.4% among anti-HCV-negative patients. TT Virus positivity was unrelated to the length of haemodialysis or amounts of blood the patients had received in the past. More anti-HCV-positive patients had a history of transfusion, but TTV positivity was not as closely associated with transfusion as anti-HCV positivity. The severity of chronic liver disease was estimated from peak serum alanine aminotransferase levels in the preceding 6 months. Among anti-HCV positives, TTV-positive patients tended to have less active disease; at least there was no indication that TTV superinfection aggravated chronic hepatitic C in longterm dialysis patients. Four of 35 anti-HCV-negative, TTV-positive patients had chronic active liver disease, while none of the anti-HCV-negative and TTV-negative patients did.
    Conclusions: TT Virus infection is prevalent among haemodialysis patients. Its transmission occurs not only by blood transfusion, but also by non-parenteral infection. Superinfection of TTV does not exert deleterious effects on the liver disease induced by HCV. However, it may cause chronic hepatitis in a limited number of patients, but remains dormant most of the time. Triple infection, HCV and TTV plus HBV or HGV (one case each), did not cause severe liver disease. (C) 1999 Blackwell Science Asia Pty Ltd.

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  • [Clinical feature of TTV-related hepatitis].

    Kanda T, Yokosuka O

    Nihon rinsho. Japanese journal of clinical medicine   1999.6

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    It has been clarified that hepatitis G/GB virus-C is the minor cause of acute and chronic non-A-E hepatitis. But there exist non-A-E viral hepatitis patients. Recently, one of non-A-E hepatitis associated virus was identified and the new virus was named TT virus. We highly detected TT virus in the serum of hepatitis patients. TT virus were reported to be detected 1-37% of the general population in the world. TT virus may account for only a minor part of acute non-A-E hepatitis in Japan. However, whether TT virus infection really causes severe acute hepatitis is required to be elucidated.

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  • Quantification of hepatitis C virus by TaqMan PCR: Comparison with HCV Amplicor Monitor assay Reviewed

    S Kawai, O Yokosuka, T Kanda, F Imazeki, Y Maru, H Saisho

    JOURNAL OF MEDICAL VIROLOGY   58 ( 2 )   121 - 126   1999.6

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    The quantitation of serum levels of hepatitis C virus RNA in chronic hepatitis C has been regarded as one of the most important indicators for the outcome of interferon therapy. A new method was used for quantitating the copy number of hepatitis C virus RNA using TaqMan polymerase chain reaction and for comparing the ability and usefulness of this assay with Amplicor Monitor assay in 138 patients. The detection range of hepatitis C virus RNA by TaqMan polymerase chain reaction was from 2 x 10(3) to 2 x 10(8) copies/ml. Hepatitis C virus RNA was detectable in 128 cases (92.8%) and undetectable in 10 cases (7.2%) by this method. The RNA levels measured by Amplicor Monitor assay correlated significantly with those measured by TaqMan polymerase chain reaction assay and the sensitivity of the two assays was almost equal. Thus, TaqMan polymerase chain reaction assay appears sufficiently sensitive for the evaluation of hepatitis C virus RNA and would be useful for the diagnosis and management of hepatitis C virus infection. J. Med. Virol. 58:121-126, 1999. (C) 1999 Wiley-Liss, Inc.

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  • The role of TT virus infection in acute viral hepatitis Reviewed

    T Kanda, O Yokosuka, T Ikeuchi, T Seta, S Kawai, F Imazeki, H Saisho

    HEPATOLOGY   29 ( 6 )   1905 - 1908   1999.6

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    Recently, transfusion-transmitted virus (TTV) was discovered to be a potential causative agent for non-A-E hepatitis. Little is known about the relation between TTV and the clinical courses of various types of acute viral hepatitis. One hundred twenty-five patients with acute viral hepatitis who were admitted to the Chiba University Hospital between 1984 and 1998 and 100 persons with normal liver function tests were tested for the presence of TTV in their sera. Serum samples were tested for TTV DNA and genotype by polymerase chain reaction (PCR). TTV DNA was detected in 15 of 35 patients (43%) with non-A-E hepatitis, 14 of 33 patients (42%) with hepatitis C, 8 of 28 patients (29%) with hepatitis A, 7 of 29 patients (24%) with hepatitis B, and 37 of 100 subjects with normal liver function tests (37%). The detection rate did not differ statistically between non-A-E hepatitis and hepatitis A, B, C, or controls. The distribution of TTV genotypes was similar in non-A-E, A, B, C types, and controls. The clinical characteristics of the acute illnesses were similar for patients with or without TTV in hepatitis non-A-E, A, B, or C. Although TTV was detected frequently in non-A-E acute hepatitis, no etiologic role for TTV could be established.

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  • Quantitative analysis of GBV-C RNA in liver and serum by strand-specific reverse transcription polymerase chain reaction Reviewed

    T Kanda, O Yokosuka, M Tagawa, S Kawai, F Imazeki, H Saisho

    JOURNAL OF HEPATOLOGY   29 ( 5 )   707 - 714   1998.11

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    Background/Aims: Although GB virus C (GBV-C) is frequently detectable in patients with liver diseases, it is not known whether it actually replicates in the liver, Therefore we have quantitatively examined the strand-specific RNA of this virus.
    Methods: Fourteen patients (two GBV-C RNA only seropositive, seven both GBV-C RNA and HCV RNA seropositive, and five HCV RNA only seropositive) were examined, Extracted RNAs from sera and liver specimens of these patients were serially diluted and strand-specific RNAs of GBV-C and HCV were quantitatively measured using strand-specific primers by reverse transcription-polymerase chain reaction.
    Results: Positive-strand GBV-C RNA in serum was detected in all nine GBV-C RNA seropositive cases, and negative-strand RNA was detected in three, uncertain in three, and undetected in three. Positive-strand GBV-C RNA in the liver was detected in seven and undetected in two, while negative-strand RNA in the liver was undetected in eight and uncertain in one, On the other hand, positive-strand HCV RNA was detected in serum from all 12 HCV RNA seropositive patients and negative-strand HCV RNA was detected in one, uncertain in seven, and undetected in four, Positive-strand HCV RNA was detected in the liver from all 12 HCV RNA seropositive patients, and the presence of negative-strand HCV RNA in the liver was confirmed in 10 and uncertain in the remaining two.
    Conclusion: GBV-C is considered to be far less hepatotropic than HCV and it is suggested that GBV-C might not be replicating in the liver.

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  • 第1回日本肝臓学会大会記録:ワークショップ (1) 非B非C型肝炎の実態と予後

    神田 達郎, 横須賀 収, 小林 正和, 田中 栄司, 大崎 牧, 須磨崎 亮, 阿部 弘一, 石川 和克, 松下 栄紀, 金子 周一, 道尭 浩二郎, 堀池 典生, 鈴木 宏, 佐田 通夫, 坂本 雅史, 岡上 武, 茶山 一彰, 熊田 博光, 岡田 俊一, 赤羽 賢浩

    肝臓   39 ( 8 )   565 - 586   1998

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    DOI: 10.2957/kanzo.39.565

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  • GB virus-C infection among chronic haemodialysis patients: Clinical implications Reviewed

    K Okuda, T Kanda, O Yokosuka, H Hayashi, K Yokozeki, Y Ohtake, Y Irie

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   12 ( 11 )   766 - 770   1997.11

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    It is known that patients on chronic haemodialysis are frequently infected with hepatitis C virus (HCV). It has recently been found that GB virus-C (GBV-C) and hepatitis G virus frequently coinfect patients with HCV. This study aimed at elucidating the clinical implications of GBV-C infection among haemodialysis patients who have and do not have HCV infection. GBV-C RNA was detected in sera of randomly selected 98 anti-HCV-positive and 85 -negative patients on dialysis by reverse transcription-polymerase chain reaction using two sets of amplification primers made from the reported sequences of the non-structural protein 3 and 5' untranslated regions. In these patients, liver function tests were carried out at regular intervals. There were six patients who were coinfected with HCV and GBV-C and three who had only GBV-C RNA. All had a history of past blood transfusion. The onset of mild hepatitis was identified in three HCV-negative patients; elevation of alanine aminotransferase (ALT) following blood transfusion was very mild hut recognizable, and aspartate aminotransferase (AST) was higher than ALT. In mio of six coinfected patients, the onset of liver disease was recognized with a peak ALT of 72 and 90 IU/L, respectively. Two of these six were Amplicore (HCV-RNA) negative and asymptomatic, two had low-grade HCV viraemia and two moderate-grade HCV viraemia. Of the 98 anti-HCV-positive cases, 41 were thought to have had nosocomial infection of HCV or non-A, non-B virus; none of them had GBV-C. GBV-C RNA was negative in nine patients who had chronic non-A-E hepatitis. GBV-C infection was detected in 6.1% of anti-HCV-positive and in 3.5% of-negative dialysis patients. All had blood transfusion in the past, and there was no evidence of patient-to-patient spread of GBV-C in hospital. The liver disease was very mild and self-limited in GBV-C infection alone. The natural history of coinfected patients may be similar to that of those with chronic HCV infection, but the liver disease appears to be milder.

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  • GB virus-C RNA in Japanese patients with hepatocellular carcinoma and cirrhosis Reviewed

    T Kanda, O Yokosuka, F Imazeki, M Tagawa, T Ehata, H Saisho, M Omata

    JOURNAL OF HEPATOLOGY   27 ( 3 )   464 - 469   1997.9

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    Background/Aims: The involvement of non-B, non-C virus in the incidence of hepatocellular carcinoma (HCC) is not yet known. We have therefore examined the occurrence of GBV-C RNA in such patients.
    Methods: One hundred and eleven patients diagnosed as having HCC and 67 patients with cirrhosis without HCC were examined for the prevalence of GBV-C RNA by nested reverse transcription polymerase chain reaction with primers located at the helicase region. Sera were obtained and kept at -20 degrees C until analysis.
    Results: GBV-C RNA was positive in 11/111 (9.9%) cases with HCC, in 10/74 (13.5%) anti-HCV positive cases, in 1/25 (4%) HBsAg positive cases, and in 0/8 (0%) anti-HCV and HBsAg negative cases. GBV-C RNA was also positive in 7/67 (10.4%) cases with cirrhosis, in only 1/18 (5.6%) anti-HCV and HBsAg negative cases, in 4/33 (12.1%) anti-HCV positive, and in 2/14 (14.3%) HBsAg positive cases. The clinical background of patients with anti-HCV positive HCC who were also positive for GBV-C RNA did not differ from the background of those negative for GBV-C RNA.
    Conclusions: GBV-C is unlikely to be a major etiologic agent of non-B, non-C chronic liver diseases and HCC in Japan.

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  • Detection of GBV-C RNA in patients with non-A-E fulminant hepatitis by reverse-transcription polymerase chain reaction Reviewed

    T Kanda, O Yokosuka, T Ehata, Y Maru, F Imazeki, H Saisho, Y Shiratori, M Omata

    HEPATOLOGY   25 ( 5 )   1261 - 1265   1997.5

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    GBV-C might be a causative agent of fulminant hepatitis of unknown etiology, Fulminant hepatitis is an indication for liver transplantation. However, in Japan, because of the legal difficulties associated with cadaveric donation, patients with fulminant hepatitis are still treated by plasmapheresis and multiple transfusions of fresh frozen plasma, So, the possibility that GBV-C might be transmitted by transfusions after the onset of fulminant hepatitis is real, Therefore, we have examined the possible role of GBV-C in non-A-E fulminant hepatitis, Nine patients with non-A-E fulminant hepatitis and one with non-A-E late onset hepatic failure were examined, Sera were obtained from the patients at admission before any blood or blood products were given, and again after transfusions. GBV-C RNA was detected by nested reverse transcription polymerase chain reaction with primers based on the reported sequence, GBV-C RNA was negative in all 10 pretransfusion patients with non-A-E fulminant hepatitis or late onset hepatic failure, Then, fresh frozen plasma was transfused to these patients, and four of them became seropositive, GBV-C is unlikely to be a major etiologic agent for non-A-E fulminant hepatitis in Japan.

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  • [Clinical features of HGBV-C-related liver cancer].

    Kanda T, Yokosuka O

    Nihon rinsho. Japanese journal of clinical medicine   1997.3

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    Recently, one of non-A to E hepatitis viruses was identified and the new virus was named HGV/GBV-C(HGBV-C). In Japan, more than 90% of liver cirrhosis and hepatocellular carcinoma were associated with hepatitis B or C virus infection. Proportion of HGBV-C infection was only 3.4% of patients with non-A to E chronic liver disease we examined. Thus, HGBV-C was considered to play only a minor role in chronic liver disease of unknown etiology. HGBV-C positive cases have a history of blood transfusion and/or operation and/or drug self-injection, and frequently co-infected with hepatitis C virus. Whether HGBV-C infection really causes severe chronic liver disease is required to be elucidated.

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  • [A case of antiphospholipid syndrome associated with Buerger's disease and portal hypertension].

    Kanda T, Azemoto R, Yokosuka O, Ai T, Yugi H, Matsutani S, Ohto M

    Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   1995.4

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Books

  • 専門医のための消化器病学 第3版(下瀬川徹, 渡辺守監修, 木下芳一, 金子周一, 樫田博史, 村上和成, 安藤朗, 糸井隆夫編集) Reviewed

    ( Role: Joint author ,  A型肝炎)

    医学書院  2021 

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    Responsible for pages:341-343   Language:Japanese Book type:Textbook, survey, introduction

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  • 『今日の臨床サポート』(第5版)監修: 持田智

    佐々木玲奈, 土屋淳紀, 神田達郎, 寺井崇二( Role: Contributor ,  A型肝炎)

    エルゼビア・ジャパン  2024.12 

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  • 肝臓専門医テキスト 改訂第4版 (日本肝臓学会編集)

    日本肝臓学会編集( Role: Contributor ,  第4版改訂者 神田達郎ほか)

    南江堂  2024.11 

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  • 慢性ウイルス性肝炎および自己免疫性肝炎.

    Jean-Michel Pawlotsky, 神田達郎, 神田達郎, ゴールドマン・セシル内科学 日本対応版. Online eBook Library( Role: Translator/Editor)

    エルゼビア・ジャパン(東京都港区)  2021 

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  • 肝臓専門医テキスト 改訂第3版 (日本肝臓学会編集)

    ( Role: Contributor)

    南江堂 (東京都文京区)  2020.11 

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  • 健診で肝障害と言われました むかしの頭で診ていませんか?消化器診療をスッキリまとめました (加藤直也編集)

    神田達郎( Role: Contributor)

    南江堂 (東京都文京区)  2020 

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    Responsible for pages:p.146-150   Language:Japanese Book type:General book, introductory book for general audience

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  • 肝の感染症 肝膿瘍 liver abscess 改訂第9版 内科学書 vol.4 消化管・腹膜疾患 肝・胆道・膵疾患 (南学正臣 総編集, 千葉勉, 持田智 部門編集)

    神田達郎, 森山光彦( Role: Contributor)

    中山書店(東京)  2019 

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MISC

  • 当科における進行肝細胞癌に対するレゴラフェニブの初期使用経験 実臨床における課題は?

