著者

澁谷 美穂子 藤尾 圭志 山本 一彦

出版者

一般社団法人 日本臨床リウマチ学会

雑誌

臨床リウマチ (ISSN:09148760)

巻号頁・発行日

vol.25, no.4, pp.281-285, 2013-12-30 (Released:2015-06-30)

参考文献数

11

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目的:自己免疫疾患における自己免疫寛容破綻のメカニズムを解析する. 方法:コラーゲン誘発性関節炎を用いて,所属リンパ節で増殖するCD4陽性T細胞を単一細胞レベルで解析した.また,抗原特異性の判明している2種類のT細胞受容体(T cell receptor: TCR)トランスジェニックマウスのCD4陽性T細胞とその特異抗原を用いた実験系(拡張抗原刺激モデル)を構築し,抗原濃度を種々に変化させてT細胞の解析を行った. 結果:Ⅱ型コラーゲン存在下に増殖するクローンを複数認め,分化した表現型を示したクローンのTCRを再構築したが,再構築したTCRをもつT細胞にはⅡ型コラーゲン特異性は認められなかった.しかしⅡ型コラーゲン特異的なT細胞存在下に共培養すると,増殖反応を認めた.拡張抗原刺激モデルを用いた実験では抗原Xが大量に存在しそのXに特異的なT細胞が十分に増殖する条件下で,ごく少量しか存在しない抗原Yに依存してY特異的なT細胞が活性化する現象を観察した.抗原X以外の抗原Yによる刺激に依存性が高い点で,従来のbystander activationとは異なる新しい活性化様式と考えた.3種類のT細胞を共培養する実験系でも,特異抗原の存在しないT細胞はまったく分裂せず,抗原特異的な刺激が重要であることが示された. 結論:免疫反応を惹起した抗原Xとは異なる抗原Yに対する免疫反応が確認され,自己免疫病態において観察されるエピトープスプレディングの基盤現象である可能性が考えられた.

著者

高橋 春樹 中川 隆雄 仁科 雅良 須賀 弘泰 西浦 輝浩 出ロ 善純 小林 尊志 澁谷 美穂子 佐藤 隆幸 西久保 俊士

出版者

一般社団法人 日本温泉気候物理医学会

雑誌

日本温泉気候物理医学会雑誌 (ISSN:00290343)

巻号頁・発行日

vol.72, no.1, pp.50-55, 2008 (Released:2013-03-14)

参考文献数

17

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Content We investigated 76 cases during the 6-year period from 1999 to 2005 in which a patient who developed a consciousness disorder while bathing was brought to the Emergency and Critical Care Center of Tokyo Women's Medical University Medical Center East. In. 86% of the cases the patient was in cardiopulmonary arrest, and they had a group of diseases with a poor prognosis in which the outcome was death, even the 6% of the patients who were resuscitated.The most common age group was the 70-to 79-year group, which contained 46% of the patients, and those 70 years of age and older accounted for 70% of the total.  Examination was possible in 16 cases, and the most common category, in 10 of them, was “drowning/suspicion of transient ischemic attack”. Adequate examinations were not performed on the patients who died in the outpatient department. Moreover, because the autopsy rate was low, it was impossible to make a definitive etiological diagnosis. However, the fact that “many were elderly persons whose autonomic nervous system's regulatory function is reduced” and that “the incidence was highest during the winter (53% during the 3 months from December to February)” suggests involvement of cardiovascular and cerebrovascular diseases secondary to changes in blood pressure. Many preventive measures have been described in the literature, and improvement in the resuscitation rate is expected as a result of becoming familiar with. and thoroughly implementing them. All 10 cases that occurred in public baths, where the time before discovery should have been short, were cases of cardiopulmonary arrest, and it is impossible to clearly explain why resuseitation attempts failed in all 10 of them. In order to identify the causative diseases we think it would be worthwhile to consider 1) performing a whole-body CT examination after confirming death, and 2) perforrning open-chest cardiac massage (only in patients brought to the hospital within a short time).