慶應義塾研究者情報データベース

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• Clinical outcomes of patients with remitting ulcerative colitis after discontinuation of indigo naturalis

  Shimada F., Yoshimatsu Y., Sujino T., Fukuda T., Aoki Y., Hayashi Y., Tojo A., Kawaguchi T., Kiyohara H., Sugimoto S., Nanki K., Mikami Y., Miyamoto K., Takabayashi K., Hosoe N., Kato M., Ogata H., Naganuma M., Kanai T.

  Scientific Reports （Scientific Reports)  14 （ 1 ）  2024年12月

  　概要を見る

  Indigo naturalis is an effective treatment for ulcerative colitis. However, long-term use of indigo naturalis causes adverse events, such as pulmonary hypertension. The natural history of patients with ulcerative colitis who discontinued indigo naturalis after induction therapy is unknown. Moreover, the clinical features of patients who relapsed within 52 weeks after the discontinuation of indigo naturalis are unclear. This study aimed to assess the clinical outcomes of patients with ulcerative colitis after discontinuation of indigo naturalis and to identify potential markers responsible for relapse. This single-center retrospective study investigated the follow-up of 72 patients who achieved a clinical response 8 weeks after indigo naturalis treatment. We observed relapse in patients with ulcerative colitis after the discontinuation of indigo naturalis. We analyzed the factors predicting long-term outcomes after discontinuation of indigo naturalis. Relapse was observed in 24%, 57%, and 71% of patients at 8, 26, and 52 weeks, respectively. There were no predictive markers in patients who relapsed within 52 weeks after the discontinuation of indigo naturalis. The ulcerative colitis relapse rate after indigo naturalis discontinuation was high. Follow-up treatment is required after the discontinuation of indigo naturalis in patients with ulcerative colitis.

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• Characteristics of flat-type ulcerative colitis-associated neoplasia on chromoendoscopic imaging with indigo carmine dye spraying

  Takabayashi K., Sugimoto S., Nanki K., Yoshimatsu Y., Kiyohara H., Mikami Y., Sujino T., Kato M., Hosoe N., Shimoda M., Yahagi N., Ogata H., Iwao Y., Kanai T.

  Digestive Endoscopy （Digestive Endoscopy)  36 （ 4 ） 446 - 454 2024年04月

  ISSN  09155635

  　概要を見る

  Objectives: Despite recent advances in endoscopic equipment and diagnostic techniques, early detection of ulcerative colitis-associated neoplasia (UCAN) remains difficult because of the complex background of the inflamed mucosa of ulcerative colitis and the morphologic diversity of the lesions. We aimed to describe the main diagnostic patterns for UCAN in our cohort, including lateral extension surrounding flat lesions. Methods: Sixty-three lesions in 61 patients with flat-type dysplasia that were imaged with dye chromoendoscopy (DCE) were included in this analysis. These DCE images were analyzed to clarify the dye-chromoendoscopic imaging characteristics of flat dysplasia, and the lesions were broadly classified into dysplastic and nondysplastic mucosal patterns. Results: Dysplastic mucosal patterns were classified into two types: small round patterns with round to roundish structures, and mesh patterns with intricate mesh-like structures. Lesions with a nondysplastic mucosal pattern were divided into two major types: a ripple-like type and a gyrus-like type. Of note, 35 lesions (55.6%) had a small round pattern, and 51 lesions (80.9%) had some type of mesh pattern. About 70% of lesions with small round patterns and 49% of lesions with mesh patterns were diagnosed as high-grade dysplasia or carcinoma, while about 30% of lesions with small round patterns and 51% of lesions with mesh patterns were diagnosed as low-grade dysplasia. Conclusion: When a characteristic mucosal pattern, such as a small round or mesh pattern, is found by DCE, the possibility of UCAN should be considered.

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• Video capsule endoscopy in overt and occult obscure gastrointestinal bleeding: Insights from a single-center, observational study in Japan

  Tojo A., Sujino T., Hayashi Y., Kamiya K.J.L.L., Sato M., Hinako S., Yoshimatsu Y., Kinoshita S., Kiyohara H., Mikami Y., Takabayashi K., Kato M., Ogata H., Kanai T., Hosoe N.