    小笠原 定久, 千葉 哲博, 大岡 美彦, 鈴木 英一郎, 前田 隆宏, 横山 昌幸, 小林 和史, 清野 宗一郎, 中村 昌人, 齊藤 朋子, 中本 晋吾, 安井 伸, 太和田 暁之, 新井 誠人, 神田 達郎, 丸山 紀史, 加藤 直也

    The Liver Cancer Journal   ( Suppl.1 )   61 - 62   2018.6

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  • アルコール性・非アルコール性肝疾患におけるネフェロメトリー法による血清糖鎖欠損トランスフェリン(CDT)測定 多施設検討結果の報告

    野村 文夫, 神田 達郎, 影山 洋子, 寺田 奈美, 山下 毅, 丸山 勝也

    アルコールと医学生物学   36   20 - 21   2018.4

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  • HCV患者における経口剤による抗ウイルス療法後の早期発がんリスク因子

    大岡 美彦, 千葉 哲博, 斎藤 朋子, 清野 宗一郎, 小林 和史, 中村 昌人, 小笠原 定久, 鈴木 英一郎, 安井 伸, 太和田 暁之, 新井 誠人, 神田 達郎, 今関 文夫, 横須賀 收, 加藤 直也

    肝臓   59 ( Suppl.1 )   A416 - A416   2018.4

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  • 本邦のB型慢性肝炎におけるTDFのHBs抗原低下作用

    中本 晋吾, 神田 達郎, 中村 昌人, 安井 伸, 小笠原 定久, 鈴木 英一郎, 大岡 美彦, 太和田 暁之, 齊藤 朋子, 小林 和史, 清野 宗一郎, 千葉 哲博, 新井 誠人, 丸山 紀史, 加藤 直也

    肝臓   59 ( Suppl.1 )   A488 - A488   2018.4

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  • 時間依存ROC解析を用いた肝細胞癌根治治療後の再発リスクの検討

    黒杉 茜, 小笠原 定久, 大岡 美彦, 井上 将法, 千葉 哲博, 鈴木 英一郎, 横山 昌幸, 前田 隆宏, 若松 徹, 小林 和史, 清野 宗一郎, 中村 昌人, 齊藤 朋子, 中本 晋吾, 安井 伸, 太和田 暁之, 新井 誠人, 神田 達郎, 丸山 紀史, 久保木 知, 大塚 将之, 加藤 直也

    肝臓   59 ( Suppl.1 )   A436 - A436   2018.4

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  • 代謝異常がA型肝炎ウイルス増殖および肝細胞MAPKシグナル伝達経路に与える影響

    神田 達郎, Nwe Win Nan, 中村 昌人, 中本 晋吾, 岡本 宏明, 横須賀 收, 白澤 浩

    糖尿病   60 ( Suppl.1 )   S - 493   2017.4

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  • 早期から脾腎短絡路の発達を認めたAMA・M2抗体陰性の無症候性非硬変性原発性胆汁性胆管炎の一例

    清野 宗一郎, 丸山 紀史, 小林 和史, 近藤 孝行, 嶋田 太郎, 高橋 正憲, 奥川 英博, 神田 達郎, 横須賀 收

    肝臓   58 ( 1 )   38 - 45   2017.1

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    症例は67歳、女性。55歳の頃からシェーグレン症候群で近医に通院していた。57歳時に、スクリーニングのCTで脾臓付近の異常血管を指摘され精査目的にて当院を受診した。超音波上、慢性肝疾患の所見に乏しかったが遠肝性血流の脾腎短絡路を認めた。門脈や脾静脈は順流で腹水や脾腫を認めず、肝酵素値は正常範囲で抗ミトコンドリア抗体およびM2抗体も陰性であったことから原因不明の血行異常症として経過観察することとなった。その7年後から脾静脈血流に逆流成分が見られ、血清アンモニアも異常値を呈するようになった。顕性脳症を認めなかったが精査を要すると判断し肝静脈圧測定と肝生検を行った。肝静脈圧較差は4.8mmHgと正常であったが、肝組織所見から原発性胆汁性胆管炎(PBC、Scheuer 2、中沼分類Stage 3)と診断された。本例は病初期から脾腎短絡路を合併し、無症候性から症候性PBCへの移行を認めた稀な一例である。(著者抄録)

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  • 巨脾を伴った若年性非硬変性門亢症の一例

    清野 宗一郎, 丸山 紀史, 小林 和史, 神田 達郎, 横須賀 收

    日本門脈圧亢進症学会雑誌   22 ( 3 )   169 - 169   2016.8

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  • 診療最前線Q&A アルブミン定量

    芳賀 祐規, 神田 達郎, 清宮 正徳, 野村 文夫, 横須賀 收

    たんじゅうさん   14 ( 1 )   20 - 20   2015.6

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  • 【薬物性肝障害の新展開-疑問点の集約とその解決を探る】臨床的に示唆に富む病態 慢性C型肝炎に対する抗ウイルス療法施行中のトランスアミナーゼ上昇について

    中村 昌人, 神田 達郎, 宮村 達雄, 呉 霜, 中本 晋吾, 横須賀 收

    肝胆膵   68 ( 2 )   295 - 299   2014.2

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  • The state of asymptomatic HBV carriers with HBeAb positive in Japan

    58 ( 2 )   207 - 212   2014.2

  • テラプレビルによる3剤併用療法時の消化器症状と胃排泄能との関連

    小山田新, 新井誠人, 峯村荘子, 齊藤景子, 佐塚小百合, 坪井優, 丸岡大介, 田中健史, 松村倫明, 中川倫夫, 神田達郎, 勝野達郎, 横須賀收

    肝臓   54 ( Supplement 2 )   2013

  • HCV NS5A protein inhibits lipopolysaccharide-mediated apoptosis of hepatocytes by decreasing Toll-like receptor 4 expression

    53 ( 5 )   585 - 588   2011.11

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  • [HBeAg and HBV DNA in chronic hepatitis B]. Reviewed

    Imazeki F, Wu S, Arai M, Kanda T, Yokosuka O

    Nihon rinsho. Japanese journal of clinical medicine   69 Suppl 4   428 - 433   2011.5

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  • Natural history of viral hepatitis

    60 ( 1 )   49 - 54   2011.1

  • 急性肝障害-薬物性肝障害とウイルス肝炎 2 急性肝障害を起こす疾患(2)ウイルス性急性肝障害とその治療 b.B型肝炎

    丸岡大介, 神田達郎, 横須賀收

    臨床消化器内科   25 ( 11 )   1507 - 1513   2010.9

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    B型急性肝炎とは,B型肝炎ウイルス(HBV)の肝細胞への急性感染によって惹起される肝臓の炎症である.本邦における成人期のHBV感染では,輸血や医療従事者の針刺し事故などによる新規感染が減少している一方,性交渉を介したgen-otype A2/Ae型の感染が増加している.肝炎発症より2~4ヵ月程度までにHBs抗原は消失し,ウイルス学的治癒を判定するにあたり重要であるが,6ヵ月以上持続して陽性の場合には慢性化と判断し,B型慢性肝炎に準じた治療が必要となる.B型急性肝炎の生命予後は比較的良好であるが,経過中にプロトロンビン時間(PT)の低下がみられる場合などでは劇症化の可能性を考え,専門医へのコンサルトを行う.劇症肝炎もしくは遅発性肝不全(LOHF)と診断されれば,人工肝補助療法を中心とした集中治療を開始する.(著者抄録)

    J-GLOBAL

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  • [Viral factors and host factors in pathogenesis of fulminant hepatitis, type B]. Reviewed

    Kanda T, Nagao K, Yokosuka O, Imazeki F

    Nihon rinsho. Japanese journal of clinical medicine   62 Suppl 8   259 - 263   2004.8

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  • A case of steatohepatitis associated with tamoxifen Reviewed

    Tatsuo Kanda, Osamu Yokosuka, Tetsuhiro Chiba, Hiroshige Kojima, Kenichi Fukai, Fumio Imazeki, Hiromitsu Saisho

    Japanese Journal of Gastroenterology   99 ( 9 )   1119 - 1121   2002.9

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Presentations

  • 酢酸亜鉛によるA型肝炎ウイルス増殖抑制効果の検討

    神田達郎, 佐々木玲奈, 寺井崇二

    第45回日本肝臓学会東部会(パネルディスカッション 2 急性肝不全・ACLFの現状と課題)  2024.12 

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    Event date: 2024.12

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

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  • Zinc acetate inhibits hepatitis A virus replication in vitro

    Tatsuo Kanda, Reina Sasaki-Tanaka, Hiroyuki Abe, Naruhiro Kimura, Masaki Mito, Moeno Sugita, Yoshihisa Arao, Satoshi Abe, Akira Sakamaki, Hiroteru Kamimura, Kazunao Hayashi, Takeshi Yokoo, Kenya Kamimura, Atsunori Tsuchiya, Takeshi Suda, Hiroaki Okamoto, Shuji Terai

    The Liver Meeting (TLM) 2024 - AASLD  2024.11 

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    Event date: 2024.11

    Language:English   Presentation type:Poster presentation  

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  • HAV感染雄マウスXenograftモデルを用いた抗HAV薬剤開発

    佐々木-田中-玲奈, 神田達郎, 寺井崇二

    第28回日本肝臓学会大会 (ワークショップ5 肝臓・消化器領域における新興・再興感染症)  2024.10 

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    Event date: 2024.10 - 2024.11

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

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  • Hepaic Dysfunction in 879 ICI-treated Patients; Does Referral to a Hepatologist Improve OS?

    Kaori Matsumoto, Tatsuo Kanda, Masao Omata

    APASL Oncology 2024 Genomics Meets Immunology: Interdisciplinary Approach for Liver Cancer  2024.9 

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    Event date: 2024.9

    Language:English   Presentation type:Poster presentation  

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  • よくわかる肝臓健康講座 Invited

    神田達郎

    よくわかる肝臓健康講座(主催: 魚沼地域振興局健康福祉部; 共催: 地域医療魚沼学校; 於: 魚沼市立小出病院2階講堂)  2024.9 

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    Event date: 2024.9

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

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  • 本邦におけるA型肝炎診療の問題点とその対策: AMED HAV/HEV Study Group

    神田達郎, 佐々木玲奈, 岡本宏明

    第60回日本肝臓学会総会  2024.6 

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    Event date: 2024.6

    Language:Japanese  

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  • In Vitroおよびin vivoモデルを用いたA型肝炎ウイルスに対する創薬研究

    佐々木玲奈, 神田達郎, 岡本宏明

    第60回日本肝臓学会総会  2024.6 

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    Language:Japanese  

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  • Long-term follow up of patient with occurrence of autoimmune hepatitis post-COVID-19 vaccination.

    Shuhei Arima, Tatsuo Kanda, Masayuki Honda, Mai Totsuka, Reina Sasaki-Tanaka, Shini Kanezawa, Tomotaka Ishii, Naoki Matsumoto, Ryota Masuzaki, Hiroaki Yamagami, Masahiro Ogawa, Hirofumi Kogure

    The 33rd Annual Meeting of the Asian Pacific Association for the Study of the Liver.  2024.3 

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    Event date: 2024.3

    Language:English   Presentation type:Oral presentation (general)  

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  • Hepatitis A and E viruses: recent advances in research and clinical practice recommendations Invited

    Tatsuo Kanda

    The 33rd Annual Meeting of the Asian Pacific Association for the Study of the Liver  2024.3 

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    Event date: 2024.3

    Language:English   Presentation type:Symposium, workshop panel (nominated)  

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  • Elderly patient with unresectable advanced HCC who received atezolizumab plus bevacizumab and achieved complete response by mRECIST Criteria

    Tatsuo Kanda, Shuhei Arima, Masayuki Honda, Mai Totsuka, Reina Sasaki-Tanaka, Shini Kanezawa, Tomotaka Ishii, Naoki Matsumoto, Ryota Masuzaki, Hiroaki Yamagami, Masahiro Ogawa, Hirofumi Kogure

    The 33rd Annual Meeting of the Asian Pacific Association for the Study of the Liver  2024.3 

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    Event date: 2024.3

    Language:English   Presentation type:Oral presentation (general)  

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  • In vitro and in vivo hepatitis A virus infection models for anti-HAV drugs screening.

    Reina Sasaki-Tanaka, Tatsuo Kanda, Noriko Nakajima, Hiroaki Okamoto

    The 33rd Annual Meeting of the Asian Pacific Association for the Study of the Liver.  2024.3 

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    Event date: 2024.3

    Language:English   Presentation type:Oral presentation (general)  

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  • Powell-Sarin Achievement Award "Recent advances of viral hepatitis, and current situation of hepatitis A and E in Japan" Invited

    Tatsuo Kanda

    The 33rd Annual Meeting of the Asian Pacific Association for the Study of the Liver  2024.3 

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    Event date: 2024.3

    Language:English   Presentation type:Oral presentation (invited, special)  

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  • アテゾリズマブ+ベバシズマブ併用療法にてCRを得た進行肝細胞癌の一例

    神田達郎, 有間修平, 本田真之, 松本直樹, 十束茉衣, 田中(佐々木)玲奈, 金澤芯依, 増﨑亮太, 小川眞広, 山上裕晃, 木暮宏史

    第29回日本肝がん分子標的治療研究会  2024.1 

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    Language:Japanese   Presentation type:Poster presentation  

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  • ウイルス性肝炎と悪性腫瘍の治療など Invited

    神田達郎

    SAKURA病診連携講演会  2023.11 

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    Event date: 2023.11

    Language:Japanese  

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  • 講演4 肝疾患と腸内細菌 Invited

    司会, 神田達郎

    日本消化器病学会関東支部 第43回教育講演会  2023.11 

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    Event date: 2023.11

    Language:Japanese  

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  • ウイルス性肝炎 最近の話題 Invited

    神田達郎

    Hepatology Seminar in Atami 2023  2023.11 

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    Event date: 2023.11

    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

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  • Workshop 13 Tumor Markers & Biochemistry, CCC, other Invited

    Tatsuo Kanda, Chair

    APASL Oncology 2023  2023.10 

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    Event date: 2023.10

    Language:Japanese  

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  • 講演I 「早く見つけよう! 肝臓の病気」増﨑亮太 Invited

    司会) 神田達郎

    日本消化器病学会関東支部第128回市民公開講座  2023.9 

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    Event date: 2023.9

    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

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  • Chairs. Parallel Session 3. Invited

    Tatsuo Kanda, Shuhei Yamashina

    JSH-ILC 2023. The 3rd JHS International Liver Conference, Hotel New Otani Tokyo, Tokyo, Japan.  2023.9 

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    Event date: 2023.9

    Language:English   Presentation type:Oral presentation (general)  

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  • Clinical features of HCV-infected older patients treated with glecaprevir plus piblentasvir.

    Tatsuo Kanda, Mai Totsuka, Shuhei Arima, Masayuki Honda, Reina Sasaki, Naoki Matsumoto, Ryota Masuzaki, Masahiro Ogawa, Hirofumi Kogure

    JSH-ILC 2023. The 3rd JHS International Liver Conference, Hotel New Otani Tokyo, Tokyo, Japan.  2023.9 

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    Event date: 2023.9

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  • Acute-on-chronic liver failure associated with alcohol-associated liver disease and hepatitis E virus infection

    Tatsuo Kanda, Shuhei Arima, Mai Totsuka, Masayuki Honda, Reina Sasaki-Tanaka, Ryota Masuzaki, Naoki Matsumoto, Tomotaka Ishii, Masahiro Ogawa, Masaharu Takahashi, Hiroaki Okamoto, Hirofumi Kogure

    JSH-ILC 2023. The 3rd JHS International Liver Conference, Hotel New Otani Tokyo, Tokyo, Japan.  2023.9 

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    Event date: 2023.9

    Language:English   Presentation type:Oral presentation (general)  

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  • 肝生検が診断に有用であり, ステロイドが著効した肝サルコイドーシスの1例

    上原兼礼, 神田達郎, 本田真之, 十束茉衣, 有間修平, 金澤芯依, 佐々木玲奈, 松本直樹, 増﨑亮太, 山上裕晃, 木暮宏史, 羽尾裕之

    日本消化器病学会関東支部第376回例会, 海運クラブ, 東京都千代田区  2023.9 

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    Event date: 2023.9

    Language:Japanese   Presentation type:Oral presentation (general)  

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  • Moderator. Session 5. Liver-directed Loco-regional therapies for advanced HCC.

    Tatsuo Kanda

    APASL Liver Cancer Preceptorship (ALCAP) Program.  2023.8 

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    Event date: 2023.8

    Language:English   Presentation type:Symposium, workshop panel (nominated)  

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  • グレカプレビル・ピブレンタスビル併用療法を行った80歳以上C型肝炎の特徴.

    神田 達郎, 中島典子, 有間 修平, 佐々木 玲奈, 十束 茉衣, 石井 大雄, 本田 真之, 松本 直樹, 増崎 亮太, 小川 眞広, 木暮宏史

    第19回消化器病における性差医学・医療研究会  2023.7 

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    Event date: 2023.7

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

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  • 75歳以上の高齢者C型肝炎に対するDAA治療の治療効果, 有害事象, 予後に関する検討

    神田 達郎, 森山 光彦, 有間 修平, 佐々木 玲奈, 十束 茉衣, 石井 大雄, 本田 真之, 松本 直樹, 増崎 亮太, 小川 眞広, 木暮 宏史

    第25回日本高齢消化器病学会総会  2023.7 

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    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

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  • 経口感染によるウイルス性肝炎(A型及びE型)の感染防止、病態解明、治療等に関する研究. Invited

    神田達郎

    令和5年度肝炎等克服緊急対策研究事業(肝克)キックオフミーティング  2023.7 

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    Event date: 2023.7

    Language:Japanese  

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  • COVID-19治療中に非昏睡型肝不全を併発したアラジール症候群の1例.

