著者
東 直行 狩野 律子
出版者
日本医科大学医学会
雑誌
日本医科大学医学会雑誌 (ISSN:13498975)
巻号頁・発行日
vol.4, no.4, pp.205-209, 2008 (Released:2009-01-15)
参考文献数
5
被引用文献数
2

Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe disease associated with multiorgan failure. The association of DIHS with human herpes virus 6 (HHV-6) has recently been reported. We report on an 89-year-old woman with allopurinol-induced DIHS diagnosed on the basis of symptoms and laboratory examinations. A rash appeared as erythema on the trunk and extremities and edematous erythema on the face. Renal dysfunction, leukocytosis, eosinophilia, and atypical lymphocytes were also present. An elevated titer of antibodies against HHV-6 and HHV-6 DNA in the blood were observed during the course of the disease (1 : 20 to 1 : 1280). Discontinuation of allopurinol administration and systemic corticosteroid treatment led to an improvement, but symptoms worsened when the corticosteroid dosage was tapered. An elevated titer of antibodies against cytomegalovirus was detected during the course of the disease. The patient died of pneumonia, most likely related to cytomegalovirus. This case indicates that, in addition to the reactivation of HHV-6, reactivation of cytomegalovirus may modify clinical disease activity.
著者
東 直行
出版者
日本医科大学医学会
雑誌
日本医科大学医学会雑誌 (ISSN:13498975)
巻号頁・発行日
vol.13, no.1, pp.8-21, 2017-02-15 (Released:2017-03-07)
参考文献数
115
被引用文献数
1

Atopic dermatitis (AD) is the most common chronic and relapsing inflammatory skin disease. Both abnormal barrier function and abnormal immune function are closely involved in the etiology of AD. Patients with AD have been subdivided into abnormal filaggrin, normal filaggrin, high immunoglobulin E, normal IgE groups, and so on. Regarding local cytokine profiles in the skin of patients with AD, the involvement of Th2, Th22, and Th17 cells at the acute stage, and the involvement of Th2, Th22, and Th1 cells at the chronic stage have been suggested. The IL-9 level has been reported to be higher in patients with AD than in healthy individuals, but it has also been reported that there are no differences in IL-9 levels between patients with AD and normal individuals. Thus, the role of IL-9 is unclear. The serum IL-18 level is high and induces Th2 reactions in patients with AD. IL-21 is thought to suppress IgE formation, but its activity in relation to AD remains unknown. IL-22 is involved in hyperplasia, increased antimicrobial peptide formation, and reduced filaggrin in patients with AD. IL-25, IL-33, and thymic stromal lymphopoietin are produced in epidermal cells and activate type 2 innate lymphoid cells or premature dendritic cells, resulting in the induction of Th2 reactions. IL-31 is produced by Th2 cells, causing an itching sensation and scratching behavior. A correlation has been reported between serum IL-32 levels and the severity of dermatitis. IL-34 is an element of the control system that suppresses inflammation, but its activity in cases of AD is unknown. One published report describes a correlation between serum IL-37 levels and the severity of dermatitis, but this relationship has not been sufficiently clarified to date, and requires further analysis. In this review, the author has attempted to summarize reports on cytokine expression in patients with AD. The author expects that important cytokines and cells involved in the pathophysiology of AD will be revealed, contributing to strategies for treating AD.
著者
橋本 知幸 琴 基天 東 直行
出版者
日本衛生動物学会
雑誌
衛生動物 (ISSN:04247086)
巻号頁・発行日
vol.68, no.3, pp.113-117, 2017-09-25 (Released:2017-10-31)
参考文献数
12
被引用文献数
1 1

2015年10月に経口ダニアナフィラキシーと見られる1症例を経験し,その事故品中より,ヒョウヒダニ属の一種Dermatophagoides siboneyを多数認めた.得られた標本の計測では雌の胴体長は平均296±S.D. 35 µm,雄の胴体長は平均256±S.D. 17 µmであり,一般的なコナヒョウヒダニよりも一回り小型であった.雄成虫では第I脚基節条に分離型とV字型が見られたが,その比は47匹:16匹であった.さらに,患者宅の屋内塵中のダニ相を検査した結果,コナヒョウヒダニとヤケヒョウヒダニに混ざって本種を認めた.本種は本邦初報告と考えられる.
著者
東 直行
出版者
日本医科大学医学会
雑誌
日本医科大学医学会雑誌
巻号頁・発行日
vol.13, no.1, pp.8-21, 2017
被引用文献数
1