  DEN Open （DEN Open)  4 （ 1 ）  2024年04月

  　概要を見る

  Objective: This study aimed to evaluate the use of video capsule endoscopy (VCE) in patients with obscure gastrointestinal bleeding (OGIB), compare cases of overt and occult OGIB, assess the rates of balloon-assisted enteroscopy (BAE) interventions and rebleeding, and identify predictive markers of positive VCE findings. Methods: Medical records of 430 patients who underwent VCE for OGIB between 2004 and 2022 were analyzed. Occult OGIB was defined as IDA or positive fecal occult blood, whereas overt OGIB was defined as clinically imperceptible bleeding. We retrospectively analyzed demographics, VCE findings based on Saurin classification (P0, P1, and P2), outcome of BAE interventions, and rebleeding rates. Results: A total of 253 patients with overt OGIB and 177 with occult OGIB were included. P1 findings were predominant in both groups, with a similar distribution. The percentage of patients receiving conservative therapy was higher in P1 than in P2 for both overt and occult OGIB. BAE was more frequently performed in P2 than in P1 VCE (83.0% vs. 35.3% in overt OGIB, 84.4% vs. 24.4% in occult OGIB). The percentage of positive findings and intervention in total BAE performed patients were comparable in P1 and P2 of overt OGIB, whereas these percentages in P2 were more than P1 of occult OGIB. Conclusion: VCE effectively identified OGIB lesions requiring intervention, particularly occult OGIB lesions, potentially reducing unnecessary BAE. Rebleeding rates varied according to the VCE findings, emphasizing the importance of follow-up in high-risk patients.

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• Gastrointestinal symptoms in COVID-19 and disease severity: a Japanese registry-based retrospective cohort study

  Matsubara Y., Kiyohara H., Mikami Y., Nanki K., Namkoong H., Chubachi S., Tanaka H., Azekawa S., Sugimoto S., Yoshimatsu Y., Sujino T., Takabayashi K., Hosoe N., Sato T., Ishii M., Hasegawa N., Okada Y., Koike R., Kitagawa Y., Kimura A., Imoto S., Miyano S., Ogawa S., Fukunaga K., Kanai T.

  Journal of gastroenterology （Journal of gastroenterology)  59 （ 3 ） 195 - 208 2024年03月

  　概要を見る

  BACKGROUND: Research on whether gastrointestinal symptoms correlate with the severity of Coronavirus Disease 2019 (COVID-19) has been inconclusive. This study aimed to clarify any associations between gastrointestinal symptoms and the prognosis of COVID-19. METHODS: We collected data from the Japanese nationwide registry for COVID-19 to conduct a retrospective cohort study. Data from 3498 Japanese COVID-19 patients, diagnosed at 74 facilities between February 2020 and August 2022, were analyzed in this study. Hospitalized patients were followed up until discharge or transfer to another hospital. Outpatients were observed until the end of treatment. Associations between gastrointestinal symptoms and clinical outcomes were investigated using multivariable-adjusted logistic regression models. RESULTS: The prevalence of diarrhea, nausea/vomiting, abdominal pain, and melena were 16.6% (581/3498), 8.9% (311/3498), 3.5% (121/3498), and 0.7% (23/3498), respectively. In the univariable analysis, admission to intensive care unit (ICU) and requirement for mechanical ventilation were less common in patients with diarrhea than those without (ICU, 15.7% vs. 20.6% (p = 0.006); mechanical ventilation, 7.9% vs. 11.4% (p = 0.013)). In the multivariable-adjusted analysis, diarrhea was associated with lower likelihood of ICU admission (adjusted odds ratio (aOR), 0.70; 95% confidence interval (CI), 0.53-0.92) and mechanical ventilation (aOR, 0.61; 95% CI, 0.42-0.89). Similar results were obtained in a sensitivity analysis with another logistic regression model that adjusted for 14 possible covariates with diarrhea (ICU; aOR, 0.70; 95% CI, 0.53-0.93; mechanical ventilation; aOR 0.62; 95% CI, 0.42-0.92). CONCLUSIONS: Diarrhea was associated with better clinical outcomes in COVID-19 patients.

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• Downregulation of chemokine receptor 9 facilitates CD4⁺CD8αα⁺ intraepithelial lymphocyte development

  Ono K., Sujino T., Miyamoto K., Harada Y., Kojo S., Yoshimatsu Y., Tanemoto S., Koda Y., Zheng J., Sayama K., Koide T., Teratani T., Mikami Y., Takabayashi K., Nakamoto N., Hosoe N., London M., Ogata H., Mucida D., Taniuchi I., Kanai T.