    羽尾裕平, 神田達郎, 本田真之, 有間修平, 増崎亮太, 佐々木玲奈, 松本直樹, 山上裕晃, 小川眞広, 木暮宏史

    第688回日本内科学会関東地方会, 第1会場, 日本都市センター6階・Web  2023.7 

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    Language:Japanese   Presentation type:Oral presentation (general)  

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  • A型肝炎と抗ウイルス剤の開発 Invited

    神田達郎, 佐々木玲奈

    第5回ファーマラボEXPO東京内 第5回アカデミックフォーラム  2023.7 

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    Language:Japanese   Presentation type:Oral presentation (invited, special)  

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  • 原因不明肝硬変の臨床的特徴の変遷

    十束茉衣, 松本直樹, 本田真之, 有間修平, 増﨑亮太, 小川眞広, 神田達郎, 木暮宏史

    特別企画1. 「ポスターシンポジウム関東 肝硬変の成因と病態の推移(発表)」第59回日本肝臓学会総会, ミニオーラル会場 ブース3(奈良県コンベンションセンター 1階 コンベンションホールB+C)  2023.6 

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  • アルコール依存症を伴うアルコール性肝障害患者に対するナルメフェンの効果

    神田達郎, 佐々木玲奈, 増﨑亮太, 本田真之, 有間修平, 石井大雄, 松本直樹, 金澤芯依, 小川眞広, 木暮宏史

    第59回日本肝臓学会総会  2023.6 

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  • 脂肪性肝疾患と慢性腎臓病における非侵襲的肝線維化指標の有用性.

    増﨑亮太, 松本直樹, 小川眞広, 十束茉衣, 本田真之, 有間修平, 金澤芯依, 山上裕晃, 神田達郎, 木暮宏史

    第59回日本肝臓学会総会  2023.6 

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  • ドラッグリポジッショニングによるA型肝炎ウイルスに対する既存薬剤スクリーニング.

    佐々木玲奈, 神田達郎, 木暮宏史

    第59回日本肝臓学会総会  2023.6 

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  • MRエラストグラフィによる肝細胞癌腫瘍硬度のバイオマーカーとしての有用性.

    阿部勇人, 岡村行泰, 神田達郎

    第59回日本肝臓学会総会  2023.6 

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  • 献血時HEV Nucleic acid Amplification Test陽性で来院した2症例について.

    池上千香子, 神田達郎, 本田真之, 有間修平, 石井大雄, 佐々木玲奈, 増﨑亮太, 松本直樹, 山上裕晃, 金澤芯依, 小川眞広, 木暮宏史

    特別企画4-2. 「研修医・専攻医セッション~症例から学ぶ~2」第59回日本肝臓学会総会, 第8会場(奈良県コンベンションセンター 2階 会議室202)  2023.6 

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  • アルコール性肝硬変に併発したE型肝炎重症化救命例について

    神田達郎, 有間修平, 本田真之, 田中玲奈, 増﨑亮太, 石井大雄, 松本直樹, 小川眞広, 高橋雅春, 岡本宏明, 木暮宏史

    第49回日本急性肝不全研究会, 奈良県コンベンションセンター 2階 会議室203  2023.6 

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    Presentation type:Oral presentation (general)  

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  • 肝疾患治療を考える~C型肝炎とSVR後の諸問題~ Invited

    神田達郎

    【WEB Seminar】 明日の診療を考える, ギリアド・サイエンシズ株式会社本社, M3配信  2023.6 

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    Presentation type:Oral presentation (invited, special)  

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  • 特別講演 肝疾患最近の話題~ウイルス性肝炎、C型肝炎を中心に~ Invited

    神田達郎

    第122回熊谷地区生活習慣病講演会, 熊谷市医師会, 熊谷市  2023.5 

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    Presentation type:Oral presentation (invited, special)  

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  • Lecture

    神田達郎

    第5回城北肝疾患セミナー  2023.3  ギリアド・サイエンシズ株式会社

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    Event date: 2023.3

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:京王プラザホテル「スターライト」43階,東京都新宿区西新宿2-2-1   Country:Japan  

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  • Session 8- Primary prophylaxis of variceal bleeding and acute variceal bleeding. Invited International coauthorship International conference

    Tatsuo Kanda

    How do I treat in Hepatology- Case based algorithmic approach. APASL SCHOOL E-LARNING SEMINAR SERIES FOR STUDENTS/FELLOWS-SERIES 3  2023.2  Institute of Liver and Biliary Sciences New Delhi, India

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    Event date: 2023.2

    Language:English   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:(Zoom) Institute of Liver and Biliary Sciences New Delhi, India   Country:India  

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  • C型肝炎ウイルス持続陰性化後に発症した原発不明AFP産生腺癌の一例

    池上千香子, 本田真之, 渋谷真史, 有間修平, 石井大雄, 佐々木玲奈, 金澤芯依, 國吉宣行, 藤澤真理子, 野村修三, 齋藤 圭, 増﨑亮太, 松本直樹, 山上裕晃, 小川眞広, 神田達郎, 岡村行泰, 木暮宏史.

    日本消化器病学会関東支部第373回例会  2023.2  日本消化器病学会関東支部

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:海運クラブ, 東京都千代田区平河町  

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  • 肝疾患治療を考える~C型肝炎とSVR後の諸問題~ Invited

    神田達郎

    肝疾患治療を考える~  2022.12  ギリアド・サイエンシズ株式会社

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    Event date: 2022.12

    Language:Japanese  

    Venue:ギリアド・サイエンシズ株式会社本社, Zoom配信   Country:Japan  

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  • Successful retreatment of direct-acting antiviral therapy against hepatitis C virus infection in a patient who underwent a liver transplant from HLA-matched sibling donor. International conference

    Tatsuo Kanda, Reina Sasaki-Tanaka, Naoki Matsumoto, Tomotaka Ishii, Ryota Masuzaki, Masahiro Ogawa, Shintaro Yamazaki, Osamu Aramaki, Hirofumi Kogure, Yukiyasu Okamura.

    APASL Oncology 2022 “Liver Cancer: Clinical and Basic Research”  2022.9  The Asian Pacific Association of Study of the Liver

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    Event date: 2022.9

    Language:English   Presentation type:Poster presentation  

    Venue:Takamatsu, Kagawa, Japan   Country:Japan  

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  • Poster Free Paper 2; “Viral Hepatitis-related HCC-HCV-related HCC”. Invited International conference

    Tatsuo Kanda

    APASL Oncology 2022 “Liver Cancer: Clinical and Basic Research”  2022.9  The Asian Pacific Association of Study of the Liver

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    Event date: 2022.9

    Language:English  

    Venue:Takamatsu, Kagawa, Japan   Country:Japan  

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  • During the chemotherapy against lung cancer in patients with HCV and decompensated cirrhosis, DAA could support sufficient lung cancer treatment. International conference

    Tatsuo Kanda, Shinji Shibuya, Shuhei Arima, Masayuki Honda, Tomotaka Ishii, Reina Sasaki-Tanaka, Shini Kanezawa, Ryota Masuzaki, Naoki Matsumoto, Hirofumi Kogure, Hiroaki Yamagami, Masahiro Ogawa.

    APASL Oncology 2022 “Liver Cancer: Clinical and Basic Research”  2022.9  The Asian Pacific Association of Study of the Liver

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    Event date: 2022.9

    Language:English   Presentation type:Poster presentation  

    Venue:Takamatsu, Kagawa, Japan   Country:Japan  

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  • Short-Term Effects of Nalmefene as Needed Use in Alcoholism with or without Cirrhosis in the Northern Part of Tokyo, Japan. International conference

    Tatsuo Kanda, Shinji Shibuya, Shuhei Arima, Masayuki Honda, Tomotaka Ishii, Reina Sasaki-Tanaka, Shini Kanezawa, Ryota Masuzaki, Hirofumi Kogure, Masahiro Ogawa.

    APASL Oncology 2022 “Liver Cancer: Clinical and Basic Research”  2022.9  The Asian Pacific Association of Study of the Liver

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    Event date: 2022.9

    Language:English   Presentation type:Poster presentation  

    Venue:Takamatsu, Kagawa, Japan   Country:Japan  

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  • Post-SVR Events, compared to the APASL HCV Guidelines 2019 of Virus Eradicated Patients by DAA on How to Monitor HCC Occurrence and HBV Reactivation. Invited International conference

    Tatsuo Kanda

    APASL Oncology 2022 “Liver Cancer: Clinical and Basic Research”  2022.9  The Asian Pacific Association of Study of the Liver

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    Event date: 2022.9

    Language:English   Presentation type:Symposium, workshop panel (nominated)  

    Venue:Takamatsu, Kagawa, Japan   Country:Japan  

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  • Panelist. APASL Hepatology Webinar Episode 6-1. “Recent Advancement of HCV Beyond Cure” Invited International coauthorship International conference

    APASL Hepatology Webinar Episode 6-1. “Recent Advancement of HCV Beyond Cure”  2022.6  The Asian Pacific Association for the Study of the Liver [APASL]

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    Event date: 2022.6

    Language:English   Presentation type:Symposium, workshop panel (nominated)  

    Venue:Zoom   Country:Taiwan, Province of China  

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  • 最近経験したE型肝炎ウイルス感染の5例.

    石井大雄, 山名陽一郎, 熊川まり子, 金澤芯依, 佐々木玲奈, 水谷卓, 増﨑亮太, 山上裕晃, 松本直樹, 楡井和重, 神田達郎, 森山光彦, 金子朋広.

    第58回日本肝臓学会総会  2022.6  日本肝臓学会

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    Language:Japanese   Presentation type:Poster presentation  

    Venue:パシフィコ横浜会議センター   Country:Japan  

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  • 肝疾患患者におけるLeg cramps (足のつり)に関する検討

    神田達郎, 佐々木玲奈, 石井大雄, 本田真之, 有間修平, 山名陽一郎, 熊川まり子, 金澤芯依, 増﨑亮太, 水谷卓, 松本直樹, 楡井和重, 山上裕晃, 小川眞広, 森山光彦.

    第58回日本肝臓学会総会  2022.6  日本肝臓学会

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    Language:Japanese   Presentation type:Poster presentation  

    Venue:パシフィコ横浜会議センター   Country:Japan  

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  • 司会. 口演1「C型肝炎臨床-1」

    神田達郎

    第58回日本肝臓学会総会  2022.6  日本肝臓学会

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    Event date: 2022.6

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:パシフィコ横浜会議センター   Country:Japan  

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  • RNA結合蛋白ELAVL1のB型肝炎ウイルス複製と肝細胞癌増殖への関わり.

    神崎洋彰, 千葉哲博, 興梠慧輔, 日下部裕子, 小林和史, 叶川直哉, 清野宗一郎, 中村昌人, 近藤孝行, 齊藤朋子, 中川良, 小笠原定久, 室山良介, 中本晋吾, 神田達郎, 丸山紀史, 加藤順, 關場一磨, 大塚基之, 大塚将之, 加藤直也.

    第58回日本肝臓学会総会  2022.6  日本肝臓学会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:パシフィコ横浜会議センター   Country:Japan  

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  • FavipiravirによるHAV Genome RNAに対する塩基変異誘導効果. ワークショップ1 ウイルス肝炎研究 – ウイルスゲノム・ホストゲノム・免疫

    佐々木玲奈, 神田達郎, 森山光彦.

    第58回日本肝臓学会総会  2022.6  日本肝臓学会

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    Event date: 2022.6

    Language:Japanese  

    Venue:パシフィコ横浜会議センター   Country:Japan  

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  • C型肝炎治療~肝不全や肝発癌回避に向けて~. Invited

    神田達郎

    第48回日本急性肝不全研究会 共催モーニングセミナー.  2022.6  第48回日本急性肝不全研究会

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    Event date: 2022.6

    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:パシフィコ横浜会議センター   Country:Japan  

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  • A case of BRTO performed with Cerecon MP catheter and CANDIS together.ビデオワークショップ 2「How I do it (血管内治療)」

    石井大雄, 本田真之, 有間修平, 松本直樹, 増崎亮太, 山上裕晃, 小川眞広, 神田達郎, 松岡俊一.

    第58回日本肝癌研究会  2022.5  日本肝癌研究会

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    Event date: 2022.5

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

    Venue:虎ノ門ヒルズフォーラム   Country:Japan  

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  • 非B非C肝硬変からの肝発癌リスク因子の検討. シンポジウム1「新たな肝癌サーベイランスモデルの構築(非ウイルス性慢性肝疾患のスクリーニングを中心に)」

    松本直樹, 金子朋広, 金子真大, 本田真之, 有間修平, 石井大雄, 渡邊幸信, 増崎亮太, 山上裕晃, 小川眞広, 神田達郎, 松岡俊一, 木暮宏史.

    第58回日本肝癌研究会  2022.5  日本肝癌研究会

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    Event date: 2022.5

    Language:Japanese  

    Venue:虎ノ門ヒルズフォーラム, 東京都港区   Country:Japan  

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  • A型肝炎ウイルス増殖制御におけるMAP2K3の役割について. ワークショップ9. ウイルス肝炎基礎研究の新たな展開.

    神田達郎, 田中玲奈, 森山光彦.

    第108回日本消化器病学会総会  2022.4  日本消化器病学会

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    Event date: 2022.4

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

    Venue:京王プラザホテル(新宿), 東京   Country:Japan  

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  • 原因不明消化管出血を機に診断された多発性骨髄腫の1例

    笠巻敬太, 岩本真帆, 酒井康行, 田村めぐみ, 春田明子, 中島典子, 神田達郎, 森山光彦, 高橋宏道, 八田善弘

    日本内科学会関東支部主催 第675回関東地方会  2022.2  日本内科学会関東支部

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    Event date: 2022.2

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:Web開催   Country:Japan  

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  • 座長. 消化器1 演題番号1~8 日本内科学会関東支部主催 第675回関東地方会 Invited

    神田達郎

    日本内科学会関東支部主催 第675回関東地方会  2022.2  日本内科学会関東支部

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    Event date: 2022.2

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:Web開催   Country:Japan  

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  • C型非代償性肝硬変に対するDAA治療直後重症COVID-19肺炎を併発した1例

    池上千賀子, 神田達郎, 本田真之, 石井大雄, 山名陽一郎, 松本直樹, 楡井和重, 山上裕晃, 水谷卓, 森山光彦

    日本内科学会関東支部主催 第675回関東地方会  2022.2  日本内科学会関東支部

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    Event date: 2022.2

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:Web開催   Country:Japan  

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  • Clinical Symptom of Liver Diseases: Pathogenesis and Treatment. Invited International conference

    Tatsuo Kanda

    APASL Oncology 2021 “Your Gateway to Oncology in Asia-Pacific Region”  2021.12  APASL

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    Event date: 2021.12

    Language:English   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:Tokyo (Hybrid Meeting)   Country:Japan  

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  • 座長. 消化器2 演題番号21~25 日本内科学会関東支部主催 第674回関東地方会 Invited

    神田達郎

    日本内科学会関東支部主催 第674回関東地方会  2021.12  日本内科学会関東支部

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    Event date: 2021.12

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:ハイブリッド開催. 第1会場, 日本都市センター6階 (オンライン発表), 東京   Country:Japan  

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  • 非アルコール性脂肪肝(NAFL)と非アルコール性脂肪性肝炎(NASH)の鑑別における臨床・遺伝情報に基づく包括的 risk scoreの意義.

    神田達郎, 森山光彦.

    日本人類遺伝学会第66回大会 第28回日本遺伝子診療学会大会 合同開催  2021.10  日本人類遺伝学会,日本遺伝子診療学会

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    Event date: 2021.10

    Language:Japanese   Presentation type:Symposium, workshop panel (nominated)  

    Venue:パシフィコ横浜 会議センター 第2会場  

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  • C型肝炎・B型肝炎治療の最新の話題 Invited

    神田達郎

    ギリアド・サイエンシズ株式会社・社内研修会  2021.9  ギリアド・サイエンシズ株式会社

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    Event date: 2021.9

    Language:Japanese  

    Venue:ギリアド・サイエンシズ株式会社本社  

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  • 肝転移・肝門部リンパ節転移を伴う上咽頭癌にニボルマブによる肝障害と帯状疱疹を併発した1例.

    十束茉衣, 神田達郎, 本田真之, 石井大雄, 山名陽一郎, 佐々木玲奈, 金澤芯依, 熊川まり子, 増崎亮太, 水谷卓, 松本直樹, 楡井和重, 山上裕晃, 三浦勝浩, 森山光彦.