<p>Atopic dermatitis (AD) is the most common chronic and relapsing inflammatory skin disease. Both abnormal barrier function and abnormal immune function are closely involved in the etiology of AD. Patients with AD have been subdivided into abnormal filaggrin, normal filaggrin, high immunoglobulin E, normal IgE groups, and so on. Regarding local cytokine profiles in the skin of patients with AD, the involvement of Th2, Th22, and Th17 cells at the acute stage, and the involvement of Th2, Th22, and Th1 cells at the chronic stage have been suggested. The IL-9 level has been reported to be higher in patients with AD than in healthy individuals, but it has also been reported that there are no differences in IL-9 levels between patients with AD and normal individuals. Thus, the role of IL-9 is unclear. The serum IL-18 level is high and induces Th2 reactions in patients with AD. IL-21 is thought to suppress IgE formation, but its activity in relation to AD remains unknown. IL-22 is involved in hyperplasia, increased antimicrobial peptide formation, and reduced filaggrin in patients with AD. IL-25, IL-33, and thymic stromal lymphopoietin are produced in epidermal cells and activate type 2 innate lymphoid cells or premature dendritic cells, resulting in the induction of Th2 reactions. IL-31 is produced by Th2 cells, causing an itching sensation and scratching behavior. A correlation has been reported between serum IL-32 levels and the severity of dermatitis. IL-34 is an element of the control system that suppresses inflammation, but its activity in cases of AD is unknown. One published report describes a correlation between serum IL-37 levels and the severity of dermatitis, but this relationship has not been sufficiently clarified to date, and requires further analysis. In this review, the author has attempted to summarize reports on cytokine expression in patients with AD. The author expects that important cytokines and cells involved in the pathophysiology of AD will be revealed, contributing to strategies for treating AD.</p>
著者
川名 誠司 東 直行 山岡 淳一 井村 純 片山 美玲
出版者
日本医科大学
雑誌
基盤研究(C)
巻号頁・発行日
2003

本研究の目的は、皮膚におけるCRH-POMC反応系が毛周期の制御機構に及ぼす影響を解明することにある。前年度(2003)は、心理ストレスがマウス毛周期のtelogen stageを有意に延長させ、そのメカニズムは毛包ケラチノサイト、脂腺細胞に強く発現するCRHの作用を介することを証明した。従来、毛周期の研究にはC57BL/6マウスの背部皮膚を機械的に脱毛し、直後から成長期が同調して開始する性質を利用する。我々の研究もこの性質を応用している。しかしながら、現在、成長期の強制発現がどのようなメカニズムに基づいているか不明である。本研究の遂行にあたって、このメカニズムを明らかにしておくことは必要不可欠のことと考える。特に、CRHの関与については興味深い。そこで、今年度(2004)はCRHノックアウトマウスとwildマウスにおいて、脱毛によって誘導された毛周期毎に皮膚に分布する神経線維ならびに活性化肥満細胞数の経時的変化、神経ペプチド(CRHおよびSubstance P ;SP)、神経成長因子(Nerve growth factor ; NGFおよびGlial cell line-derived neutrophilic factor ; GDNF)の発現についてELISAにて測定し、同時に免疫組織化学染色にてその局在を検討した。その結果、両マウスに共通して、成長期初期(anagen I〜III)に毛包ケラチノサイト、脂腺細胞、平滑筋細胞にNGFが急速かつ多量に発現することが一義的変化であることが明らかになった。その後、POMCの発現、SP陽性神経線維の増加、活性化肥満細胞の増加、毛包におけるTNF-αなどサイトカインの増加が続いた。CRHノックアウトマウスにおいてはCRHの発現はなかったが、α-MSH、ACTHなどPOMCの発現はwild typeと有意の差はなかった。以上の結果は、機械的脱毛によって皮膚に創傷反応をきたした結果NGFが産生され、ケラチノサイトの増殖、神経細胞の可塑化/成長、肥満細胞由来のサイトカインによる毛乳頭細胞の活性化などの反応が進展していったことを示唆した。また、CRHの存在がなくとも別のルート(例えば、NGFなどの作用)でPOMCの発現が誘導され、その後の毛周期が進行、維持されることが推測された。