  Nature Communications （Nature Communications)  14 （ 1 ）  2023年12月

  　概要を見る

  Intestinal intraepithelial lymphocytes (IELs) reside in the gut epithelial layer, where they help in maintaining intestinal homeostasis. Peripheral CD4+ T cells can develop into CD4+CD8αα+ IELs upon arrival at the gut epithelium via the lamina propria (LP). Although this specific differentiation of T cells is well established, the mechanisms preventing it from occurring in the LP remain unclear. Here, we show that chemokine receptor 9 (CCR9) expression is low in epithelial CD4+CD8αα+ IELs, but CCR9 deficiency results in CD4+CD8αα+ over-differentiation in both the epithelium and the LP. Single-cell RNA sequencing shows an enriched precursor cell cluster for CD4+CD8αα+ IELs in Ccr9 −/− mice. CD4+ T cells isolated from the epithelium of Ccr9 −/− mice also display increased expression of Cbfβ2, and the genomic occupancy modification of Cbfβ2 expression reveals its important function in CD4+CD8αα+ differentiation. These results implicate a link between CCR9 downregulation and Cbfb2 splicing upregulation to enhance CD4+CD8αα+ IEL differentiation.

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• 生体イメージングを利用した腸管内免疫細胞4次元動態解析と腸管内微小環境の統合的理解

  筋野, 智久

  福澤諭吉記念慶應義塾学事振興基金事業報告集 （福澤基金運営委員会)  2021年

• 炎症抑制制御性T細胞の腸管絨毛内における時空間的解析と病態解明

  筋野, 智久

  科学研究費補助金研究成果報告書 2020年

• 炎症抑制能をもつ新規腸管上皮内細胞の遺伝子制御の解明

  筋野, 智久

  科学研究費補助金研究成果報告書 2020年

• 生体イメージングを利用した腸管内細胞4次元動態解析と腸管内微小環境の統合的理解

  筋野, 智久

  福澤諭吉記念慶應義塾学事振興基金事業報告集 （福澤基金運営委員会)  2020年

• 肥満、糖尿病関連遺伝子レプチンと炎症性腸疾患の関連性の検討

  筋野, 智久

  科学研究費補助金研究成果報告書 2018年

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• Epithelium Replacement Contributes to Field Expansion of Squamous Epithelium and Ulcerative Colitis–Associated Neoplasia

  Sugimoto S., Iwao Y., Shimoda M., Takabayashi K., Sato T., Kanai T., Mutaguchi M., Nanki K., Okabayashi K., Kawaida M., Aoki Y., Yoshimatsu Y., Kiyohara H., Kawaguchi T., Mikami Y., Fukuhara K., Sujino T., Hosoe N., Ogata H., Yahagi N.

  Gastroenterology (Gastroenterology)  162 ( 1 ) 334 - 337.e5 2022年01月

  ISSN  00165085

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• CD4CD8aa intestinal epithelial lymphocyte regulate homeostasis

  筋野 智久

  International Congress of Mucosal Immunology, 

  2017年07月

  , 

  ポスター発表

競争的研究費の研究課題 【 表示 ／ 非表示 】

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• 微小環境変化により小腸免疫細胞の1細胞時空間的制御機構破綻がひきおこす疾患の理解

  2023年04月

  -

  2026年03月

  筋野 智久, 基盤研究(B), 補助金,  研究代表者

• 免疫細胞の腸管内における局在、動態を支配する腸管神経シグナルの探索

  2021年07月

  -

  2025年03月

  文部科学省・日本学術振興会, 科学研究費助成事業, 筋野 智久, 挑戦的研究（開拓）, 補助金,  研究代表者

• 生体イメージングによる免疫細胞4次元動態解析を利用した腸管内微小環境の統合的理解

  2020年04月

  -

  2023年03月

  文部科学省・日本学術振興会, 科学研究費助成事業, 筋野 智久, 基盤研究(B), 補助金,  研究代表者

• 炎症抑制制御性Ｔ細胞の腸管絨毛内における時空間的解析と病態解明

  2019年06月

  -

  2021年03月

  文部科学省・日本学術振興会, 科学研究費助成事業, 筋野　智久, 挑戦的研究（萌芽), 補助金,  研究代表者

• 肥満、糖尿病関連遺伝子レプチンと炎症性腸疾患の関連性の検討

  2017年06月

  -

  2019年03月

  文部科学省・日本学術振興会, 科学研究費助成事業, 筋野　智久, 挑戦的研究(萌芽), 補助金,  研究代表者

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• Young investigator award: society of mucosal immunology

  2017年07月

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• 内科学（消化器）講義

  2024年度

• 内科学（消化器）講義

  2023年度