    日本消化器病学会関東支部第366回例会  2021.9  日本消化器病学会関東支部

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    Event date: 2021.9

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:オンライン開催  

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  • 基調講演. 高齢者C型肝炎の予後に関する検討. 楡井和重. Invited

    神田達郎

    城北肝がんWEBセミナー  2021.9  中外製薬

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    Event date: 2021.9

    Language:Japanese  

    Venue:オンライン配信(ZOOM), 中外製薬 大塚オフィス, 豊島区南大塚2-45-8ニッセイ大塚駅前ビル7階より配信  

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  • Zinc chloride enhances dsRNA-induced beta-interferon promoter activity through the inhibition of Mitogen-activated protein kinase kinase 3 expression in human hepatocytes. International conference

    Tatsuo Kanda, Reina Sasaki Tanaka, Ryota Masuzaki, Naoki Matsumoto, Hiroaki Okamoto, Mitsuhiko Moriyama.

    APASL Single Topic Conference 2021 in Osaka(Web)  2021.9  APASL

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    Event date: 2021.9

    Language:English   Presentation type:Oral presentation (general)  

    Venue:Osaka (Web)  

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  • 若年女性にみられたANA陰性, IgG値正常の自己免疫性肝炎の1例.

    北原麻衣, 神田達郎, 石井大雄, 本田真之, 水谷卓, 山名陽一郎, 熊川まり子, 田中(佐々木)玲奈, 金澤芯依, 増崎亮太, 松本直樹, 楡井和重, 山上裕晃, 森山光彦.

    日本消化器病学会関東支部第365回例会  2021.7  日本消化器病学会関東支部

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    Event date: 2021.7

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:オンライン開催   Country:Japan  

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  • COVID-19 Era に息切れを主訴に来院する肝硬変患者について. Invited

    神田達郎

    明日から役立つ 門脈圧亢進症に伴う肺高血圧症(PoPH)診療 消化器内科医が診るPoPH診断 Up to Date.  2021.7  ヤンセン

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    Event date: 2021.7

    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:TKPガーデンシティ御茶ノ水, オンライン・ハイブリッド開催   Country:Japan  

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  • 小胞体シャペロン蛋白GRP78と亜鉛によるA型肝炎ウイルス増殖抑制作用について

    神田達郎, 田中(佐々木)玲奈, 増崎亮太, 石井大雄, 松本直樹, 楡井和重, 小川眞広, 森山光彦.

    第43回日本栄養アセスメント研究会  2021.6  日本栄養アセスメント研究会

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    Event date: 2021.6

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:WEB開催   Country:Japan  

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  • IgM HBc抗体陰性, トランスアミナーゼ正常で来院したB型急性肝炎の1例(研修医・専攻医セッション1 )

    青木央, 神田達郎, 山名陽一郎, 石井大雄, 本田真之, 金子朋弘, 高橋央, 増崎亮太, 佐々木玲奈, 熊川まり子, 金澤芯依, 楡井和重, 山上裕晃, 松本直樹, 森山光彦.

    第57回日本肝臓学会総会  2021.6  日本肝臓学会

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    Event date: 2021.6

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:京王プラザホテル札幌, ロイトン札幌 (北海道札幌市), ハイブリッド形式   Country:Japan  

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  • 司会. 特別企画3-1 研修医・専攻医セッション1 Invited

    森山 光彦, 加藤 淳二, 神田 達郎

    第57回日本肝臓学会総会  2021.6  日本肝臓学会

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    Language:Japanese  

    Venue:京王プラザホテル札幌, ロイトン札幌 (北海道札幌市), ハイブリッド開催  

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  • 肝細胞において塩化亜鉛がTLRを含む自然免疫シグナル伝達経路に与える影響. (ミニオーラル5)

    神田達郎, 佐々木玲奈, 森山光彦

    第57回日本肝臓学会総会  2021.6  日本肝臓学会

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    Event date: 2021.6

    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:京王プラザホテル札幌, ロイトン札幌(北海道札幌市), ハイブリッド形式   Country:Japan  

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  • 肝疾患最近の話題~C型肝炎を中心に~ Invited

    神田 達郎

    SAKURA病診連携講演会  2021.6  AbbVie

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    Event date: 2021.6

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:ホテルメトロポリタン池袋 3F「朝日」ハイブリッド形式  

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  • HCV Guidelines of Virus-Eradicated Patients by DAA on How to Monitor HCC Occurrence and HBV Reactivation. Invited International coauthorship International conference

    Tatsuo Kanda

    HCV Symposium, Istanbul Health and TECHNOLOGY UNIVERSITY (ISTUN)  2021.6  Istanbul Health and TECHNOLOGY UNIVERSITY (ISTUN)

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    Event date: 2021.6

    Language:English   Presentation type:Symposium, workshop panel (nominated)  

    Venue:Istanbul, Turkey (Web)   Country:Turkey  

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  • 肝疾患に伴うかゆみについて. Invited

    神田達郎

    第18回 城北消化器病研究会<LIVE配信講演会>  2021.5  大日本住友製薬

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    Event date: 2021.5

    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:ホテルメトロポリタン池袋 4F「春陽」, オンライン開催   Country:Japan  

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  • 基調講演. 当院における集学的肝癌治療. 松本 直樹. Invited

    神田達郎

    城北肝がんWEBセミナー on Hepatocellular Carcinoma  2021.5  中外製薬

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    Event date: 2021.5

    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:Web 配信, 中外製薬 大塚オフィス, 豊島区南大塚2-45-8ニッセイ大塚駅前ビル7階より配信   Country:Japan  

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  • 特別講演. 『Multi-MTA時代におけるTACE不応・不適/進行肝細胞癌治療--Lenvatinibの効果を最大限にいかすために考えるべきこと--』川村 祐介 先生 Invited

    神田達郎

    第3回板橋大山肝臓カロキアム 肝癌診療 Meet the Expert  2021.5  エーザイ株式会社

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    Event date: 2021.5

    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:Web配信, 東京都新宿区パークタワーエーザイ本社より配信   Country:Japan  

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  • 肝細胞癌に対するレンバチニブ使用後の腫瘍血流評価, 後治療についての検討.

    本田真之, 森山光彦, 松岡俊一, 有間修平, 石井大雄, 金子朋弘, 高橋央, 山名陽一郎, 水谷卓, 増崎亮太, 楡井和重, 山上裕晃, 松本直樹, 神田達郎.

    第56回日本肝癌研究会  2020.12  日本肝癌研究会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:大阪国際会議場, 大阪   Country:Japan  

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  • MRエラストグラフィーを用いた肝細胞癌根治術後の再発評価~ウイルス性肝炎患者を中心に~

    阿部勇人, 緑川泰, 山崎慎太郎, 中山壽之, 森口正倫, 檜垣時夫, 岡田真広, 神田達郎, 森山光彦, 高山忠利.

    第56回日本肝癌研究会  2020.12  日本肝癌研究会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:大阪国際会議場, 大阪  

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  • Lenvatinib投与中増悪したHCCに対しB-TACEとLenvatinib併用治療に変更した症例.

    石井大雄, 本田真之, 有間修平, 松本直樹, 神田達郎, 松岡俊一, 森山光彦.

    第56回日本肝癌研究会  2020.12  日本肝癌研究会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:大阪国際会議場, 大阪  

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  • 多発肝細胞癌に対して41回のIVRとテガフール・ウラシル内服を服用し8年の長期生存を得た1例

    有間修平, 金子朋弘, 高橋央, 石井大雄, 松本直樹, 楡井和重, 神田達郎, 松岡俊一, 森山光彦.

    第56回日本肝癌研究会  2020.12  日本肝癌研究会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:大阪国際会議場, 大阪   Country:Japan  

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  • The real world practice of systemic therapies in patients with advanced hepatocellular carcinoma in Japan: what has changed since lenvatinib approval?

    Susumu Maruta, Sadahisa Ogasawara, Yoshihiko Ooka, Masanori Inoue, Norio Itokawa, Masamichi Obu, Atsuyoshi Seki, Yuki Haga, Shinichiro Okabe, Ei Itobayashi, Masanori Atsukawa, Ryosaku Azemoto, Hideaki Mizumoto, Nobuyuki Sugiura, Takahiro Maeda, Kazufumi Kobayashi, Eiichiro Suzuki, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato

    JOURNAL OF HEPATOLOGY  2019.4  ELSEVIER

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    Event date: 2019.4

    Language:English  

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  • Survival among patients with advanced hepatocellular carcinoma in the pre-TKI versus TKI eras

    Miyuki Sensui, Sadahisa Ogasawara, Yoshihiko Ooka, Kazufumi Kobayashi, Susumu Maruta, Hiroaki Kanzaki, Kengo Kanayama, Takahiro Maeda, Yuko Kusakabe, Soichiro Kiyono, Masato Nakamura, Tomoko Saito, Eiichiro Suzuki, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato

    JOURNAL OF HEPATOLOGY  2019.4  ELSEVIER

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  • Post progression survival in patients with intermediate-stage hepatocellular carcinoma after receiving transarterial chemoembolization

    Yukiko Shima, Sadahisa Ogasawara, Yoshihiko Ooka, Kazufumi Kobayashi, Susumu Maruta, Hiroaki Kanzaki, Kengo Kanayama, Takahiro Maeda, Yuko Kusakabe, Soichiro Kiyono, Masato Nakamura, Tomoko Saito, Eiichiro Suzuki, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato

    JOURNAL OF HEPATOLOGY  2019.4  ELSEVIER

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  • Transition to the era of direct-acting antiviral changes in the prognosis of patients with hepatitis C virus-related hepatocellular carcinoma

    Yoshifumi Miura, Sadahisa Ogasawara, Yoshihiko Ooka, Kazufumi Kobayashi, Susumu Maruta, Hiroaki Kanzaki, Kengo Kanayama, Takahiro Maeda, Soichiro Kiyono, Yuko Kusakabe, Masato Nakamura, Eiichiro Suzuki, Tomoko Saito, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato

    JOURNAL OF HEPATOLOGY  2019.4  ELSEVIER

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  • Analysis of the relationship between serum creatinine/cystatin C ratio and muscle mass in patients with hepatocellular carcinoma

    Hirotaka Oura, Sadahisa Ogasawara, Yoshihiko Ooka, Kazufumi Kobayashi, Susumu Maruta, Hiroaki Kanzaki, Kengo Kanayama, Takahiro Maeda, Yuko Kusakabe, Soichiro Kiyono, Masato Nakamura, Tomoko Saito, Eiichiro Suzuki, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato

    JOURNAL OF HEPATOLOGY  2019.4  ELSEVIER

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  • Analysis of sorafenib-regorafenib sequential therapy in patients with advanced hepatocellular carcinoma using baseline date of sorafenib

    Sae Yumita, Sadahisa Ogasawara, Yoshihiko Ooka, Kazufumi Kobayashi, Susumu Maruta, Hiroaki Kanzaki, Kengo Kanayama, Takahiro Maeda, Yuko Kusakabe, Soichiro Kiyono, Masato Nakamura, Tomoko Saito, Eiichiro Suzuki, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Naoya Kato

    JOURNAL OF HEPATOLOGY  2019.4  ELSEVIER

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    Event date: 2019.4

    Language:English  

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  • 本邦のB型慢性肝炎におけるTDFのHBs抗原低下作用

    中本 晋吾, 神田 達郎, 中村 昌人, 安井 伸, 小笠原 定久, 鈴木 英一郎, 大岡 美彦, 太和田 暁之, 齊藤 朋子, 小林 和史, 清野 宗一郎, 千葉 哲博, 新井 誠人, 丸山 紀史, 加藤 直也

    肝臓  2018.4  (一社)日本肝臓学会

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  • HCV患者における経口剤による抗ウイルス療法後の早期発がんリスク因子

    大岡 美彦, 千葉 哲博, 斎藤 朋子, 清野 宗一郎, 小林 和史, 中村 昌人, 小笠原 定久, 鈴木 英一郎, 安井 伸, 太和田 暁之, 新井 誠人, 神田 達郎, 今関 文夫, 横須賀 收, 加藤 直也

    肝臓  2018.4  (一社)日本肝臓学会

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  • Effects of interferon-free treatment on chronic hepatitis C patients with autoimmune liver diseases

    Tatsuo Kanda, Masato Nakamura, Shin Yasui, Makoto Arai, Shingo Nakamoto, Tetsuhiro Chiba, Hitoshi Maruyama, Mitsuhiko Moriyama, Naoya Kato

    HEPATOLOGY  2017.10  WILEY

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    Event date: 2017.10

    Language:English  

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  • Inhibition of microRNA-200b/c improved liver inflammation and liver fibrosis in NASH model mice

    Masato Nakamura, Tatsuo Kanda, Shingo Nakamoto, Shuang Wu, Shin Yasui, Hitoshi Maruyama, Naoya Kato

    HEPATOLOGY  2017.10  WILEY

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  • 奇静脈結合と門脈結合を合併した下大静脈低形成の一例

    清野 宗一郎, 丸山 紀史, 小林 和史, 中村 昌人, 安井 伸, 神田 達郎, 小笠原 定久, 鈴木 英一郎, 大岡 美彦, 千葉 哲博, 加藤 直也

    日本門脈圧亢進症学会雑誌  2017.8  (一社)日本門脈圧亢進症学会

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    Event date: 2017.8

    Language:Japanese  

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  • Panelist, Zoom Webinar Invited

    Tatsuo Kanda

    APASL Hepatology Webinar APASL Liver Cancer Preceptorship (ALCAP) Program  2024.2 

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    Language:English   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

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  • 慢性B型肝炎と総胆管結石に併発したE型肝炎の1例

    平野怜, 神田達郎, 本田真之, 有間修平, 増崎亮太, 佐々木玲奈, 齋藤圭, 松本直樹, 小川眞広, 木暮宏史

    日本内科学会関東支部主催 第690回関東地方会、アキバプラザ・Web  2023.10 

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  • A型肝炎最近の話題 Invited

    神田達郎, 田中(佐々木)玲奈

    第13回 首都圏Liver Forum  2023.10 

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  • 特別講演「ウイルス性肝炎撲滅を目指して~啓発・創薬研究から臨床応用へ~」田中靖人 先生 Invited

    座長 神田達郎

    第13回 首都圏Liver Forum  2023.10 

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  • 座長. 講演1, 講演2. Invited

    神田達郎

    SAKURA病診連携講演会  2022.12 

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    Venue:ホテルメトロポリタン 25F「ポラリス」, 池袋, 東京  

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  • C型非代償性肝硬変のDAA治療前後の末梢血好中球/リンパ球比について.

    神田達郎, 松本直樹, 楡井和重, 石井大雄, 有間修平, 本田真之, 佐々木玲奈, 増﨑亮太, 小川眞広, 木暮宏史.

    第44回日本肝臓学会東部会  2022.11 

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    Venue:仙台国際センター  

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  • Active NASHを示唆する超音波Bモード所見の検討.

    松本直樹, 田村祐, 金子真大, 渡邊幸信, 平山みどり, 増﨑亮太, 小川眞広, 神田達郎, 木暮宏史.

    第44回日本肝臓学会東部会  2022.11 

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    Venue:仙台国際センター  

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  • 乾燥濃縮人アンチトロンビンIIIを用いた門脈血栓溶解療法を施行した7症例.

    石井大雄, 渋谷真史, 本田真之, 有間修平, 石井大雄, 金澤芯依, 佐々木玲奈, 松本直樹, 増﨑亮太, 山上裕晃, 小川眞広, 神田達郎, 木暮宏史.

    第44回日本肝臓学会東部会  2022.11 

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    Venue:仙台国際センター  

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  • 一般演題「B型肝炎/ウイルス性肝炎」 Invited

    神田達郎

    第44回日本肝臓学会東部会  2022.11 

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    Venue:仙台国際センター  

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  • オートファジーを介したAmantadineのA型肝炎ウイルス抑制効果. パネルディスカッション 2 肝疾患に適応する新規科学技術をめぐって

    佐々木(田中)玲奈, 神田達郎, 木暮宏史.

    第44回日本肝臓学会東部会  2022.11 

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    Venue:仙台国際センター  

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  • 肝内胆管癌と鑑別が困難であった術後15年目に肝転移再発をきたした子宮体癌の一例. 若手セッション.

    渋谷真史, 松本直樹, 本田真之, 有間修平, 石井大雄, 佐々木玲奈, 金澤芯依, 増﨑亮太, 山上裕晃, 小川眞広, 神田達郎, 木暮宏史.

    第44回日本肝臓学会東部会  2022.11 

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    Venue:仙台国際センター  

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  • 特別講演. 『自治医科大学における進行肝細胞癌の治療戦略』 森本 直樹.

    神田達郎

    第5回板橋大山肝臓カロキアム 肝癌診療 Meet the Expert Web配信  2022.11  エーザイ株式会社

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    Venue:東京都新宿区パークタワーエーザイ本社より配信  

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  • 肝硬変における利尿剤使用方法が腎機能に与える影響

    松本直樹, 渋谷真史, 須田清一郎, 田村祐, 金子真大, 本田真之, 有間修平, 石井大雄, 渡邊幸信, 佐々木玲奈, 平山みどり, 金澤芯依, 増﨑亮太, 山上裕晃, 小川眞広, 神田達郎, 木暮宏史.

    第64回日本消化器病学会大会  2022.10 

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    Venue:マリンメッセ福岡  

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  • 「肝硬変5」 Invited

    神田達郎

    第26回日本肝臓学会大会  2022.10 

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    Venue:マリンメッセ福岡  

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  • 閉会の辞. Invited

    神田達郎.

    第12回首都圏Liver Forum  2022.10 

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    Venue:第一ホテル東京 プリマヴェーラII, 新橋, 東京  

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  • 肝機能が比較的安定していたが肝発癌を認めたB型肝炎症例について.

    神田達郎, 森山光彦, 有間修平, 本田真之, 石井大雄, 松本直樹, 佐々木玲奈, 増﨑亮太, 木暮宏史, 小川眞広.

    第30回日本がん検診・診断学会総会  2022.9  第30回日本がん検診・診断学会総会

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    Venue:一橋大学一橋講堂  

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  • 「多施設共同研究からみる肝疾患のReal world-LEN-TACE sequential療法の使用経験を含めて-」. 厚川正則. Invited

    神田達郎

    第30回日本がん検診・診断学会総会イブニングセミナー  2022.9 

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    Venue:一橋大学一橋講堂  

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  • 肝硬変を含む慢性肝疾患における皮膚掻痒症の意義と今後の対策

    神田達郎, 佐々木 玲奈, 森山 光彦

    第44回日本肝臓学会西部会  2021.11  日本肝臓学会

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    Venue:岡山コンベンションセンター, 第9会場  

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  • 慢性肝疾患における皮膚掻痒症の頻度とその治療法について

    神田達郎, 増崎 亮太, 佐々木 玲奈, 石井 大雄, 山名 陽一郎, 本田 真之, 水谷 卓, 松本 直樹, 楡井 和重, 森山 光彦

    第25回日本肝臓学会大会  2021.11  日本肝臓学会

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    Venue:神戸国際展示場1号館 デジタルポスター会場  

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  • 当院における慢性C型肝炎におけるSVR後発癌のサーベイランス

    楡井 和重, 本田 真之, 増崎 亮太, 松本 直樹, 山上 裕晃, 神田 達郎, 森山 光彦

    第25回日本肝臓学会大会  2021.11  日本肝臓学会

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    Venue:神戸国際展示場3号館 デジタルポスター会場  

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  • デジタルポスターセッション肝5(肝臓学会) C型肝炎3 Invited

    神田達郎(座長)

    第25回日本肝臓学会大会  2021.11  日本肝臓学会

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    Venue:第16会場(神戸国際展示場3号館 デジタルポスター会場)  

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  • APASL SCHOOL E-LEARNING SERIES FOR STUDENTS/FELLOWS-SERIES 2- HOW DO I DO IT IN HEPATOLOGY? Invited International coauthorship International conference

    Tatsuo Kanda, Wasim Jafri, Ian Homer Y. Cua, Pier Amodio.

    APASL SCHOOL E-LEARNING SERIES FOR STUDENTS/FELLOWS-SERIES 2- HOW DO I DO IT IN HEPATOLOGY?, Zoomにて  2021.4  Institute of Liver and Biliary Sciences New Delhi, India, Web配信

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    Venue:New Delhi   Country:India  

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  • サイトメガロウイルス初感染を併発した潰瘍性大腸炎の1例.

    杵渕広志, 岩本真帆, 岩男彩, 田村めぐみ, 酒井康行, 山川俊, 春田明子, 中島典子, 神田達郎, 今津博雄, 森山光彦, 後藤田卓志.

    日本消化器病学会関東支部第364回例会.  2021.4  日本消化器病学会関東支部

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    Venue:東京, Web開催.   Country:Japan  

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  • 心窩部痛を主訴に来院したベンズブロマロンによる薬物性肝障害の一例.

    星野慶次郎, 石井大雄, 本田真之, 金子朋弘, 山名陽一郎, 高橋央, 佐々木玲奈, 熊川まり子, 増崎亮太, 水谷卓, 松本直樹, 山上裕晃, 神田達郎, 森山光彦.

    日本消化器病学会関東支部第364回例会  2021.4  日本消化器病学会関東支部

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  • 肝疾患と脂質代謝異常改善について Invited

    神田達郎

    KOWA Web Conference  2021.4  興和株式会社

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    Venue:興和株式会社東京支店, 中央区日本橋, 東京   Country:Japan  

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  • 心不全合併肝硬変症例の臨床的特徴.

    松本直樹, 高橋央, 金子真大, 金子朋弘, 本田真之, 有間修平, 石井大雄, 佐々木玲奈, 熊川まり子, 渡邊幸信, 金澤芯依, 水谷卓, 増崎亮太, 山上裕晃, 楡井和重, 小川眞広, 神田達郎, 森山光彦.

    第107回日本消化器病学会総会  2021.4  日本消化器病学会

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  • Role of hepatitis A virus infection in acute-on-chronic liver failure.

    Tatsuo Kanda, Reina Sasaki, Mitsuhiko Moriyama.

    The 10th International Forum of The Japanese Society of Gastroenterology Acute-on-Chronic Liver Failure (ACLF): Difference among APASL, EASL, AASLD and Japan.  2021.4  日本消化器病学会

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    Venue:京王プラザホテル (新宿), 東京都新宿区, オンライン・ハイブリッド開催   Country:Japan  

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  • 肝細胞癌薬物治療の現状と今後~カボザンチニブへの期待~ 大久保裕直. Invited

    神田 達郎

    <HCC領域> Takeda Expert Web Seminar Web配信  2021.3  武田薬品工業

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    Venue:東京新宿オフィスより配信   Country:Japan  

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  • 肝疾患・最近の話題~肝疾患に伴う痒みと治療について」~肝疾患に伴う痒みと治療について. Invited

    神田達郎.

    大日本住友webセミナー.  2021.3  大日本住友

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    Venue:東京, Web開催   Country:Japan  

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  • メサラジンにより心タンポナーデをきたした潰瘍性大腸炎の1例.

    北原麻衣, 岩本真帆, 岩男彩, 田村めぐみ, 酒井康行, 山川俊, 春田明子, 杵渕広志, 中島典子, 神田達郎, 今津博雄, 森山光彦, 後藤田卓志.

    日本消化器病学会関東支部第363回例会.  2021.2  日本消化器病学会関東支部

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    Venue:東京, Web開催.   Country:Japan  

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  • Inhibitory effects of zinc chloride on hepatitis A virus replication through the cytokines in hepatocytes. International conference

    Tatsuo Kanda, Reina Sasaki, Ryota Masuzaki, Naoki Matsumoto, Hiroaki Okamoto, Mitsuhiko Moriyama.

    APASL 2021 Annual Meeting Bangkok (Web).  2021.2  The Asian Pacific Association for the Study of the Liver [APASL]

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    Venue:Bangkok (Web)   Country:Thailand  

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  • Screening for inhibitors of hepatitis A virus internal ribosomal entry site and HAV replication. International conference

    Reina Sasaki, Tatsuo Kanda, Ryota Masuzaki, Naoki Matsumoto, Hiroaki Okamoto, Mitsuhiko Moriyama.

    APASL 2021 Annual Meeting Bangkok (Web).  2021.2  The Asian Pacific Association for the Study of the Liver [APASL]

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    Venue:Bangkok (Web)   Country:Thailand  

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  • アルコール性肝硬変にE型肝炎ウイルス(HEV) 感染とアルコール多飲をAcute insultとしたAcute on chronic liver failure (ACLF)の1例.

    神田達郎, 石井大雄, 本田真之, 金子朋弘, 高橋央, 山名陽一郎, 熊川まり子, 佐々木玲奈, 金澤芯依, 増崎亮太, 山上裕晃, 楡井和重, 水谷卓, 松本直樹, 森山光彦.

    第1回 劇症肝炎研究会.  2021.1  劇症肝炎研究会

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    Venue:国際医療福祉大学, 成田, Web開催.   Country:Japan  

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  • 特別講演. LEN-TACE Sequential療法~今後の位置づけと具体的アプローチ~ 土谷 薫. Invited

    神田 達郎

    第2回板橋大山肝臓カロキアム 肝癌診療 Meet the Expert Web配信  2021.1  エーザイ株式会社

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    Venue:東京都豊島区南池袋2-22-1 第3高村ビル 5FよりWeb 配信   Country:Japan  

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  • ワークショップ4 宿敵B型肝炎ウイルスに挑む. Invited

    村田一素、鈴木文孝、神田達郎

    第43回日本肝臓学会東部会  2020.12  日本肝臓学会

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    Venue:オンライン開催  

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  • HBV再活性化の早期発見・早期治療介入の重要性について.

    神田達郎, 松本直樹, 森山光彦.

    第43回日本肝臓学会東部会  2020.12  日本肝臓学会

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    Venue:オンライン開催  

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  • 塩化亜鉛によるA型肝炎ウイルス感染肝細胞の炎症性サイトカイン抑制について

    神田達郎, 佐々木玲奈, 森山光彦.

    第43回日本肝臓学会東部会  2020.12  日本肝臓学会

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    Venue:オンライン開催  

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  • 2018年以降当院でみられたA型肝炎症例について

    本田真之, 神田達郎, 森山光彦.

    第43回日本肝臓学会東部会  2020.12  日本肝臓学会

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    Venue:オンライン開催  

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  • グレカプレビル・ピブレンタスビル併用療法によりSVRが得られたHCV GT-4a肝硬変症例の1例

    十束茉衣, 本田真之, 神田達郎, 水谷卓, 山名陽一郎, 有間修平, 石井大雄, 高橋央, 金子朋弘, 熊川まり子, 佐々木玲奈, 増崎亮太, 山上裕晃, 松本直樹, 楡井和重, 松岡俊一, 岡本宏明, 森山光彦.

    第43回日本肝臓学会東部会  2020.12  日本肝臓学会

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    Venue:オンライン開催  

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  • 右腎盂癌に対するぺムブロリズマブ投与後, 急性肝不全を発症した1例

    淺谷真也, 神田達郎, 金子朋弘, 本田真之, 石井大雄, 水谷卓, 松本直樹, 山上裕晃, 楡井和重, 森山光彦.

    日本内科学会関東支部主催 第664回関東地方会  2020.11  日本内科学会関東支部主催

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    Venue:ステーションコンファレンス東京, 千代田区, 東京  

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  • 塩化亜鉛によるA型肝炎ウイルス増殖抑制効果の検討.

    神田達郎, 佐々木玲奈, 増崎亮太, 高橋央, 熊川まり子, 松本直樹, 楡井和重, 小川眞広, 森山光彦.

    第24回日本肝臓学会大会  2020.11  日本肝臓学会

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    Language:Japanese   Presentation type:Poster presentation  

    Venue:神戸コンベンションセンター, 神戸  

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  • 特別講演. 肝癌診療マニュアル改訂のポイントとTACE不適に対する治療戦略 上嶋一臣. Invited

    神田達郎. 座長.

    第1回板橋大山肝臓カロキアム 肝癌診療 Meet the Expert (第二報)Web配信  2020.10  エーザイ株式会社

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    Language:Japanese   Presentation type:Symposium, workshop panel (nominated)  

    Venue:ホテルメトロポリタン池袋より配信  

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  • Acute-on-chronic liver failure (AARC vs. Japan). International conference

    Tatsuo Kanda

    8th Annual Meeting of APASL-ACLF Research consortium. India (Zoom).  2020.10  APASL

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    Language:English   Presentation type:Oral presentation (invited, special)  

    Venue:India (Zoom).  

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  • 座長. Session 2. 当院におけるDAA治療実績と院内連携の取り組み. Invited

    神田達郎, 朝比奈靖浩.

    Hepatology Summit In Tokyo ~C型肝炎の撲滅に向けて 肝臓専門医の取り組みを考える~  2020.10  アッヴィ合同会社

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    Language:Japanese  

    Venue:配信元: 帝国ホテル東京, 本館3階, 雅の間  

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  • Drug Development for Fatty Liver Diseases. Invited International conference

    Arun Sanyal (USA)

    APASL HEPATOLOGY Webinar Episode 3 [Session 7]  2020.9  APASL

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    Language:English   Presentation type:Oral presentation (invited, special)  

    Venue:Tokyo  

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  • HAVによるAcute-on-chronic liver failureについて Invited

    神田達郎

    第10回首都圏Liver Forum  2020.8  アッヴィ合同会社

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    Venue:配信元: 第一ホテル東京  

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  • 亜鉛化合物によるA型肝炎ウイルス増殖抑制効果の検討.

    346.神田達郎, 高橋央, 本田真之, 金子朋弘, 有間修平, 佐々木玲奈, 熊川まり子, 金澤芯依, 増崎亮太, 石井大雄, 山名陽一郎, 水谷卓, 松本直樹, 樋口晃久, 中村仁美, 楡井和重, 山上裕晃, 小川眞広, 松岡俊一, 森山光彦.

    第56回日本肝臓学会総会  2020.8  日本肝臓学会総会

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    Language:Japanese  

    Venue:大阪国際会議場, 大阪  

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  • B型肝炎2, HBV 2. Invited

    神田達郎, 井上 淳.

    第56回日本肝臓学会総会  2020.8  日本肝臓学会

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    Venue:大阪国際会議場, 大阪  

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  • C型慢性肝疾患に対するグレカプレビル/ピブレンタスビル併用療法の実臨床成績について.

    345.神田達郎, 高橋央, 本田真之, 金子朋弘, 有間修平, 佐々木玲奈, 熊川まり子, 金澤芯依, 増崎亮太, 石井大雄, 山名陽一郎, 水谷卓, 松本直樹, 樋口晃久, 中村仁美, 楡井和重, 山上裕晃, 小川眞広, 松岡俊一, 森山光彦.

    第56回日本肝臓学会総会  2020.8  日本肝臓学会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:大阪国際会議場, 大阪  

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  • C型肝炎 Invited

    神田達郎

    TBSテレビ『サンデージャポン』番組内コーナー『サンデージャンクション』  2020.3  アッヴィ

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    Language:Japanese   Presentation type:Media coverage  

    Venue:TBSテレビ、東京  

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  • 多量の胸腹水貯留を呈したCastleman病の1例.

    笠巻敬太, 有間修平, 本田真之, 石井大雄, 水谷卓, 松本直樹, 楡井和重, 神田達郎, 松岡俊一, 森山光彦.

    日本内科学会関東支部主催第657回関東地方会  2020.2  日本内科学会関東支部

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    Venue:ステーションコンファレンス東京, サピアタワー5階, 千代田区丸の内, 東京  

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  • B型肝炎診療; 未来への展望を踏まえた現在の在り方.ワークショップ11 司会 Invited

    第23回日本肝臓学会大会  2019.11  日本肝臓学会・日本消化器病学会

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    Venue:神戸コンベンションセンター, 神戸  

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  • 各種分子標的薬が肝癌細胞株自然免疫シグナル伝達経路に与える影響に関する検討

    神田達郎, 松本直樹, 森山光彦

    第23回日本肝臓学会大会  2019.11  日本肝臓学会

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    Language:Japanese   Presentation type:Poster presentation  

    Venue:神戸コンベンションセンター, 神戸  

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  • Different mechanism of action of regorafenib and lenvatinib on toll-like receptor-signaling pathways in human hepatoma cell lines. International conference

    Kanda T, Moriyama M.

    AASLD The Liver Meeting 2019  2019.11  AASLD

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    Venue:John B. Hynes Memorial Convention Center, Boston, MA, USA  

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  • 座長. <1部> B型肝疾患予防に関する最新の話題. Invited

    四柳 宏 座長.神田 達郎

    HBV expert meeting  2019.11  ギリアド・サイエンシズ株式会社

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    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:京王プラザホテル 本館44階「ハーモニー」, 新宿区, 東京  

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  • C型肝炎治療薬選択~非代償性肝硬変を含む~ Invited

    神田達郎

    城北Liver Forum  2019.10  ギリアド・サイエンシズ株式会社

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    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:ホテルメトロポリタン池袋3階「カシオペア」, 池袋  

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  • C型肝炎の最新の知見と治療 Invited

    神田達郎

    第21回みつわ台総合病院医療連携懇談会  2019.10  みつわ台総合病院, 日本医師会生涯教育講座

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  • 腎機能低下および透析症例に対するC型肝炎治療. Invited

    神田達郎

    SAKURA肝腎ネットワーク講演会.  2019.10 

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    Venue:ホテルメトロポリタン 3F「朝日」池袋, 東京  

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  • 類洞性門脈圧亢進症による胃静脈瘤に対してバルーン下逆行性経静脈的塞栓術(BRTO)を施行した2症例の検討.

    本田真之, 石井大雄, 有間修一, 山名陽一郎, 熊川まり子, 水谷卓, 松本直樹, 楡井和重, 今津博雄, 神田達郎, 山上裕晃, 松岡俊一, 森山光彦.

    第26回日本門脈圧亢進症学会総会  2019.9  日本門脈圧亢進症学会

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    Venue:海峡メッセ下関, 山口  

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  • 肝疾患~最近の話題から~ Invited

    神田達郎

    日本大学医師会. 令和元年度夏季医学講座 テーマ「総合診療のPitfall」  2019.7  日本大学医師会

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    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:日本大学医学部リサーチセンター4Fホール, 板橋区, 東京  

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  • 論文を書くことについて - 平成時代から令和時代へ – Invited

    神田達郎

    千葉大学消化器内科特別セミナー  2019.7  千葉大学消化器内科

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    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:千葉大学医学部附属病院セミナー室3, 千葉市  

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  • DEB-TACEとC-TACEの治療効果と副反応の比較検討 Invited

    石井大雄, 松岡俊一, 高橋央, 金子朋弘, 本田真之, 有間修平, 山名陽一郎, 熊川まり子, 金澤芯依, 水谷卓, 上村慎也, 松本直樹, 樋口晃久, 楡井和重, 山上裕晃, 神田達郎, 森山光彦.

    第55回日本肝癌研究会  2019.7  日本肝癌研究会

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    Venue:ホテル椿山荘, 文京区, 東京  

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  • ミリプラチン水和物を使用したB-TACEの安全性の検討.

    小川眞広, 金子真大, 渡邊幸信, 平山みどり, 三浦隆生, 松本直樹, 中河原浩史, 山本敏樹, 神田達郎, 松岡俊一, 森山光彦, 武藤晴臣.

    第55回日本肝癌研究会  2019.7  日本肝癌研究会

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    Venue:ホテル椿山荘, 文京区, 東京  

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  • B型肝細胞癌患者におけるエンテカビル先発品と後発品薬品の有効性と安全性の比較検討.

    高橋央, 神田達郎, 金子朋弘, 有間修平, 本田真之, 石井大雄, 金澤芯依, 水谷卓, 上村慎也, 樋口晃久, 山上裕晃, 松本直樹, 楡井和重, 松岡俊一, 森山光彦.

    第55回日本肝癌研究会  2019.7  日本肝癌研究会

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  • 非B非C型肝細胞癌に対するスクリーニング方法の検討

    平山みどり, 小川眞広, 金子真大, 渡邊幸信, 三浦隆生, 松本直樹, 中河原浩史, 山本敏樹, 神田達郎, 神田達郎, 松岡俊一, 森山光彦.

    第55回日本肝癌研究会  2019.7  日本肝癌研究会

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    Venue:ホテル椿山荘, 文京区, 東京  

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  • レンバチニブが肝癌細胞Toll-like receptor関連シグナルに与える影響.

    神田達郎, 松岡俊一, 小川眞広, 松本直樹, 上村慎也, 水谷卓, 有間修平, 本田真之, 金澤芯依, 金子朋弘, 高橋央, 山名陽一郎, 石井大雄, 樋口晃久, 山上裕晃, 中村仁美, 楡井和重, 森山光彦.

    第55回日本肝癌研究会  2019.7  日本肝癌研究会

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    Venue:ホテル椿山荘, 文京区, 東京  

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  • ウイルス性肝炎の最新治療と診療連携 Invited

    神田達郎

    第3回千葉消化器疾患診療連携会  2019.6  千葉消化器疾患診療連携会

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    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:国立病院機構 千葉医療センター「地域医療研修センター」千葉市  

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  • 味噌, 亜鉛のもつA型肝炎ウイルスに対する抗ウイルス作用に関する検討.

    神田 達郎, 上村 慎也, 水谷 卓, 本田 真之, 金子 朋弘, 高橋 央, 藤澤 真理子, 松本 直樹, 楡井 和重, 松岡 俊一, 小川 眞広, 森山 光彦.

    第42回日本栄養アセスメント研究会  2019.6  日本栄養アセスメント研究会

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    Venue:大阪大学銀杏会館, 吹田市, 大阪  

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  • HBsAg陽性,かつanti-HBs陰性,anti-HBc陰性を示した4症例の検討.

    神田 達郎, 松本 直樹, 森山 光彦.

    ワークショップ3 成因不明の肝疾患,その実態を探る Investigate the actual condition of liver disease of unknown origin. 第55回日本肝臓学会総会  2019.5  日本肝臓学会

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    Venue:京王プラザホテル, 新宿, 東京  

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  • 司会. ワークショップ3 成因不明の肝疾患,その実態を探る Investigate the actual condition of liver disease of unknown origin. Invited

    第55回日本肝臓学会総会  2019.5  日本肝臓学会

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    Venue:京王プラザホテル, 新宿, 東京  

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  • レゴラフェニブの肝癌細胞Toll-like receptor関連シグナルに対する影響

    319.神田達郎, 高橋央, 金子朋弘, 本田真之, 有間修平, 上村慎也, 金澤芯依, 山名陽一郎, 水谷卓, 松本直樹, 中村仁美, 石井大雄, 楡井和重, 山上裕晃, 小川眞広, 松岡俊一, 森山光彦

    第55回日本肝臓学会総会  2019.5  日本肝臓学会

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    Venue:京王プラザホテル, 新宿, 東京, 2019.5.31.  

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  • 司会. セッション15 B型肝炎1. HBV1. Invited

    第55回日本肝臓学会総会  2019.5  日本肝臓学会

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    Venue:京王プラザホテル, 新宿, 東京  

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  • 亜鉛による小胞体ストレス蛋白GRP78増加とA型肝炎増殖抑制に関する検討

    神田達郎, 松岡俊一, 森山 光彦

    第55回日本肝臓学会総会  2019.5  日本肝臓学会

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    Venue:京王プラザホテル, 新宿, 東京  

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  • ジエノタイプ2型C型肝炎に対するソフォスブビル・リバビリン療法再燃例のNS5B領域塩基配列の検討.

    金子朋弘, 神田達郎, 高橋央, 本田真之, 有間修平, 石井大雄, 山名陽一郎, 熊川まり子, 金澤芯依, 水谷卓, 上村慎也, 田村彰教, 松本直樹, 樋口晃久, 中村仁美, 山上裕晃, 松岡俊一, 森山光彦.

    第105回日本消化器病学会総会  2019.5  日本消化器病学会

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    Venue:ホテル日航金沢, 金沢, 石川  

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  • 核酸アナログ投与前または投与中に急性増悪を来したHBV Genotype C全塩基配列解析

    高橋央, 神田達郎, 金子朋弘, 本田真之, 有間修平, 熊川まり子, 山名陽一郎, 金澤芯依, 水谷卓, 上村慎也, 田村彰教, 樋口晃久, 山上裕晃, 松本直樹, 中村仁美, 松岡俊一, 森山光彦

    第105回日本消化器病学会総会  2019.5  日本消化器病学会

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    Venue:ホテル金沢, 金沢, 石川  

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  • HCC (1) Invited International conference

    APASL Single Topic Conference on Liver Immunology and Genetics  2019.4  APASL

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    Venue:Keio Plaza Hotel, Tokyo, Japan  

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  • Inhibitory effects of HAV infection on HBV replication in hepatocytes and Japanese rice-koji miso has inhibitory effects on HAV replication. Invited International conference

    Tatsuo Kanda, Naoki Matsumoto, Masahiro Ogawa, Shunichi Matsuoka, Mitsuhiko Moriyama.

    APASL Single Topic Conference on Liver Immunology and Genetics  2019.4  APASL

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    Venue:Keio Plaza Hotel, Tokyo, Japan  

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  • Effects of regorafenib on the toll-like receptor signaling pathways in HCC. Invited International conference

    Tatsuo Kanda, Naoki Matsumoto, Hiroaki Yamagami, Shunichi Matsuoka, Mitsuhiko Moriyama.

    APASL Single Topic Conference on Liver Immunology and Genetics  2019.4  APASL

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    Venue:Keio Plaza Hotel, Tokyo, Japan  

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  • Effects of knockdown of ARRDC3 on inflammasome-associated pathways in human hepatocytes. Invited International conference

    Tatsuo Kanda, Naoki Matsumoto, Masahiro Ogawa, Shunichi Matsuoka, Mitsuhiko Moriyama.

    APASL Single Topic Conference on Liver Immunology and Genetics  2019.4  APASL

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    Venue:Keio Plaza Hotel, Tokyo, Japan  

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  • SVR in HCV GT1b-patient with alanine aminotransferase elevation who discontinued grazoprevir/elbasvir combination treatment at week 8. Invited International conference

    Tatsuo Kanda, Kazushige Nirei, Masahiro Ogawa, Shunichi Matsuoka, Mitsuhiko Moriyama

    APASL Single Topic Conference on Liver Immunology and Genetics  2019.4  APASL

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    Venue:Keio Plaza Hotel, Tokyo, Japan  

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  • Zinc sulfate inhibits HAV replication. Invited International conference

    Tatsuo Kanda, Shingo Nakamoto, Shunichi Matsuoka, Hiroaki Okamoto, Mitsuhiko Moriyama.

    APASL Single Topic Conference on Liver Immunology and Genetics  2019.4  APASL

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    Venue:Keio Plaza Hotel, Tokyo, Japan  

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  • ウイルス性肝炎の最新治療と診療連携 Invited

    神田達郎

    第3回千葉消化器疾患診療連携会.  2019.3  国立病院機構 千葉医療センター

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    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:国立病院機構 千葉医療センター「地域医療研修センター」, 千葉県千葉市  

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  • 特別講演 C型肝炎最新知見 Invited

    神田達郎

    第3回熊谷HCVセミナー  2019.3  アッヴィ合同会社

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    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:熊谷総合病院PET検診棟 多目的ルーム, 埼玉県熊谷市  

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  • Arrestin domain-containing protein 3 is associated with NAFLD and NASH development. International conference

    Tatsuo Kanda, Masahiro Ogawa, Naoki Matsumoto, Shunichi Matsuoka, Mitsuhiko Moriyama.

    28th Annual Conference, Asian Pacific Association for the Study of the Liver “Soaring to New Heights in Hepatology”  2019.2  APASL

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    Language:English   Presentation type:Oral presentation (general)  

    Venue:Philippine International Convention Center, Manila, Philippinnes  

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  • B型・C型肝炎ウイルス増殖抑制~基礎的検討から~ 特別講演I Invited

    神田 達郎

    第2回城東B型肝炎セミナー  2019.2  ギリアド・サイエンシズ

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    Language:Japanese  

    Venue:ロイヤルパークホテル 2階 春海A, 東京都中央区日本橋  

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  • C型肝炎治療の現状と問題点 Invited

    神田達郎

    第1回城北肝疾患セミナー  2018.12 

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    Venue:京王プラザホテル 43階 ムーンライト  

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  • 特別講演 明日から役立つ肝炎診療 Invited

    神田 達郎

    新潟肝性脳症講演会2018 -How to use Rifaximin-  2018.12 

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    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:ホテルオークラ新潟 4F「コンチネンタル」, 新潟市  

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  • 味噌, 亜鉛によるHAV増殖抑制の検討 Invited

    神田達郎

    平成 30 年度 年度末 国立研究開発法人 日本医療研究開発機構(AMED) 肝炎等克服実用化研究事業(肝炎等克服緊急対策研究事業)「経口感染によるウイルス性肝炎(A 型及び E 型)の感染防止、病態解明、治療等に関する研究」班会議  2018.12  日本医療研究開発機構(AMED)

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:KKR ホテル東京 10 階平安  

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  • C型肝炎 Invited

    神田達郎

    平成30年度日本肝臓学会後期教育講演会  2018.12  日本肝臓学会

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    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:ザ・プリンス パークタワー東京 (港区芝公園)  

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  • 高度進行肝癌に対しIVR治療を継続しえたビリルビン5mg/dL超のChild分類C肝硬変症

    有間修平, 松岡俊一, 本田真之, 石井大雄, 山名陽一郎, 水谷卓, 上村慎也, 中村仁美, 樋口晃久, 山上裕晃, 神田達郎, 森山光彦

    第42回日本肝臓学会東部会  2018.12  日本肝臓学会東部会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:ザ・プリンス パークタワー東京 地下2階 コンベンションホールE (港区芝公園)  

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  • 味噌抽出液のA型肝炎ウイルス増殖抑制効果に関する検討 Invited

    神田達郎, 中本晋吾, 森山光彦

    第42回日本肝臓学会東部会 シンポジウム3「ゲノミクス・メタボロミクスからバイオマーカ・創薬への展開」  2018.12  日本肝臓学会

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    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

    Venue:ザ・プリンス パークタワー東京 地下2階 第3会場 (港区芝公園)  

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  • シンポジウム3「ゲノミクス・メタボロミクスからバイオマーカ・創薬への展開」 Invited

    加藤淳二, 神田達郎

    第42回日本肝臓学会東部会  2018.12  日本肝臓学会

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    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

    Venue:ザ・プリンス パークタワー東京 地下2階 第3会場 (港区芝公園)  

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  • 今年当院でみられたA型肝炎症例について

    本田真之, 松岡俊一, 水谷卓, 山名陽一郎, 有間修平, 石井大雄, 高橋央, 金子朋弘, 金澤芯依, 上村慎也, 中村仁美, 樋口晃久, 山上裕晃, 松本直樹, 神田達郎, 森山光彦

    第42回日本肝臓学会東部会  2018.12  日本肝臓学会

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    Language:Japanese   Presentation type:Oral presentation (general)  

    Venue:ザ・プリンス パークタワー東京 地下2階 さくら (港区芝公園)  

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  • A型肝炎ウイルスのMiso extractsによる増殖抑制の検討

    神田 達郎, Nan Nwe Win, 中本 晋吾, 菅波 晃子, 田村 裕, 加藤直也, 白澤 浩, 松岡 俊一, 森山 光彦

    第49回日本消化吸収学会総会  2018.11  日本消化吸収学会総会

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    Venue:オークラ千葉ホテル 3階第1会場, 千葉市  

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  • Pre and post-Transplant HBV treatment, HBIG Prophylaxis. Invited International conference

    Tatsuo Kanda

    APASL Single Topic Conference “Non Responders: Chronic Viral Hepatitis Liver Cirrhosis HCC”  2018.9  Asian Pacific Association for the Study of the Liver

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    Language:English   Presentation type:Oral presentation (invited, special)  

    Venue:Swissotel, Istanbul, Turkey  

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  • A型肝炎重症化阻止を目指した対策の開発とその検証:味噌によるHAV増殖抑制に関する検討と最近経験したA型肝炎について

    神田 達郎

    平成30 年度 第1 回 国立研究開発法人 日本医療研究開発機構(AMED) 感染症実用化研究事業 肝炎等克服実用化研究事業(肝炎等克服緊急対策研究事業) 「経口感染によるウイルス性肝炎(A 型及びE 型)の感染防止、病態解明、治療等に関する研究」班会議  2018.8  日本医療研究開発機構(AMED)

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    Language:Japanese  

    Venue:丸ビルホール&コンファレンススクエア8 階 ROOM 5  

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  • 肝がんの予防 Invited

    神田達郎

    平成30年度 肝がん撲滅運動 市民公開講座「肝がんを防ぐ、治す!」  2018.7  日本肝臓学会

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    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:日本大学医学部(図書館棟4階講堂)  

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  • C型肝炎の病態と治療の最前線 Invited

    神田達郎

    市民公開講座 健康セミナー肝炎について勉強しよう! ~肝炎は検査から。早期発見、早期治療が肝要~  2018.7  ギリアド・サイエンシズ株式会社 BSフジ

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    Language:Japanese   Presentation type:Oral presentation (keynote)  

    Venue:ベルサール西新宿 ホール  

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  • ウイルス性肝炎治療と治療後の問題点 Invited

    神田達郎

    平成30年度第1回医療従事者肝疾患研修会  2018.7  肝疾患診療拠点病院(武蔵野赤十字病院)

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    Language:Japanese   Presentation type:Public lecture, seminar, tutorial, course, or other speech  

    Venue:新宿エルタワー30F サンスカイルームB室  

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  • 非アルコール性脂肪肝炎病態進展におけるARRDC3の役割

    神田達郎, 樋口晃久, 中村仁美, 松本直樹, 高橋央, 金子朋弘, 藤澤真理子, 金澤芯依, 山名陽一郎, 水谷卓, 上村慎也, 山上裕晃, 今津博雄, 松岡俊一, 森山光彦

    第41回日本栄養アセスメント研究会  2018.7 

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    Venue:第一会場]日本大学医学部 記念講堂(記念図書館棟 4F)  

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  • HAMP遺伝子低下が肝細胞サイトカイン産生および肝癌進展に及ぼす影響

    神田達郎, 松岡俊一, 楡井和重, 松本直樹, 中村仁美, 熊川まり子, 金澤芯依, 上村慎也, 樋口晃久, 山上裕晃, 高橋央, 金子朋弘, 森山光彦

    第54回日本肝臓学会総会  2018.6  日本肝臓学会

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    Language:Japanese   Presentation type:Poster presentation  

    Venue:大阪国際会議場(グランキューブ大阪), 3F イベントホールCE, 大阪府大阪市  

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  • ジエノタイプ2型C型肝炎に対するソフォスブビル・リバビリン療法再燃例のNS5B領域塩基配列の検討

    金子朋弘, 神田達郎, 山崎元美, 芝田敏克, 高橋央, 佐々木翔一, 石井大雄, 有間修平, 熊川まり子, 金澤芯依, 水谷卓, 上村慎也, 松本直樹, 中村仁美, 樋口晃久, 楡井和重, 山上裕晃, 黒田和道, 森山光彦

    第54回日本肝臓学会総会  2018.6  日本肝臓学会

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    Venue:大阪国際会議場(グランキューブ大阪), 10F会議室1008, 大阪府大阪市  

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  • 司会. ME8. Meet the Expert 8

    第54回日本肝臓学会総会  2018.6  日本肝臓学会

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    Venue:大阪国際会議場(グランキューブ大阪), 12F会議室1202, 大阪府大阪市  

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  • C型肝炎合併自己免疫性肝疾患に対するDAA治療効果

    神田達郎, 森山光彦, 安井伸, 中村昌人, 中本晋吾, 加藤直也

    第54回日本肝臓学会総会  2018.6  日本肝臓学会

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    Venue:大阪国際会議場(グランキューブ大阪), 3F イベントホールCE, 大阪府大阪市  

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  • Acute exacerbationをきたした慢性B型肝炎2例のGenotype C HBV遺伝子解析

    高橋央, 神田達郎, 金子朋弘, 佐々木翔一, 山崎元美, 芝田敏克, 熊川まり子, 金澤芯依, 上村慎也, 田村彰教, 樋口晃久, 松本直樹, 中村仁美, 楡井和重, 黒田和道, 松岡俊一, 森山光彦

    第54回日本肝臓学会総会  2018.6  日本肝臓学会

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    Language:Japanese   Presentation type:Poster presentation  

    Venue:大阪国際会議場(グランキューブ大阪), 3F イベントホールCE, 大阪府大阪市  

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  • Arrestin domain-containing protein 3 (ARRDC3)はNASH・NAFLD増悪因子の一つである

    神田達郎, 佐々木翔一, 森山光彦

    第54回日本肝臓学会総会  2018.6  日本肝臓学会

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    Venue:大阪国際会議場(グランキューブ大阪), 11F会議室1101-2, 大阪府大阪市  

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  • 肝疾患 最近の話題 Invited

    神田達郎

    第64回日本大学医学部消化器肝臓内科・糖尿病内科創立記念式典 記念講演  2018.5 

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  • 膵癌進展におけるアンドロゲン受容体, 小胞体ストレス蛋白GRP78の関与

    神田達郎, 松岡俊一, 森山光彦

    第104回日本消化器病学会総会  2018.4  日本消化器病学会

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    Venue:京王プラザホテル(新宿)42階 富士  

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  • 当院のC型肝炎に対するDAA治療効果、治療後RASと有害事象の検討

    金子朋弘, 楡井和重, 森山光彦, 高橋央, 佐々木翔一, 石井大雄, 有間修平, 山名陽一郎, 金澤芯依, 水谷卓, 上村慎也, 松本直樹, 樋口晃久, 中村仁美, 山上裕晃, 神田達郎

    第104回日本消化器病学会総会  2018.4 

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    Venue:京王プラザホテル(新宿)4階 花ABCD  

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  • G蛋白質共役受容体制御因子ARRDC3はNASH線維化進展に関与する

    佐々木翔一, 神田達郎, 森山光彦

    第104回日本消化器病学会総会  2018.4  日本消化器病学会

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    Venue:京王プラザホテル(新宿)42階 富士  

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  • HCV-147. Successful retreatment of 12-week combination regimen of grazoprevir and elbasvir for HCV GT1b patient, who failed to be treated by sofosbuvir/ledipasvir due to ventricular tachycardia. International conference

    Tatsuo Kanda, Mitsuhiko Moriyama, Shingo Nakamoto, Masato Nakamura, Tetsuhiro Chiba, Hitoshi Maruyama, Shunichi Matsuoka, Naoya Kato.

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”  2018.3  Asian Pacific Association for the Study of the Liver

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    Venue:New Delhi, India  

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  • HCV-148. Successful retreatment with grazoprevir plus elbasvir for cirrhotic patients with hepatitis C virus genotype 1b, who discontinued the prior DAA treatment. International conference

    Tatsuo Kanda, Mitsuhiko Moriyama, Masato Nakamura, Shin Yasui, Shingo Nakamoto, Tetsuhiro Chiba, Hitoshi Maruyama, Naoya Kato.

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”  2018.3  Asian Pacific Association for the Study of the Liver

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    Venue:New Delhi, India  

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  • Hepatovirology Symposium: Hepato-Virology Symposium: Viral Hepatitis Testing: Way Forward. Drug Resistance Testing in the Era of DAA: Is there a Need? Invited International conference

    Tatsuo Kanda

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”  2018.3  Asian Pacific Association for the Study of the Liver

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    Language:English   Presentation type:Symposium, workshop panel (nominated)  

    Venue:HOTEL PULLMAN, HALL P3, New Delhi, India  

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  • General Hepatology (Symposium Session 2): Viral Hepatitis C – Challenges in Treatment Of HCV infection. Newer Options for Treatment for HCV infection: Drugs and Schedules. Invited International conference

    Tatsuo Kanda

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”  2018.3  Asian Pacific Association for the Study of the Liver

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    Language:English   Presentation type:Symposium, workshop panel (nominated)  

    Venue:HOTEL HYATT ANDAZ, HALL-H1,New Delhi, India  

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  • HBV-B25. RNA sequencing analysis of diversity of hepatitis B virus transcripts in hepatocytes derived from chimeric mice. International conference

    Shingo Nakamoto, Tatsuo Kanda, Shuang Wu, Koji, Takahashi, Masato Nakamura, Shin Yasui, Sadahisa Ogasawara, Eiichiro Suzuki, Yoshihiko Ooka, Akinobu, Tawada, Tetsuhiro Chiba, Makoto Arai, Kazufumi Kobayashi, Soichiro Kiyono, Hitoshi Maruyama, Naoya Kato, Hiroshi Shirasawa.

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”  2018.3  Asian Pacific Association for the Study of the Liver

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    Venue:New Delhi, India  

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  • HAV-1. Japanese miso extract suppresses HAV replication with the upregulation of glucose-regulated protein 78. International conference

    Tatsuo Kanda, Nan Nwe Win, Shingo Nakamoto, Xia Jiang, Mitsuhiko Moriyama, Yutaka Tamura, Akiko Suganami, Hiroshi Shirasawa, Hiroaki Okamoto.

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”  2018.3  Asian Pacific Association for the Study of the Liver

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    Venue:New Delhi, India  

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  • Chairpersons. Oral Papers Session: Acute Liver Failure and Acute on chronic Liver failure. Invited International conference

    Tatsuo Kanda, S.K. Sinha, Abby Phillips.

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”  2018.3  Asian Pacific Association for the Study of the Liver

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    Venue:HOTEL PULLMAN, HALL-P4, New Delhi, India  

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  • HCC-64. Initial experiences with sorafenib and regorafenib sequential therapies in Japanese patients with advanced hepatocellular carcinoma. International conference

    Sadahisa Ogasawara, Tetsuhiro Chiba, Yoshihiko Ooka, Eiichiro Suzuki, Takahiro Maeda, Masayuki Yokoyama, Kazufumi Kobayashi, Soichiro Kiyono, Masato Nakamura, Tomoko Saito, Shingo Nakamoto, Shin Yasui, Akinobu Tawada, Makoto Arai, Tatsuo Kanda, Hitoshi Maruyama, Osamu Yokosuka, Naoya Kato.

    27th Annual Conference, Asian Pacific Association for the Study of the Liver “Hepatology: The Next Genre”,  2018.3  Asian Pacific Association for the Study of the Liver

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    Venue:New Delhi, India  

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  • 肝臓のエラストグラフィ Invited

    松本直樹

    城北肝疾患 Meeting 2018  2018.3 

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    Venue:ホテルメトロポリタン池袋 4階「桜」, 東京池袋  

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  • 肝細胞ヘプシジンとサイトカイン産生に関する考察

    神田達郎, 松岡俊一, 楡井和重, 松本直樹, 中村仁美, 熊川まり子, 金澤芯衣, 上村慎也, 樋口晃久, 山上裕晃, 森山光彦

    第12回肝免疫フォーラム  2018.2 

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    Venue:芝パークホテル 別館, 東京  

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  • 新しいC型肝炎の治療とHCV排除後の問題点 Invited

    神田 達郎

    SAKURA病診連携勉強会  2018.1 

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    Venue:ホテルメトロポリタン25階「ポラリス」  

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  • Session 3: Special Lectures. Topic 2: Recovery of immune function after HCV eradication from patients. Outcome of chronically hepatitis C virus-infected patients treated with direct antiviral agents. Invited International conference

    T. Kanda.

    Concurrent USJCMSP Panel Meetings: Hepatitis Panel Meeting (36th US-Japan Hepatitis Panel Meeting New Approaches to HBV Therapy Shenzhen, China January 10-11, 2018).  2018.1 

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    Venue:Shenzhen, China  

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  • HCV Clearance by Antivirals Makes Changes in the Immune Related Cytokines. Invited International conference

    T. Kanda, R. Sasaki.

    20th International Conference on Emerging Infectious Diseases in the Pacific Rim.  2018.1 

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    Venue:Shenzhen, China  

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  • Poster Session: HCV Clearance by Antivirals Makes Changes in the Immune Related Cytokines. Invited International conference

    T. Kanda, R. Sasaki.

    20th International Conference on Emerging Infectious Diseases in the Pacific Rim.  2018.1 

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    Venue:Shenzhen, China  

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  • GRP78誘導剤によるHAV増殖抑制の検討

    神田 達郎

    平成29年度年度末 国立研究開発法人 日本医療研究開発機構(AMED) 肝炎等克服実用化研究事業 (肝炎等克服緊急対策研究事業) 「経口感染によるウイルス性肝炎(A型及びE型)の感染防止、病態解明、治療等に関する研究」班会議  2017.12 

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    Language:Japanese  

    Venue:KKRホテル東京 10階平安, 東京都千代田区  

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  • Inhibition of microRNA-200b/c improved liver inflammation and liver fibrosis in NASH model mice. International conference

    Masato Nakamura, Tatsuo Kanda, Shingo Nakamoto, Shuang Wu, Shin Yasui, Hitoshi Maruyama, Naoya Kato.

    The Liver Meeting 2017. The 68th Annual Meeting of The American Association for the Study of Liver Diseases  2017.10  AASLD

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    Venue:Walter E. Washington Convention Center, Washington, DC, USA  

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  • Effects of interferon-free treatment on chronic hepatitis C patients with autoimmune liver diseases. International conference

    141.Tatsuo Kanda, Masato Nakamura, Shin Yasui, Makoto Arai, Shingo Nakamoto, Tetsuhiro Chiba, Hitoshi Maruyama, Mitsuhiko Moriyama, Naoya Kato.

    The Liver Meeting 2017. The 68th Annual Meeting of The American Association for the Study of Liver Diseases  2017.10  AASLD

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    Venue:Walter E. Washington Convention Center, Washington, DC, USA  

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  • HLA-DRB1-DQB1 haplotypes and BTNL2 gene associate with response to a hepatitis B vaccine. International conference

    143.Nao Nishida, Masaya Sugiyama, Hiromi Sawai, Shoji Nishina, Aiko Sakai, Keisuke Kakisaka, Keisuke Hino, Ryo Sumasaki, Yasuhiro Takikawa, Kazumoto Murata, Tatsuo Kanda, Osamu Yokosuka, Katsushi Tokunaga, Masashi Mizokami.

    The Liver Meeting 2017. The 68th Annual Meeting of The American Association for the Study of Liver Diseases  2017.10  AASLD

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    Language:English   Presentation type:Poster presentation  

    Venue:Walter E. Washington Convention Center, Washington, DC, USA  

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  • C型慢性肝炎の最新治療~肝硬変・肝がん撲滅を目指して

    神田 達郎

    平成29年日本大学医学会秋季学術大会 シンポジウム「慢性疾患の病態・治療研究の最前線  2017.10 

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    Language:Japanese   Presentation type:Symposium, workshop panel (nominated)  

    Venue:医学部リサーチセンター4階ホール  

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  • デジタルポスターセッション20 (肝臓学会) 原発性肝癌(分子標的治療)2

    神田 達郎

    第21回日本肝臓学会大会  2017.10 

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    Language:Japanese   Presentation type:Poster presentation  

    Venue:第15会場マリンメッセ福岡 アリーナ, 福岡  

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  • Effects of interferon-free treatment on chronic hepatitis C patients with autoimmune liver diseases. Invited International conference

    Tatsuo Kanda

    Saint Louis University  2015.10  Ratna Ray, Ranjit Ray

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    Language:English   Presentation type:Oral presentation (invited, special)  

    Venue:Saint Louis University, St. Louis, MO, USA  

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Industrial property rights

  • 抗ウイルス剤及び医薬組成物

    神田達郎, 田中(佐々木)玲奈.

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    Applicant:日本大学

    Application no:特願2023-014730  Date applied:2023.2

    Country of applicant:Domestic   Country of acquisition:Domestic

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  • Compositions and Methods for Generation of Infectious Hepatitis C Virus in Immortalized Human Hepatocytes.

    Ray RB, Ray R, Basu A, Kanda T.

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    Application no:United States Patent No.: US 7,504,255 B2.  Date applied:2009.3

    Country of applicant:Foreign country   Country of acquisition:Foreign country

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Awards

  • Best Editor for the year 2023

    2024.5   Hepatology International, Springer  

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  • APASL 2024 Powell-Sarin Achievement Award

    2024.3   Asian Pacific Association for the Study of the Liver [APASL]   Recent advances of viral hepatitis, and current situation of hepatitis A and E in Japan

    Tatsuo Kanda

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  • 第688回日本内科学会関東地方会 (2023年7月9日(日)) 指導医賞

    2023.7   日本内科学会   演題番号16 演者:羽尾 裕平 指導医:神田 達郎 / 日本大学消化器肝臓内科 COVID-19治療中に非昏睡型肝不全を併発したアラジール症候群の1例

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  • 第24回日本肝がん分子標的治療研究会 優秀論文「各種分子標的薬が肝癌細胞TLRシグナル伝達経路に与える影響に関して」

    2021.8   日本肝がん分子標的治療研究会  

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  • Asian Pacific Association for the Study of the Liver (APASL) Appreciation Award

    2019.11   Asian Pacific Association for the Study of the Liver (APASL)  

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  • 第11回消化器病における性差医学・医療研究会優秀演題賞

    2013.7   第11回消化器病における性差医学・医療研究会  

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  • 2012年度第40回かなえ医薬振興財団アジア・オセアニア交流研究助成金受賞

    2011.11   かなえ医薬振興財団  

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  • 平成23年度日本肝臓学会 研究奨励賞

    2011.6   日本肝臓学会  

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  • ウイルス肝炎研究財団平成21年度研究奨励賞

    2010.3   ウイルス肝炎研究財団  

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  • 国際科学振興財団フォーラム第16回浜名湖シンポジウム特別賞(アイデアの独創性部門)

    2009.12   国際科学振興財団フォーラム第16回浜名湖シンポジウム  

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  • American Society for Virology 2006 Postdoctoral Fellow Travel Award

    2006.7   American Society for Virology  

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  • Asian Pacific Association for the Study of the Liver, 14th Biennial Conference, Young Investigator Award

    2004.12   Asian Pacific Association for the Study of the Liver  

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  • 国際科学振興財団フォーラム第12回浜名湖シンポジウム 第17位

    2004.12   国際科学振興財団フォーラム第12回浜名湖シンポジウム  

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  • 平成16年度国際学会に伴う費用一部助成

    2004.11   日本肝臓学会  

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  • 第12回日本消化器関連学会週間(DDW-Japan 2004 Fukuoka)ポスター演題優秀賞

    2004.10   日本消化器関連学会週間(JDDW)  

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  • 平成15年度国際学会に伴う費用一部助成

    2003.11   日本肝臓学会  

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  • 平成15年度結核予防千葉基金助成金 研究奨励金

    2003.4   財団法人ちば県民保健財団   慢性C型肝炎の病態進展と結核既往との関連について

    千葉大学保健管理センター 神田達郎

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  • First JSH Single Topic Conference Award

    2002.11   日本肝臓学会  

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  • 平成13年度国際学会に伴う費用一部助成

    2001.11   日本肝臓学会  

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Research Projects

  • Study of Prevention, Pathological Development and Treatment for Hepatitis A and E Virus Infection

    Grant number:23808778

    2023.4 - 2026.3

    Awarding organization:Japan Agency for Medical Research and Development (AMED)

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  • Research and development of infection prevention, pathological mechanism, diagnosis and treatment for hepatitis A and E viruses

    Grant number:20314252

    2020.4 - 2023.3

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  • 肝線維化進展機序解明を目的としたインテグリンβ1と細胞接着に関する研究

    Grant number:20K08343

    2020.4 - 2023.3

    System name:科学研究費助成事業

    Research category:基盤研究(C)

    Awarding organization:日本学術振興会

    増崎 亮太, 神田 達郎, 森山 光彦

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    Authorship:Coinvestigator(s) 

    Grant amount:\4290000 ( Direct Cost: \3300000 、 Indirect Cost:\990000 )

    インテグリンは細胞表面に存在し、その細胞外ドメインは細胞外マトリックス(ECM)の受容体としての細胞-ECMの細胞接着の主役であり、細胞-細胞間の接着にも関与する。細胞内ドメインは細胞骨格制御タンパク質や非レセプター型チロシンキナーゼを含むシグナル伝達分子と結合する。インテグリンは、細胞接着、遊走、増殖、分化、ECMの再構築に関わるだけでなく、各種サイトカインのシグナルを調節するなど多様な機能を持つことがわかっている。
    肝臓に発現するインテグリンはすべてβ1鎖をもっており、これを肝臓特異的に欠失させ、正常肝組織に起こる変化とその機序を検討する。我々はインテグリンβ1を肝特異的に欠失させることで、肝細胞の配列の乱れ、胆管細胞の増生、肝臓の線維化を来たすことを報告したが、これは欠失に伴う肝細胞死(アノイキス)がその一因を担っている可能性が示唆された。アノイキスとは、細胞とECM接着の喪失で誘導されるアポトーシスである。そのため、肝線維化モデルを作成し、ECMが過剰にある状態で、欠失が肝線維化にどのような変化を来たすかを検討する。
    これまで、インテグリンβ1肝特異的欠失マウスにおいて、肝線維化とTGFβの活性化機序を調べるために、インテグリン欠失初代肝細胞培養液を用いてJS1細胞を培養したところ、コントロールと比し、collagen 1α1とSMAのmRNA発現上昇による向線維化シグナルの亢進を認めた。これまでの結果をまとめ、投稿し英文誌に受理された(Am J Pathol 2021, 191:309-319)。
    本年度は、ヴァンダービルト大学医療センターから、インテグリンβ1のfloxedマウスを入手し、飼育を開始した。また、肝特異的欠失マウス作成のためにAAV8-MUP-iCreウイルスを入手した。次年度はマウスの交配・繁殖を継続し、チオアセトアミド投与による肝線維化モデル作成予定である。

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  • Sorafenib resistance and c-Jun in hepatocellular carcinoma

    Grant number:17K09404

    2017.4 - 2020.3

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

    KANDA Tatsuo

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    Authorship:Principal investigator 

    Grant amount:\4680000 ( Direct Cost: \3600000 、 Indirect Cost:\1080000 )

    Sorafenib has been used as an oral systemic chemotherapeutic agent for patients with advanced hepatocellular carcinoma (HCC). It is important to elucidate the mechanism of sorafenib resistance and improve the treatment efficacy. 1) Phosphorylation of c-Jun is involved in the sorafenib resistance of human hepatoma cell lines. 2) We examined whether oral tyrosine kinase inhibitors (TKIs) affect innate immunity including Toll-like receptor (TLR) signaling pathway, by real-time PCR arrays and cytotoxic assays. 3) Regorafenib upregulated C-X-C motif chemokine ligand (CXCL10) mRNA expression and downregulated Fos proto-oncogene, AP-1 transcription factor subunit (c-Fos) and ubiquitin conjugating enzyme E2 N (UBE2N) mRNAs in both HepG2 and Huh7 cells. 4) Lenvatinib upregulated interleukin 1 alpha and TLR4 mRNAs.
    TLR signaling pathway plays a role in the treatment response of TKIs. Modulation of TLR pathway may be important in the treatment of sorafenib-resistant patients with advanced HCC.

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  • Investigate the gain of immune function after hepatitis C virus eradication from patients

    2016 - 2017

    Tatsuo Kanda, Ranjit Ray

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  • Involvement of androgen receptor and unfolded protein response in human liver and pancreatic cancers

    Grant number:24590955

    2012.4 - 2015.3

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

    KANDA TATSUO

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    Grant amount:\5200000 ( Direct Cost: \4000000 、 Indirect Cost:\1200000 )

    (1) Endoplasmic reticulum (ER) stress response plays a key role in hepatic cell damage induced by an innate immune response. (2) Androgen receptor (AR) and ER-stress response are cooperatively involved in human liver cancer, one of the male-dominant cancers. (3) Hepatitis C virus (HCV) infection enhances GRP78 expression, which confers to the resistance against apoptosis in HCV-infected hepatocytes. (4) ER stress response plays an important role in pancreatic cancer cell line KP-2, in which AR highly expresses.

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  • B型肝炎ウイルス感染症におけるバイオマーカーとしてのMicro-RNAの同定

    2012

    System name:かなえ医薬振興財団第40回かなえ医薬振興財団アジア・オセアニア交流研究助成金

    Awarding organization:かなえ医薬振興財団

    神田達郎

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  • Elucidation of the molecular mechanisms on the pathology and treatment of hepatitis by computational approach

    Grant number:23300105

    2011.4 - 2014.3

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (B)

    Awarding organization:Japan Society for the Promotion of Science

    TU・BAO Ho, TAKABAYASHI Katsuhiko, YOKOSUKA Osamu, KANDA Tatsuo, DAM Hieu Chi, KAWASAKI Saori

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    Authorship:Coinvestigator(s) 

    Grant amount:\20280000 ( Direct Cost: \15600000 、 Indirect Cost:\4680000 )

    For the first task on HCV NS5A resistance mechanisms to interferon/ribavirin therapy, our semi-supervised ensemble method discovered the motifs that well characterizing two class of patients with SVR and non-SVR, especially in case of only a small number labelled NS5A sequences but much unlabelled sequences are available. For the second task on the knockdown efficacy of siRNA, one of our method discovered two siRNA design rules in addition to known design rules, and the other significantly improve the predictive ability for given siRNA sequences. This method employs both scored and labelled sequences as well as known design rules to enrich the poor sequence representation of siRNA by transformed matrices. The prediction is done by a novel tensor regression method on those matrices. For the third task on the interplay between epigenetic factors and hepatitis progression, we reached some intermediate results such as inferring the causual relationship network of histone modifications.

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  • Internal ribosomal entry-site activities of clinical isolate-derived hepatitis A virus and inhibitory effects of amantadine

    2011

    System name:(社)日本肝臓学会研究奨励賞

    Awarding organization:(社)日本肝臓学会

    神田達郎

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  • C型肝炎ウイルスNS5Aを介した肝内自然免疫の抑制

    2010

    System name:平成21年度肝炎に関する研究助成事業「研究奨励金」

    Awarding organization:(財)ウイルス肝炎研究財団

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  • Androgen receptor signaling in liver and pancreatic cancer

    Grant number:21590829

    2009.4 - 2012.3

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

    KANDA Tatsuo

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    Grant amount:\4550000 ( Direct Cost: \3500000 、 Indirect Cost:\1050000 )

    1)Interleukin-6 acts a positive regulator in androgen receptor signaling in pancreatic cancer cell lines, suggesting that interleukin-6 and androgen receptor signaling might play important roles in the progression of pancreatic carcinogenesis. 2) Hepatitis B virus affects nuclear receptors and their related signal transduction. They also might be involved in replication of hepatitis B virus and hepatitis B virus-related hepatocarcinogenesis.

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  • 若手研究者の自立的研究環境整備促進-優れた若手研究型教員の人材育成システム(千葉大学)

    2009 - 2012

    System name:科学技術振興調整費テニュア・トラックシステム研究経費

    Research category:肝炎および肝癌に関する先駆的研究

    Awarding organization:文部科学省

    神田達郎

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  • Finding Medical Knowledge from Clinical Data based on Interpretations

    Grant number:21500135

    2009 - 2011

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

    KAWASAKI Saori, TU Bao Ho, TAKABAYASHI Katsuhiko, KANDA Tatsuo

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    Authorship:Coinvestigator(s) 

    Grant amount:\4420000 ( Direct Cost: \3400000 、 Indirect Cost:\1020000 )

    The focus of this research is to obtain more interesting mining results for the medical experts, so that not only the data mining from the target clinical data itself but also the combining the background knowledge extraction from medical litarature and experts’interpretations have been pursued in finding the relationships among blood tests and the treatment effects. dditionally, in accordance with the high attention to sequence analysis in biomedicine, semi-supervised learning methods specially for the virus subgenotypes and the interferon/ribavirin treatments were developed to show the potentials of computational approaches.

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  • HCV core蛋白はandrogen receptor-mediated signalingを活性化する

    2009

    System name:財団法人国際科学振興財団(分子消化器病研究会)助成金

    Awarding organization:財団法人国際科学振興財団

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  • siRNAおよびアマンタジンを用いたHAV IRES-mediated translation、HAV増殖抑制の検討

    2005

    System name:財団法人国際科学振興財団(分子消化器病研究会)助成金

    Awarding organization:財団法人国際科学振興財団

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  • Analysis of Viral and host factors influencing the pathophysiology and effect of therapy of pesisitent hepatitis virus infection

    Grant number:16590576

    2004 - 2005

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

    YOKOSUKA Osamu, IMAZEKI Fumio, FUKAI Kenichi

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    Grant amount:\3500000 ( Direct Cost: \3500000 )

    In Japan, there are 2-3 million hepatitis virus carriers and approximately 45,000 patients die due to liver diseases. Regarding HCV infection, reduced incidence of t hepatocellular carcinoma and improved survival rate are observed by interferon (IFN) treatment. However, by using IFN and ribavirin combination therapy, about half of the patients cannot get a sustained response. Regarding HBV infection, antiviral agent such as lamivudine is used for chronic hepatitis B, but the effect is limited due to emergence of resistant strain. By comparing the whole HCV sequence, we have shown that complete- and partial-responders have higher mutation rate than non-responders, especially in non-structual protein (NS) 5A and 5B regions. Higher mutation rates are observed during the natural course in these responders than in non-responders. By applying the replicon system that is a model for HCV replication, higher rate of mutation in NS5A/5B regions by ribavirin was confirmed. We have also shown that replication of HCV can be suppressed by siRNA on IRES of HCV. Regarding HBV infection, precore, core, core promoter, pre-S mutations are revealed to be important factors for the advance in liver disease. The correlation between the mutation in HBV polymerase and lamivudine resistance was also demonstrated. The expression level of NFkB and AP-1 was observed to be influenced by HCV. We are now examining the correlation between these changes and treatment effect.

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  • RNA干渉による肝炎ウイルス増殖抑制効果の検討

    Grant number:15790338

    2003.4 - 2005.3

    System name:科学研究費助成事業

    Research category:若手研究(B)

    Awarding organization:日本学術振興会

    神田 達郎

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    Grant amount:\3500000 ( Direct Cost: \3500000 )

    【背景・目的】長時間持続的なA型肝炎ウイルス(HAV)の増殖抑制を目指しRNase III-prepared siRNA、short hairpin (sh) RNA発現ベクターによるHAV IRES翻訳抑制およびウイルス増殖抑制の検討を行った。【方法】(1)HAV IRES領域に対するRNase III-prepared siRNAおよびHAV IRESドメインIIIa、IIId、IIIc、IV、Vに対するshRNA発現ベクター(H1-プロモーターをもつ)psh-IIIa、psh-IIId、psh-IIIc、psh-IV、psh-Vを作成した。(2)細胞株由来HAV IRESを含むbicistronic reporterを作成した。(3)ウイルス増殖抑制効果の判定にはDNA based-HAV replicon systemを使用した(Gauss-Muller V, J Gen Virol,2002)。(4)臨床検体(劇症肝炎3例、急性肝炎3例)由来のHAV IRESを含むbicistronic reporterも作成し効果を確認した。判定はルシフェラーゼアッセイにて行った。【成績】(1)RNase III-prepared siRNAを0.5、1.0μg投与48時間後のHAV IRESからの翻訳はそれぞれ79%、45%まで減少した。また、RNase III-prepared siRNAはHAV増殖も抑制した。HAV IRESを標的としたsiRNAは有効であることが確認された。(2)psh-IIId、psh-IIIcおよびpsh-Vを0.1μg投与後HAV IRESからの翻訳はコントロールと比較し48時間でそれぞれ28%、41%および31%、144時間でそれぞれ6.6%、26%および14%と経時的に減少した。HAV増殖も抑制した。(3)臨床検体由来のHAV IRESを用いた検討でもRNase III-prepared siRNAおよびpsh-IIId、psh-IIIc、psh-Vは翻訳抑制に有効であった。【結論】HAV IRES領域に対するsiRNAおよび薬剤はHAV増殖抑制に有用である可能性が示唆された。

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  • 慢性C型肝炎の病態進展と結核既往との関連について研究奨励金

    2003

    System name:平成15年度結核予防千葉基金助成金

    Awarding organization:結核予防会

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Other research activities

  • 医学部6年生が日本内科学会 第 688 回関東地方会奨励賞受賞!!

    2024.1

  • 消化器肝臓内科学分野の田中 (佐々木) 玲奈研究員及び神田達郎診療教授らの研究グループは, オートファジーがA型肝炎ウイルス増殖を抑制し,HAVの生活環で重要な役割をはたしている ことを明らかにした研究成果を発表しました。

    2022.9

  • C型肝炎 TBSテレビ『サンデージャポン』番組内コーナー『サンデージャンクション』

    2020.3

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    神田達郎:C型肝炎 TBSテレビ『サンデージャポン』番組内コーナー『サンデージャンクション』2020年3月1日(日曜)11:23頃 (2020/2/10撮影)

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  • 教えてドクター C型肝炎は服薬で治せる時代 一度はウイルス検査を受けましょう

    2019.1

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    神田達郎:教えてドクター C型肝炎は服薬で治せる時代 一度はウイルス検査を受けましょう リビング東京副都心 2019年1月26日 p.9 (サンケイリビング新聞社 東京事業部 発行)

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  • 認知症と診断されたら肝臓の検査を

    2018.11

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    神田達郎:認知症と診断されたら肝臓の検査を 日刊ゲンダイ 2018年11月27日

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  • 第578回医心伝身 異常行動を起こす「肝性脳症」は認知症と間違えやすいので注意

    2018.10

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    異常行動を起こす「肝性脳症」は認知症と間違えやすいので注意

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  • トレンド◎食品媒介感染症が性感染症として流行 感染拡大中のA型肝炎を見逃すな

    2018.9

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    トレンド◎食品媒介感染症が性感染症として流行 感染拡大中のA型肝炎を見逃すな

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  • C型肝炎 疾患啓発ラジオ番組 「笑顔の毎日を送るために」

    2016.7

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